| Objective To investigate the expression level of intraheptic IL-17R+ cells and IL-17 in the peripheral blood of patients with chronic hepatitis B; and its association with Transforming growth factor beta-1? liver fibrosis stage and Liver stiffness measurement( instantaneous scan), then studying the immune function of helper T lymphocyte-17 with patients with chronic hepatitis B in the development of liver fibrosis preliminarily.Methods(1) From January 2012 to January 2015, 142 patients with chronic hepatitis B, aged from 15-78( 39.2±13.9 at average),were chosed for this study,including outpatient and inpatient that treated in Ningxia Medical University General Hospital Infection Diseases Department.All patients were confirmed by the guidelines that was revised in 2010 for management of chronic hepatitis B. 30 cases of normal control group were healthy people from physical examination center.(2) Differential expression of serum IL-17 and TGF-?1 were detected by enzyme-linked immunoassay( ELISA)in 30 controls and 142 patients with chronic hepatitise B; 55 cases were dealt with liver biopsy. Expression of intraheptic IL-17R+ cells( Th17) were detected by immunohistochemical staining, and positive rate of IL-17R+ cells was evaluated by pathologist; normal pathological staining of liver tissue were used to determine the extent of liver fibrosis( S); The liver stiffen measurement were recorded by Fibroscan.(3) Using SPSS17.0 to analyse the general information, serum IL-17 and TGF-?1, intraheptic IL-17R+ cells( Th17)and liver fibrosis stage, and the correlation analyses between all the above parameters were conducted.Results 1. SerumIL-17 of each liver fibrosis stage was significantiy difference(F=5.240,P<0.05). Serum IL-17 of stage S2 and S4 were higher than that at stage S0, the differences were statistically significant( P <0.05)in patients with CHB,but compared stage S0 with S1 and S3, there were no significantiy difference.Compared with stage S1,there were no significantiy difference at stage S4? S3? S2 too. and so were stage S2 with S3? S4. The expression of intraheptic helper T lymphocyte-17 of each liver fibrosis stage was significantiy difference( F=5.852,P<0.05).Intraheptic helper T lymphocyte-17 of stage S4 is higher than that at stage S0 ? S1 ? S2, the differences were statistically significant( P <0.05) in patients with CHB, but compared with stage S3, there was no significantiy difference. Compared with stage S3,there were no significantiy difference at stage S0?S1?S2 too. And so were stage S2 with S1? S0, stage S1 with S0. 2.The peripheral blood of IL-17 was positively correlated with intraheptic helper T lymphocyte-17(r=0.708,P<0.05). Serum TGF-?1 was positively correlated with serum IL-17 in CHB(r=0.302,P<0.05).And there was no siginificant correlation with intraheptic helper T lymphocyte-17(r=?0.115,P>0.05). Serum IL-17 was positively correlated with liver stiffness measurement in CHB(r=0.309,P<0.05),and so was intraheptic helper T lymphocyte-17(r=0.355,P<0.05). Serum IL-17 was positively correlated with hepatic fibrosis stage in CHB(r=0.56, P<0.05),and so was intraheptic helper T lymphocyte-17(r=0.52,P<0.05). 3. The ROC curve analysis showed that the areas of serum IL-17 and intraheptic helper T lymphocyte-17 under the curve were 0.795? 0.784 respectively. The sensitivity of IL-17 and IL-17R+cells were 0.737 ? 0.579 respectively, and specificity were 0.778? 0.852 respectively. 4.(1) The IL-17R+ cell of patients, including mild? moderate and severe chronic hepatitis B,was significantiy difference( F=12.397,P<0.05). The IL-17R+ cell of severe chronic hepatitis B was significantly higher than that in mild chronic hepatitis B, but was significantly lower than that in moderate chronic hepatitis B( P<0.05).The IL-17R+ cell of moderate chronic hepatitis B was significantly higher than that in mild chronic hepatitis B( P<0.05).(2) Serum IL-17 of patients, including mild? moderate ? severe chronic hepatitis B and hepatitic cirrhosis, was significantiy difference(F=27.913,P<0.05). Serum IL-17 of hepatitic cirrhosis ? severe and moderate chronic hepatitis B was significantly higher than that in mild chronic hepatitis B( P<0.05). Serum IL-17 of hepatitic cirrhosis and severe chronic hepatitis B was significantly higher than that in moderate chronic hepatitis B( P<0.05), but there were no significantiy difference in hepatitic cirrhosis and severe chronic hepatitis B(P>0.05).(3) Seurm TGF-?1 of patients, including healthy controls ? mild ?moderate ? severe chronic hepatitis B and hepatitic cirrhosis,was significantiy difference(F=18.846,P<0.05). Serum TGF-?1 of hepatitic cirrhosis and chronic hepatitis B was significantly higher than that in healthy controls(P<0.05). Serum TGF-?1 of hepatitic cirrhosis and severe chronic hepatitise were significantly higher than that in mild chronic hepatitis B( P<0.05),but there was no difference in moderate and mild chronic hepatitis B( P>0.05). Serum TGF-?1 of hepatitic cirrhosis and severe chronic hepatitise were significantly higher than that in moderate chronic hepatitis B( P<0.05),but there was no difference in hepatitic cirrhosis and severe chronic hepatitis B( P>0.05).Conclusion 1.Helper T lymphocyte-17 and intertleukin-17 plays an important in the process of the pathogesis of liver fibrosis in chronic hepatitis B. 2.Serum IL-17 on hepatic fibrosis has high specificity and sensitivity, and can be used to help diagnosising hepatic fibrosis. |
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