The Expression Of IL-35 In Patients With Acute-on-chronic Liver Failure Caused By HBV And The Relationship With FOXP3

The first section: The expression of IL-35 in patients with acute-on-chronic liver failure and its clinical significancesBackground:Sub- acute-on-chronic liver failure(SACLF) which mostly caused by HBV in China has a high case fatality and a complicate pathogenesy.Hadro- immune response was generally accepted as an important factor for SACLF.Treg cells can regulate innate immunity and adaptive immunity down. Internal study has found IL-35, a new suppressor cytokine secreted by Treg cells, can restrain the excessus immune reactioncaused by lymphocyte. Researches have been shew that the expression of IL-35 is ascensus during chronic liver hepatitis B,but there's little research about the expression of IL-35 in Acute-on-chronic liver failure patients.Objective: To Investigate the espression , dynamic change and clinical significance of IL-35 in SACLF patients during different periods.Methods: Detected the serum expression of IL-35 in 28 HBV-SACLF patients ,16 CHB patients and 16 health adults by fluorescence-activated cell sorter; observed dynamic changes of IL-35 during the nonage, metaphase and advanced stage of SACLF;compared the differences of IL-35 expression in SACLF patients serum not only between survival group and unsurvival group but also between the secondary infection group and the non- secondary infection group.;analyse the relationship between IL-35 and HBV-DNA,ALT ,AST by mutiple linear regression.Results: The expression of IL-35 in HBV-SACLF patients serum is 1087.00±436.26pg/ml ,which is higher than CHB patients and health adults (F=10.87, P<0.001).There are significant differences among the three groups .The expression of IL-35 in the nonage, metaphase and advanced stage of SACLF patients are 1539.00±285.72,1082.94±333.90,636.80±169.00 pg/ml,There are also significant differences among the three periods(F=3.81,P=0.018).The differences of IL-35 in SACLF patients between the secondary infection group and the non- secondary infection group are significant(t'= 2.77 ,P=0.01) , not like that between the survival group and the unsurvival group(t'=0.46,P=0.6504).Only in the nonage of SACLF are there sociativity among IL-35 ,HBV-DNA and ALT(P=0.011vs0.015).Conclusion: The expression of IL-35 obviously steped up in SACLF patients serum especially during the nonage. The expression of IL-35 may keep on steping up when the secondary infection takes place.The ascensus of IL-35 can partly reflect patient's immune level and the degree of hepatocellular injury. The second section: The expression of IL-35 mRNA on peripheral blood mononuclear cell in patients with sub-acute-on-chronic liver failure and the relationship with FOXP3Background: Treg cells play a key role in SACLF. FOXP3 expressed mainly on Treg cells ,which is also its best marker ,is important for Treg cells'function . IL-35 is a new suppressor cytokine secreted by Treg cells,which is formed by Ebi3 and IL12p35. Ebi3 is a downstream target of Foxp3,but there is little study about the relationship between IL-35and FOXP3. Objective:To investigate the expression of IL-35 mRNA on peripheral blood mononuclear cell in patients with acute-on-chronic liver failure and the relationship with FOXP3.Methods: Detected IL-35mRNA and FOXP3 on peripheral blood mononuclear cell in patients with 24 acute-on-chronic liver failure patients,12 CHB patients and 12 health adults by real time fluorescent quantitation polymerase chain reaction(RT-PCR), observed dynamic changes of IFN-γduring the nonage, metaphase and advanced stage of SACLF, analyze the associativity of IL-35mRNA and FOXP3 mRNA.Results: The level of IL-35 on peripheral blood mononuclear cell in patients with 24 acute-on-chronic liver failure patients is higher than that in CHB patients and health adults ,which has significant differences. There is positive correlation between Ebi3mRNA and IL-35 mRNA expressed on peripheral blood mononuclear cell of SACLF patients with a correlation coefficient r=0.747, which has a statistical significance.Conclusion: The level of Ebi3, IL-12p35 and FOXP3 on peripheral blood mononuclear cell in SACLF patients ascensused obviously. There is positive correlation between IL-35 and FOXP3,which means that the ascensus of IL-35 maybe one of the mechanisms for Treg cells to suppress the immunity by FOXP3.