The Effect Of The Treatment Of Nourishing Kidney And Clearing Away Toxicity On The Functions Of Dendritic Cell And Its Induced Specific T Cells In CHB Patients

Chronic Hepatitis B(CHB) is a epidemic and progressive infectious disease.There were 350 to 400 million chronic HBV-infectde persons in all the world,and China is a high prevalence area of CHB.When HBV infect in the human body,the immune response decides occuience,development and prognosis of the diseade.It had confirmed that one of the main reasons caused persistent infection is the aberrant immunologic function.The goal of treatment is to suppresse or eliminate HBV forever,reduce inflammatory necrosis of liver cells and liver fibrosis,delayed the disease progression,reduce or prevent liver decompensation,liver cirrhosis,HCC and its complications,thereby to improve the quality of life and extend the survival time.This research based on referring to domestic and international literature and mastering the current research situation,objectively ebaluate the clinical effect of the therapy of nourishing kidney and clearing away toxicity,study the mechanisms about enhancing immume function and eliminating HBV on the therapy,reserch the possibility of the treatment on CHB,and provide a new clinical ideas on the treatment of immune regulation.Part one Literature Research1.This paper summarized the name,pathogenesis,treatmentof CHB in TCM and modern traditional Chinese physician's achievements results of research on CHBin clinic.It alao summarized the domestic and foreign scholars's progress on the epidemiology,etio-logy,pathology,pathogenesis, diagnosis and treatment,and the research trend and directionat of CHB,in our country and abroad now.It was viewed that the main reasions that CHB patients with immune response cannot clear the virus and leading chronic infection is due to dysfunction,then result the HBV specific cellular immune dysfuntion.2.Through the theory of "insidious pathogen warm disease",we put forward the view that the reason of chronic hepatitis B infection is "pestilence incubated in the liver blood due to the kidney deficiency" the therapy of nourishing kidney and clearing away toxicity is the best in the Chinese traditional treatment.Persistent infection of HBV immune escape may be related to Chinese medicine theory of" pestilence incubated in the liver blood due to the kidney deficiency"Part two Clinical and Experiments ResearchObjective1.To compare the differences on the function of monocyte-derived dendritic cells between healthy donors and patients with CHB virus infection,and exploer the mechanism of HBV persisrence infection2.To evaluate the changes on the antigen presentation of dendritic cells in the patients received the therapy of nourishing kidney and clearing away toxicity,INF-α,Nucleotide synonym on different times,and to discuss the application prospect about treating CHB with Traditional Chinese Medcine.Methods1.To chose 15 CHB patients,and divid into three groups stochastically,and treat them with the therapy of nourishing kidney and clearing away toxicity,INF-α,Nucleotide synonym.To examinate the changes of serology target on the specific time,and exploer the mechanism about HBV controled by the therapy of nourishing kidney and clearing away toxicity.2.Generation of monocyte-derived Des in peripheral blood from patients with CHB and control group:moncytes were islatedfromblood samples containing heparin obtained.After 3h of culture in 6-well plates(2×10~6cell/well) the non-adherent ceils were remobed.Recombine human granulocyte macrophage-colony stimulating factor 100ng/ml and IL-4 500U/ml were added to DCs cultures.Also in the day 7,Recombinant human TNF-α60ng/ml was added in the culture.The culture was lasted to day 11,and then collect the nature Des.3.Evaluate the Des surface markers:evaluated the presence of DCs surface markers with flow cytometry using a panel of thycoerythrin-or fluorescein isothiocyanate-conjugated monoclonal antibodies specific for CD14 CD83 CD86 CD80 HLA-DR.4.Evaluate the secretecd activity of Th cells simulated DCs:In the day 9 of generation of monocyte-derived DCs,pulse the HbsAg,then evalated the level of IL-12,INF-γ,IL-2,IL-5,IL-10 by ELISA.Results1.Exam HBV-DNA and ALT of the three groups,we found that there is no difference befor the treatments.3 months later,the number of HBV-DNA and ALT decreased observably,P＜0.05 in the INF-αand Nucleotide synonym groups.The other group,HBV-DNA and ALT also decreased,but not observably.After 6 months the number of HBV-DNA and ALT decreased little compared to 3 months ago in the INF-αand Nucleotide synonym groups.P＞0.05.But the two index are all decreased compared to 6 months ago in the other group.P＜0.052.Exam the DCs surface markers on different time of the 3groups,we ound that there is significant difference after the treating,but no significant difference statistically btween the 3 groups on the same treating time.And the first therapy is more best.3.It had incresed the seeretecd activity of DCs after the therapies.But they have no significant difference statistically btween the 3 groups.4.We found that the presence of DCs surface markers was high when plused the HbsAg with the thrapy of nourishing kidney and clearing away toxicity.Conclusions1.The three groups all can clear HBV and resorate liver function of CHB, improve the clinical sumpotoms.And the effet is better in a short time in the INF-αand Nucleotide synonym groups on clearing HBV,but not on resorating liver function.But for a long time,the other groups is better.This maybe tell us that the therapy of nourishing kidney and clearing away toxicity can improve immynity of CHB patients.2.The therapy of nourishing kidney and clearing away toxicity is better than the other groups on improve the clinical sumpotoms and the DC function of CHB when treating a long time,so we think the therapy of nourishing kidney and clearing away toxicity is more waluabe on clinical treament.3.The DCs surface markers improved observly after plus HbsAg in the group of therapy of nourishing kidney and clearing away toxicity.This had4.Provide a theoretical basis on treating CHB patients with the Chinese Trditional Medicine and immunological methods.