The Study Of Immune Response Of Th1/Th2 Cells In Chronic Hepatitis B Patients During Acute Exacerbation

To investigate the immune response of Th1/Th2 cells to HBV duplication and subsequent injury of liver cells through detection of Th1/Th2 cells' ratio, HBV DNA load and liver function indexes in peripheral blood of chronic hepatitis B patients during acute exacerbation.Methods: 19 cases of normal controls and 17 cases of chronic hepatitis B patients experiencing acute exacerbation were recruited into this study. Using flow cytometry assay, Th1/Th2 ratio was estimated by quantification of cytokins (IL-4, r-IFN) inside the plasma of single CD4+ T cells. HBV DNA load in peripheral serum of chronic HBV infectants during and after acute exacerbation period was analyzed by polymerase chain reaction (PCR) assay combined with fluorescent probe (FQ-PCR). Liver function indexes (ALT,AST,TB) during acute exacerbation and after treatment was estimated by Hitachi 7170A auto-chemistry analyzer. Results: (1) The percentage of Th1 cells(14.52±4.86%) in chronic HBV infectants during acute exacerbation was higher than that these patients after treatment(9.33±2.72%)(P<0.05) and that of normal controls(9.92±4.54%)(P<0.05). Similarly, the ratio of Th1/Th2 during acute exacerbation was higher than that of normal controls (P<0.05) and that these patients after treatment (P<0.05). There was no statistic difference of Th2 cells percentage between cases and controls(P>0.05). Also, there was no statistic difference of Th1/Th2 ratio between normal controls and cases after treatment (P>0.05). There was no statistic difference of Th2 cells percentage between patients before(1.64±0.59%) and after treatment(1.81±0.75%), and between patients (1.64±0.59%)and controls(2.05±0.98%). (2) HBV DNA load of chronic HBV infectants during acute exacerbation (7.87±1.96copies/ml,log transformed) was higher than that these patients after treatment(5.45±1.95)(P<0.05). (3) ALT activity during acute exacerbation (467.52±103.46U/L) were significant higher than that these patients after treatment (137.66±53.29 U/L) (P<0.05). (4) The ratio of both Th1 (r=0.432, P<0.05) and Th1/Th2 (r=0.493, P<0.05) were positively associated with ALT activity. Nevertheless, The percentage of Th1 cells was not significantly associated with either HBV DNA load or other liver function indexes. Conclusions: (1) The percentage of Th1 cells in chronic HBV infectants during acute exacerbation is positively associated with the severity of hepatitis. (2) The aberration of Th1/Th2 ratio is closely associated with acute exacerbation of chronic HBV infectants. (3) The percentage of Th1 cells is potential biomarker for dynamic monitoring of hepatitis.