Observation On The Level Of RBC Membrane CR1, IL-2R, And Ig In Peripheral Blood Among Chronic Hepatitis B Patients With Positive Core Antibody And Negative Core Antibody

The Hepatitis B Virus(HBV) infection is a global health problem of mankind, and about350 million people have chronic HBV infection all over the world. According to WHOinvestigation, more than one million people die of HBV infection every year. About 15%-25% ofthe patients with Chronic Hepatitis B(CHB) die of cirrhosis or liver cancer. Immunologicalimbalance is one of the important factors in the occurrence of hepatic diseases. Low cellularimmune functioin, disorder and accentuation of body fluid immunity and cell factors exist in allthe patients with hepatic diseases. It has been proved by many studies that the nosogenesis andprogress of hepatic diseases are closely related to the immunity disorder of the patients. Naturalimmunity directs the choice of antigens and response type in the specific immunie response.. Themacrophage mesh endothelial system is one of the most important response areas in naturalimmunity. The incapacity of macrophage causes serious obstacle of the endotoxin clearance,hurts the liver cells, and urges the hepatitis to turn chronic. Since the C3 body is mainlysynthesized in the liver cells, damages to the liver cells will affect the natural immunity reaction.The RBCs have various natural immunity receptors and material. Due to its large quantity, RBCsplay an important role in natural immunity response and guide the T and B lymphoid cell specialimmune response. Therefore occurrence, development and treatment of liver diseases are closelyrelated with natural immunity function of red cells.ObjectiveOn account of clinical treatment for the patients with HBsAg(+), HBeAg(+) and highreplication of HBV-DNA, there are clinical differences between the chronic type B hepatitis caseswith anti-HBC(+) and anti-HBC(-). By comparing the two groups on cellular immunity, humoralimmunity, RCIA, and the damage on the hepatocyte of the host with HBV, we will detect theCR1, mIL-2R and the level of Igon the patients with anti-HBC positive or anti-HBC negative,investigate the reasons for the difference on the clinical effects, and provide theory toindividualized treatment.Methods According to the admitting criteria, the samples were divided into the anti-HBC positivegroup and the anti-HBC negative group. ELISA was adopted to examine HBV-M; indirect doubleantibody sandwich ELISA to detect serum sIL-2R; flow cytometer to detect the expression of thePBMC mIL-2R(CD25); PQ-PCR to quantitate HBV-DNA; pyruvate oxidase to detect ALT. Theexpressions of HBV-M, ALT, HBV-DNA, sIL-2R and mIL-2R and CR1 were analyzed. Theserum IgM and IgG were also analyzed and treated statistically. The differences were comparedbetween the two groups..Results1. The HBV level was high in both anti-HBc(+) and anti-HBc(-) groups. But there was noobvious difference. Two groups HBV-DNA replication had no significant difference (P＞0.05).2. The serum ALT activity in the anti-HBC positive group was significantly higher thanthat in negative one (P＜0.01). The HBV does harm to liver cell in both anti-HBc(+) andanti-HBc(-) group. Anti-HBV(+) group suffered more than negative group.3. sIL-2R level of the two groups was significantly higher than that of matched control(P＜0.01), and the expression of the mIL-2R was significantly lower than that in matchedcontrol group (P＜0.01). sIL-2R level in serum of anti-HBC(+) was significantly higher than thatof the anti-HBc(-) group (P＜0.01). The expression of the mIL-2R was significantly lower thanthat of the anti-HBc(-) group (P＜0.01). The HBV decreased the immunity of the two groupssignificantly. Immunity of anti-HBV (+) group was obviously lower than in negative group.4. IgM and IgG level in serum of the two were significantly higher than that of normalmatched control (P＜0.01), but no significant difference existed (P＞0.05). The HBV madehumoral immunity sthenic both in the two groups. But no significant difference existed betweenthe two.5. CR1 expression of red cell membrane in the two was significantly lower than that ofnormal matched control (P＜0.01), CR1 expression of red cell membrane in anti-HBc(+) groupwas significantly lower than that in anti-HBC(-) group(P＜0.01). The HBV decreased RCIAfunction of the two significantly. The positive one dropped more significantly.ConclusionsThe HBV level is high in both anti-HBc (+) and anti-HBc (-) group. When the hepatic cellis damaged on various levels, the cellular immunity is decreased, the humoral immunity isaccentuated and the RCIA function is significantly decreased. But Anti-HBV(+) group suffers from the damage of the hepatic cell more than negative group and the cellular immunity andRCIA function is significantly lower than the anti-HBc(-) group.In brief, the differences on the cellular immunity, humoral immunity, RCIA function andthe damage on the host hepatic cell between the two groups may be the reason for the clinicaltreatment effect difference between the anti-HBc (+) and anti-HBc (-) patients. Therefore, inprocess of chronic type B hepatitis treatment, distinguish to diagnosis and treat patients same withHBsAg (+), HBeAg (+) and high replication of HBV-DNA. This research conclusion has aclinical instructive value to guide the treatment of chronic type B hepatitis and for the prognosis.