| Objective:To analyze the changes of peripheral Thl7/Treg cells and the expressions of RORytmRNA and Foxp3mRNA, in combination with liver function index such as ALT, AST, TBIL, the status of HBeAg and the level of HBV replication, to explore the clinical significance in patients with HBV-related liver cirrhosis(LC). to help provide a new idea of the judgment in the progression and prognosis of HBV-related liver cirrhosis. and to further explore the immunological mechanism in the progression of disease.Methods:Sixty-four patients with HBV-related liver cirrhosis and chronic hepatitis B were involved in this study, who came from inpatient or outpatient in infectious diseases department of our hospital from June 2015 to December 2015. Among them,21 patients were chronic hepatitis B(CHB),21 patients were HBV-related compensated liver cirrhosis(CLC),22 patients were HBV-related decompensated liver cirrhosis(DCLC), meanwhile,20 were normal physical examination people in our hospital as health control(HC). The frequency of Th17 cells and Treg cells in the peripheral blood of the patients group and control group were detected by flow cytometry; Real-time fluorescent quantitative reverse transcriptase polymerase chain reaction (RT-PCR) was used to measure levels of RORγtmRNA and Foxp3mRNA in the peripheral blood; The HBV-markers (including HBsAg, HBsAb, HBeAg, HBeAb, HBcAb) were determined by ELISA; The HBV-DNA were tested by real-time fluorescent quantitative PCR analyzer; The ALT, AST, TBil and other liver function indicators were detected by the automatic biochemical analyzer. All of these data were analyzed by the SPSS17.0 statistical software.Results:1. Compared with HC, The frequencies of Th17 cells and the level of RORytmRNA were obviously increased in patients with CHB, CLC and DCLC (p<0.05). Especially, compared with CLC and CHB groups, the frequencies of Th17 cells and the level of RORytmRNA in DCLC group were significantly higher (p<0.05). However, there was no statistically significant difference in CLC and CHB groups (p>0.05).2. Compared with HC, The frequencies of Treg cells and the level of Foxp3mRNA were obviously increased in patients with CHB, CLC and DCLC (p<0.05). Especially, compared with CHB groups, the frequencies of Treg cells in DCLC group were significantly higher (p<0.05). However, there were no statistically significant difference in CLC and CHB groups, DCLC and CLC groups (p>0.05). compared with CLC and CHB groups, the frequencies of Thl7 cells and the level of Foxp3mRNA in DCLC group were significantly higher (p<0.05). However, there was no statistically significant difference in CLC and CHB groups (p>0.05).3. Compared with HC, The ratio of Thl7/Treg were obviously increased in patients with CHB, CLC and DCLC (p<0.05). Especially, compared with CLC and CHB groups, the ratio of Thl7/Treg in DCLC group were significantly higher (p<0.05). However, there was no statistically significant difference in CLC and CHB groups (p>0.05). The frequencies of Th17 cells and Treg cells, the ratio of Th17/Treg between HBeAg (+) group and HBeAg (-) group had no statistically significant difference (p>0.05).4. The correlation analysis demonstrated that there were positive correlation between the level of Th17 cells and RORytmRNA, Th17 cells and ATL in patients with CHB, CLC and DCLC groups (p<0.05). However, there were no significant correlation between the frequencies of Th17 cells with the level of AST, TBIL and HBV-DNA (p>0.05). There were positive correlation between the level of Treg cells and Foxp3mRNA in patients with CHB, CLC and DCLC groups (p<0.05). However, there were no significant correlation between the frequencies of Treg cells with the level of ALT, AST, TBIL and HBV-DNA (p>0.05). There were positive correlation between the level of RORytmRNA and ALT in patients with CHB, CLC and DCLC groups (p<0.05). There were positive correlation between the level of RORytmRNA with AST and TBIL, Foxp3mRNA with ALT, AST and TBIL in patients with CHB (p<0.05). There were positive correlation between the level of Th17 cells and Treg cells in patients with CHB, CLC and DCLC groups (p<0.05).5. The correlation analysis demonstrated that there was positive correlation between the ratio of Th17/Treg and RORγtmRNA/Foxp3mRNA in patients with CLC (p<0.05). However, there were no significant correlationt between the ratio of Th17/Treg with the level of ALT, AST, TBIL and HBV-DNA in patients with CLC (p>0.05). There were no significant correlationt between the ratio of Th17/Treg with the level of ALT, AST, TBIL, HBV-DNA and the ratio of RORγtmRNA/Foxp3mRNA in patients with CHB and DCLC (p>0.05). and there were no significant correlationt between the ratio of Th17/Treg with the level of ALT, AST, TBIL, HBV-DNA and the ratio of RORγtmRNA/Foxp3mRNA in the group of HBeAg (+) and HBeAg (-) (p>0.05).Conclusion:Compared with HC, The frequencies of Th17 and Treg, the level of RORγtmRNAand Foxp3mRNA were obviously increased in patients with CHB, CLC and DCLC. meanwhie, there were positive correlationt between the level of Th17 cells and ALT, RORγtmRNA and ALT. When the frequencies of Th17 cells increased more than Treg cells, the balance of Th17/Treg was broken, liver tissue was give priority to the proinflammatory Th17 cells, which lead to aggravate liver damage, at the same time, resulting to the Treg cells increased feedbackly to suppress excessively strong inflammatory response. which make for preventing rapid development condition. But higher frequencies of Th17 cells and ratio of Thl7/Treg may suggested disease was rapidly progression and poor prognosis. This show that the Th17 cells and Treg cells and their specific transcription factors RORyt and Foxp3 might take an important role in the progression of disease. |
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