自身免疫性肝炎患者肝组织IL-35表达和外周血髓样抑制细胞百分比变化临床意义探讨*

doi:10.3969/j.issn.1672-5069.2022.02.012

摘要/Abstract

摘要： 目的观察自身免疫性肝炎(AIH)患者肝组织白介素-35(IL-35)表达和外周血髓样抑制细胞(MDSCs)百分比变化的临床意义。方法 2017年5月～2020年2月我院收治的35例AIH患者,给予泼尼松或波尼松联合硫唑嘌呤治疗。行肝穿活组织检查,根据界面破坏范围和细胞浸润深度将患者分为轻度、中度和重度组。采用Western blot法检测肝组织p35和Ebi3表达,使用流式细胞仪测定外周血MDSCs百分比。结果 6例重度组肝组织p35和Ebi3表达及MDSCs百分比分别为(0.9±0.1)、(0.9±0.1)和(1.5±0.3)%,显著高于18例轻度组【分别为(0.5±0.1)、(0.6±0.1)和(0.9±0.2)%,P<0.05】或11例中度组【分别为(0.6±0.1)、(0.7±0.1)和(1.2±0.2)%,P<0.05】;16例肝纤维化S3～S4期患者肝组织p35和Ebi3表达及外周血MDSCs百分比分别为(0.7±0.2)、(0.8±0.1)和(1.3±0.2)%,显著大于19例S1～S2期者【分别为(0.5±0.1)、(0.6±0.1)和(0.9±0.2)%,P<0.05】,17例炎症G3～G4级患者肝组织p35和Ebi3表达及外周血MDSCs百分比分别为(0.7±0.1)、(0.8±0.2)和(1.2±0.2)%,显著大于18例G1～G2级【分别为(0.5±0.1)、(0.6±0.1)和(1.0±0.1)%,P<0.05】;19例治疗＜3个月应答组肝组织p35和Ebi3表达及MDSCs分别为(0.4±0.1)、(0.5±0.1)和(1.0±0.2)%,其中肝组织p35和Ebi3表达显著低于10例治疗3～6个月应答组【分别为(0.7±0.1)和(0.8±0.2),P<0.05】或6例治疗＞6个月应答组【分别为(1.1±0.1)、(1.1±0.2)和(1.4±0.2)%,P<0.05】。结论 AIH患者肝组织IL-35表达和外周血MDSCs百分比与肝组织肝纤维化分期、炎症活动度和治疗应答相关,值得进一步研究。

关键词: 自身免疫性肝炎, 白介素-35, 髓样抑制细胞, 治疗应答

Abstract: Objective The aim of this study was to explore the clinical implications of hepatic interleukin-35 (IL-35) and the peripheral blood myeloid-derived suppressor cell (MDSCs) count changes in patients with autoimmune hepatitis (AIH). Methods 35 patients with AIH were enrolled in our hospital between May 2017 and February 2020, and all patients underwent liver biopises. The p35 and the Epstein-Barr virus-induced gene 3 (Ebi3) expressions in liver tissues were detected by Western blot. The percentages of peripheral blood MDSCs were detected by LX flow cytometry. According to interface inflammation and cell infiltration depth, the liver damage were divided into mild, moderate and severe degree. Results The hepatic expression of p35 and Ebi3, and the percentage of MDSCs in 6 patients with severe liver injury were(0.9±0.1),(0.9±0.1) and (1.5±0.3)%, significantly higher than [(0.5±0.1),(0.6±0.1) and (0.9±0.2)%, respectively, P<0.05] in 18 patients with mild or [(0.6±0.1), (0.7±0.1) and (1.2±0.2)%, respectively, P<0.05] in 11 patients with moderate liver injury; the hepatic expression of p35 and Ebi3, and the percentage of MDSCs in 16 patients with liver fibrosis S3-S4 were (0.7±0.2), (0.8±0.1) and (1.3±0.2)%, significantly higher than [(0.5±0.1),(0.6±0.1) and (0.9±0.2)%, respectively, P<0.05] in 19 patients with S1～S2, and those in 17 patients with G3-G4 were (0.7±0.1), (0.8±0.2) and (1.2±0.2)%, significantly higher than [(0.5±0.1), (0.6±0.1) and (1.0±0.1)%, respectively, P<0.05]in 18 patients with G1-G2; the hepatic expression of p35 and Ebi3, and the percentage of MDSCs in 19 patients who responded to immunosuppressive agent therapy less than 3 month were (0.4±0.1), (0.5±0.1) and (1.0±0.2)%, the former two were significantly weaker than [(0.7±0.1) and (0.8±0.2), P<0.05] in 10 patients who responded to therapy 3 to 6 months or [(1.1±0.1),(1.1±0.2) and (1.4±0.2)%, respectively, P<0.05] in 6 patients who responded to therapy longer than 6 month. Conclusion The hepatic IL-35 expression and the peripheral blood MDSCs counts are related to liver injuries in patients with AIH, which needs further investigation.

Key words: Autoimmune hepatitis, Interleukin-35, Myeloid-derived suppressor cell, Response to immunosuppressive agent therapy

马国斌, 赵晓宏, 赵鹏, 杨冰. 自身免疫性肝炎患者肝组织IL-35表达和外周血髓样抑制细胞百分比变化临床意义探讨^*[J]. 实用肝脏病杂志, 2022, 25(2): 199-202.

Ma Guobin, Zhao Xiaohong, Zhao Peng, et al. Hepatic IL-35 expression and peripheral blood myeloid-derived suppressor cell counts in patients with autoimmune hepatitis[J]. Journal of Practical Hepatology, 2022, 25(2): 199-202.

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自身免疫性肝炎患者肝组织IL-35表达和外周血髓样抑制细胞百分比变化临床意义探讨^*

Hepatic IL-35 expression and peripheral blood myeloid-derived suppressor cell counts in patients with autoimmune hepatitis

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