Changes Of Th17/Treg Balance In CHB Patient And Relationship With HBV Replication Level

Objective:Investigate the affection of Thl7/Treg balance in development and prognosis of chronic hepatitis B (CHB) through detecting the Treg cells, Th17cells, cytokines and HBV-DNA load of peripheral blood in the patients with CHB,to provide the theoretical basis for the study on immunological mechanism of HBV infection.Methods:This study selected HBV infected105patients who came to or hospitalization in our hospital and Kunming Infectious Disease Hospital from January2012to June2013. Among them,40cases were mild to moderate chronic hepatitis B patients,35cases were severe hepatitis B patients and30cases were cirrhosis patients. Select20cases who were normal physical examination people in our hospital from the same time period as control group at the same time. The frequency of Thl7cells and Treg cells in the peripheral blood of the patients group and control group were detected by flow cytometry. The levels of IL-17. IL-21, IL-10and TGF-β1in the peripheral blood of the patients group and control group were determined by ELISA kit. The ALT, AST, TBil and other indicators were analyzed by the automatic biochemical analyzer. The HBV-DNA levels of the patients group were tested by real-time fluorescent quantitative PCR analyzer. All of the date was statistic analyzed by the SPSS13.0statistical software.Results:1. The level of IL-17and IL-21in peripheral blood from the severe hepatitis B patients was the most, then was the mild to moderate group. There was no difference in the level of IL-17and IL-21between cirrhosis group and mild to moderate group. The level of IL-17and IL-21of the three CHB patient group were higher than those in the control group. IL-17and IL-21, the two kinds of cytokines secreted by Thl7cells, had a positive correlation, and increased with the severity of the disease. It suggests indirectly that the ratio of Th17cells in patients with chronic hepatitis B increased with the severity of the disease.2. The level of IL-10and TGF-βi in peripheral blood of the patients: severe group> mild to moderate group> control group, but the cirrhosis group and severe hepatitis group had no difference in the level of IL-10and TGF-β1. The levels of IL-10and TGF-β1had the same trend with the frequency of Treg cells, and the ratio of Treg cells in patients with chronic hepatitis B increased with the severity of the disease.3. The ratio of IL-17/IL-10and IL-17/TGF-β1in peripheral blood of CHB decreased with the increase of the damage. However, the ratio of1L-17/IL-10and IL-17/TGF-β1in cirrhosis group was higher than that in severe group and mild to moderate group, lower than that in the healthy control group. It shows that the ratio of Treg/Th17is closely related to the occurrence and development of the chronic hepatitis B.4. The HBV-DNA load of mild to moderate group and severe group was higher than that in liver cirrhosis group, and there was great individual differences among the cases in the same group.5. The HBV-DNA load of CHB patients was correlated with the level of IL-10and IL-17. However, it was not correlated with the ratio of IL-10/IL-17.Conclusion:The Thl7/Treg balance were broken in patients with CHB. Thl7cells were in a relatively active state, but Treg cells were in a inhibitory state. The ratio of Th17/Tregcan reflect the severity of disease in a certain extent. Doctors could determine the activity and infectious of HBV in patients by detecting the HBV-DNA load. Clinicians can grasp the patient’s condition changes, carry out a reasonable treatment plan when combined the changes of Th17/Treg balance and the level of HBV replication. A theoretical basis of immunological mechanism to HBV infection can be provided by study the changes of Th17/Treg equilibrium and the related cytokines.