Clinical Study On The Effect Of Ruangan Yin On INKT Cells And Its Surface PD-1/PD-L1 Signaling Pathway In CHB Patients With HBeAg(+)

Objective: The immune status of the human body after infection with hepatitis B virus(HBV)can predict its clinical outcome.The natural immune system is the body’s first-line defense mechanism against viral infections.NKT cells play a major role in the natural immune system.NKT cells are dominated by iNKT cells.INKT cells not only participate in the natural immune response and can further regulate the natural immune response and adaptation Sexual immune response.iNKT cells and their surface PD1 / PD-L1 signaling pathways are closely related to the pathogenesis of CHB.Observe the correlation between iNKT cells and their surface PD1 / PD-L1 signaling pathway and HBV DNA,aspartate aminotransferase(AST),alanine aminotransferase(ALT)and other indicators,and study and explore the traditional Chinese medicine Ruan Gan Yin Effect on the clinical immune mechanism of CHB patients.Methods: This is a randomized study.Forty cases of CHB patients with qi deficiency and blood stasis were selected from December 2018 to December 2019 and were admitted to the hospital and the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine.There were 24 males and 16 females.The patients were randomly divided into two groups.The control group received oral antiviral therapy.The treatment group was treated with Ruan Gan Yin.Before and after treatmentand 24 weeks after treatment,venous blood was collected from two groups of patients,and their HBs Ag,HBe Ag,HBV DNA,ALT,AST,TBIL,iNKT cell number,PD1 and PD-L1 expression levels were measured.All patients voluntarily signed informed consent to participate in this experimental study.Results: 1.After 24 weeks of treatment,the symptom scores of the two groups of patients in clinical symptoms and signs decreased compared with the previous,the difference was statistically significant(P < 0.01),and the treatment group was better than the control group(P < 0.05);2.After 24 weeks of treatment,the efficacy of TCM syndromes in both groups was effectively improved.The total effective rate in the treatment group was 80%,which was significantly higher than the total effective rate in the control group by 45%,and the difference was statistically significant(P < 0.05);3.After 24 weeks of treatment,liver function indicators ALT,AST,and TBIL in the two groups were improved compared with those before treatment.There was a statistically significant difference within the group(P < 0.01);The differences were statistically significant(P < 0.05).There was no significant difference in TBIL comparison(P > 0.05);4.After 24 weeks of treatment,the HBe Ag negative rate was 45% in the treatment group,which was higher than that of the control group(25%),but the difference was not statistically significant(P > 0.05).The HBe Ag seroconversion rate was 35% in the treatment group,which was higher than that of the control(5%),the difference was statistically significant(P < 0.05);the HBV DNA negative rate was 65% in the treatment group,which was higher than that of the control group(30%)the difference was statistically significant(P < 0.05);5.After 24 weeks of treatment,the total efficiency of antiviral response in the treatment group was 80%,which was higher than that in the control group(55%),and the difference was statistically significant(P< 0.05);6.After 24 weeks of treatment,the number of iNKT cells in the peripheral blood of the two groups of patients had no significant change before and after treatment,and the difference was not statistically significant(P > 0.05);7.After 24 weeks of treatment,the expression levels of PD-1 and PD-L1 in the two groups were lower than before treatment,and the differences were statistically significant(P <0.01),and the treatment group was better than the control group(P <0.05);8.The number of iNKT cells in peripheral blood was not significantly correlated with different HBV DNA loads,and the difference was not statistically significant(P > 0.05);PD-1 and PD-L1 increased with the increase of HBV DNA loads,and the differences were Statistical significance(P < 0.05)suggested that the expression levels of PD-1 and PD-L1 was significantly positively correlated with HBV DNA load levels.The number of iNKT cells in peripheral blood increased with the increase of ALT,and the difference was statistically significant(P < 0.05),indicating that there was a positive correlation between the two;PD-1,PD-L1 and ALT levels had no significant correlation,and there was no difference.Statistical significance(P > 0.05);9.In terms of adverse reactions during treatment,the treatment group was lower than the control group,and the difference was statistically significant(P < 0.05).Conclusions: 1.Ruan Gan Yin can effectively improve the clinical symptoms and signs of CHB patients with qi deficiency and blood stasis type,repair damaged liver cells,promote liver function recovery,and slow down the progress of liver inflammation;2.Ruan Ganin can restore the function of iNKT and down-regulate the expression of PD-1 and PD-L1 to a certain extent,so as to achieve the role of immunoregulation,help anti-virus,and reduce the occurrence of adverse reactions during the treatment process.