| Objective:To detect the expression level of Th17 cytokines IL-17,IL-21and Treg cytokine IL-35 and IL-10 in peripheral blood of patients with chronic hepatitis B（CHB）.To understand the changes in the expression of Th17/Treg-type cytokines in the peripheral blood of CHB patients during antiviral therapy.To analyze the correlation between ALT,AST,HBV DNA and IL-17,IL-21,IL-35,IL-10.To understand the relations between the levels of Th17/Treg-type cytokines.To investigate the effect of the degree of CHB patients on the level of Th17/Treg type cytokine.Methods:123 patients with CHB who received Entecavir Dispersible Tablets（referred to as Entecavir,ETV）for the first time were followed up.79cases were followed up for 24 weeks or more,among which 49 CHB patients who were followed up for 48 weeks were selected as the treatment group,while 23 healthy people as the control group.CHB patients’peripheral venous blood samples were taken before treatment and at the 4th,12th,24thh and 48thh week after treatment to detect the expression of Th17/Treg type cytokines in each observation point by using suspension chip technology.The HBV DNA load was detected by real-time fluorescence quantitative PCR.The markers of hepatitis B virus infection were detected by chemiluminescence,and liver function indexes were detected by automatic biochemical analyzer.The level of Th17/Treg type cytokines in peripheral blood of 23 healthy examiners was tested the same way as that of CHB patients.Results:1.After four weeks of treatment,the levels of ALT,AST and load of HBV DNA decreased significantly in the treatment group,and the difference was statistically significant（P<0.05）.The values of ALT and AST in the treatment group were lower than those of the reference value（40U/L）after 12weeks of treatment,and there was a statistical difference（P<0.05）.After 24weeks of treatment,the HBV DNA load of the treatment group was lower than the reference value（500IU/mL）,and the difference was statistically significant compared with those before treatment（P<0.05）.After 48 weeks of treatment,the levels of ALT,AST and the load of HBV DNA in the treatment group decreased significantly compared with those before treatment,and the difference between the two groups was statistically significant（P<0.05）.2.Before treatment,the expression level of peripheral blood IL-17,IL-35 and IL-21 in the treatment group patients increased significantly,there was statistically significant difference compared with those of the control group（P<0.05）;IL-17,IL-35 and IL-21 were significantly decreased after treatment from four to forty-eight weeks,the difference has statistical significance compared with those before treatment（P<0.05）.The expression level of IL-10 in the peripheral blood of the treatment group was significantly lower than that of the control group before treatment（P<0.05）.After treatment from four to forty-eight weeks the expression level of IL-10increased significantly,and the difference was statistically significant（P<0.05）.3.Before treatment,there was a positive correlation between the expression level of ALT and AST in the treatment group（r=0.890,P=0.000）,and there was no correlation between the expression level of ALT and AST and HBV DNA load（r=0.221,P=0.128,r=0.193,and P=0.185）.After treatment for 48 weeks,there was a positive correlation between the expression of ALT and AST in the peripheral blood of the treatment group（r=0.594,P=0.000）,and there was no correlation between the expression level of ALT and AST and HBV DNA load（r=-0.142,P=0.331,r=-0.068,and P=0.641）.4.Before treatment,there was a positive correlation between ALT and IL-35 expression（r=0.248,P=0.025）;there was no correlation between the expression level of ALT and IL-17,IL-21 and IL-10（r=-0.11,P=0.940;r=-0.147,P=0.315;r=0.245,P=0.09;AST）.Before treatment,there was no correlation between AST and IL-17,IL-21,IL-35,IL-10 level（r=0.193,P=0.185;r=-0.168,P=0.247;r=0.074,P=0.612;r=0.074,P=0.612）.After 48weeks of treatment,there was no correlation between AST,ALT and IL-17,IL-21,IL-35 and IL-10 expression.There was no correlation between HBV DNA load and IL-17,IL-21,IL-35 and IL-21 expression levels before and after 48 weeks treatment.5.Before treatment,there was a positive correlation between the expression level of IL17 and IL-21 and IL-35 in the treatment group（r=0.989,P=0.000,r=0.823,P=0.000）.There was a negative correlation between IL-35 and IL-10 expression level（r=-0.865,P=0.000）,and there was no correlation between other cytokines.After treatment for 48 weeks,there was a positive correlation between the expression level of IL-35 and IL-17、IL-21（r=0.945,P=0.000,r=0.906,P=0.000）.There was a negative correlation between IL-21 and IL-10 expression level（r=-0.947,P=0.000）,and there was no correlation between other cytokines.6.In the treatment group,the levels of IL-17,IL-21 and IL-35 in the peripheral blood of patients in the moderate and severe group were higher than those in the mild group before and after the treatment（P<0.05）.In the treatment group,the expression level of IL-10 in the peripheral blood of patients in the moderate and severe group was lower than that in the mild group before and after the treatment（P<0.05）.Conclusions:1.Antiviral therapy can inhibit the replication of HBV DNA effectively,regulate the level of cytokine,reduce the inflammation of liver tissue,and promote the liver function recovery.2.The levels of Th17/Treg cytokines IL-17,IL-21 and IL-35 were highly expressed in patients with CHB,and IL-10 levels were low,Their expression level recover as ther pathogenetic condition better.3.There was no significant correlation between the levels of ALT,AST,HBV DNA and Th17/Treg type cytokines.There was a positive correlation between IL-17 and IL-21 proinflammatory factors,and there was a disorder relationship between proinflammatory and anti inflammatory factors.4.IL-17,IL-21 and IL-35 in peripheral blood of patients with CHB were highly expressed as the severity of the disease increased,while IL-10decreased with the aggravation of the disease. |
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