Abstract: ObjectiveTo investigate the changes of HLA-DR mRNA,and Th17 and CD4⁺CD25⁺Treg cells in peripheral blood mononuclear cells（PBMCs） in patients with liver failure. Methods HLA-DR mRNA was detected by PCR,and Th17 and CD4⁺CD25⁺Treg cells were measured by flow cytometry in 50 patients with liver failure,including 15 arisen from hepatitis B,12 from drug-induced liver injury（DILI）,13 from alcoholic liver diseases,and 10 from autoimmune liver diseases,and in 17 patients with chronic hepatitis B and 10 healthy persons. Results The HLA-DR mRNA levels in PBMCs in patients with hepatitis B-induced liver failure was（134.5±15.2）,much higher than （17.9±1.2）in DILI-,（19.6±2.0）in alcoholic and[（11.2±1.2）,P<0.05] in autoimmune liver disease-induced liver failure;the percentages of Th17 cells and CD4⁺CD25⁺Treg cells [（4.4±0.6）% and（3.9±0.6）% or less,respectively] in patients with different etiologic liver failures were not significantly different（P>0.05）,while there were a significant difference as compared to（3.7±0.2）% and（6.1±0.4）% in patients with chronic hepatitis B or（2.1±0.7）% and（7.0±0.9）% in normal control （P<0.05）;the percentages of CD4⁺CD25⁺Treg cells in 19 died patients decreased gradually,while it increased gradually in 31 survived patients. Conclusion The HLA-DR mRNA levels and CD4⁺CD25⁺Treg cells are closely related to the illness severity of patients with liver failure,and they may be used as parameters to estimate the clinical prognosis.

Key words: Liver failure, HLA-DR, Th17 cells, CD4+CD25+Treg cells