Association Of HBcAg-specific Interferon-gamma Derived From Peripheral Blood Mononuclear Cells With TCM Syndrome Types In HBeAg-positive Chronic Hepatitis B Patients

Objective: To explore the association of HBcAg-specific interferon-gamma (IFNy) derived from peripheral blood mononuclear cells with traditional Chinese medicine (TCM) syndrome types in HBeAg-positive chronic hepatitis B (CHB) patients. Methods: A total of307treatment-naive patients were enrolled in this study. Patients were, respectively, zheng differentiation-classified according to principles of syndrome differentiation in TCM as eligible TCM syndrome types of retained dampness-heat (n=66), liver depression and qi stagnation (n=27), liver depression and spleen deficiency (n=149), liver-kidney yin deficiency (n=24), spleen-kidney yang deficiency (n=19), or blood-stasis obstruction (n=22). IFNy produced by the peripheral blood mononuclear cells in response to HBcAg was examined by enzyme-linked immunospot assay technique. Results and Conclusions: HBcAg-specific IFNy productions in types of spleen-kidney yang deficiency, blood-stasis obstruction, liver-kidney yin deficiency, liver depression and qi stagnation, liver depression and spleen deficiency and retained dampness-heat were238.7(70.1-1804.2),543.5(292.1-912.1),660.6(304.7-1215.0),1587.0(1440.1-1761.2),2612.6(1582.8-4620.5) and5158.6(1845.1-9829.5) pg/mL respectively. The differences of HBcAg-specific IFNy between syndrome types of TCM were statistically significant(X2=98.769, P<0.001), and significantly higher titres of HBcAg-specific IFNy were produced from dampness-heat group than that from others. A rank correlation (r=0.545, P<0.001) between TCM syndrome types and HBcAg-specific IFNy was found, which was stronger than that between TCM syndrome types and hepatic necroinflammation grading (r=0.119,P=0.037), levels of alanine aminotransferase (ALT)(r=0.406, P<0.001) and aspartate transaminase (AST)(r=0.336, P <0.001), respectively. Furthermore, correlation extents between HBcAg-specific IFNy level and respective levels of ALT, AST, HBV DNA and HBsAg varies according to the various TCM syndrome types. The results of this study indicated that TCM syndrome types of CHB patients would imply differential immune activity states, and for which HBcAg-specific IFNy level may be a more sensitive indicator.