The Research On The Correlation Between The Programmed Death-1 Expression Of Liver Tissues, TCM Syndrome, And Correlative Clinical Indexes In Chronic Hepatitis B

ObjectiveTo explore the expression of programmed death-1(PD-1)in liver tissues at different clinical activities of chronic hepatitis B, analysis the expression of PD-1 at different traditional Chinese medicine(TCM) syndromes in patients with CHB,and compare with liver inflammatory activity grade,liver fibrosis stage,ALT,AST,TBIL and HBV DNA levels.Methods100 patients of chronic hepatitis B were classified as well as diagnosed with five TCM differentiation of types: liver stagnation and spleen deficiency type,damp heat resistance type,yang deficiency of spleen and kidney type,yin deficiency of liver and kidney type, stasis resistance network type,where the damp heat resistance type and stasis resistance network type classified as partial positive group, the other three types classified as partial deficiency group.All patients underwent liver tissue puncture to clear the liver inflammatory activity grade and fibrosis stage. The expression of PD-1 in liver tissues was detected by immunohistochemistry SP method.With Image-Pro Plus 6.0 image analysis system to measure the positive expression regional and calculate the mean optical density of PD-1 expression.The five cases with the same period of hospitalization required surgical patients with hepatic hemangioma as a control group.To study the relationship between the expression of PD-1 in liver tissues,the TCM syndromes and the related laboratory indicators.ResultsA total of 100 cases of CHB patients included in this study.①Immunohistochemical staining showed that PD-1 in the normal control group, almost no expression or very weakly positive, and in CHB patients with varying degrees of liver tissue expression. There were significant differences of PD-1 expression among the hepatic inflammatory activity grades and fibrosis stages of each groups(P<0.05). There were significant differences of PD-1 expression among the low-grade chronic hepatitis B, moderate chronic hepatitis B and the severe chronic hepatitis B of each groups(P<0.05). The expression of PD-1 was positively correlated with liver inflammatory activity grade and fibrosis stage, with correlation coefficient as 0.826(P<0.001) and 0.822(P<0.001) respectively. ②The levels of ALT and AST among different groups,the differences were statistically significant(P<0.05). TBIL comparison between groups: the control group compared with the CHL Group and CHM group,the difference was statistically significant(P<0.05). Among the other groups,the difference was not statistically significant(P>0.05). HBV DNA comparison between the groups: the control group compared withthe CHL, CHM and CHH group, the difference was statistically significant(P<0.05). Among the other groups, the difference was not statistically significant(P>0.05).The expression of PD-1 was positively correlated with ALT,AST,TBIL and HBVDNA levels, with correlation coefficient as 0.472(P<0.001), 0.414(P<0.001), 0.332(P<0.05) and 0.463(P<0.05)respectively. ③The patients with liver stagnation and spleen deficiency type and damp heat resistance type were mainly in G1~G2 and S0~S2. There were no significant difference between the two groups(P>0.05). And the patients with stasis resistance network type were mainly in G3~G4 and S3~ S4, compared to the liver stagnation and spleen deficiency type with damp heat resistance type, showing significant difference(P < 0.05). The PD-1 expression of stasis resistance network type was the maximum in liver tissues, while the liver stagnation and spleen deficiency type was the lowest. The liver stagnation and spleen deficiency type compared to damp heat resistance type and stasis resistance network type, showing significant difference(P<0.01). With the other threegroups, the difference was not statistically significant(P>0.05). The damp heat resistance type and blood stasis type classified as partial positive group, the other three types classified as partial deficiency group were statistically compared, showed thatthe expression of PD-1 of partial positive group was significantly higher than the partial deficiency group(P<0.01).ConclusionsThe expression of PD-1 in different stages of CHB patients is different, as the severity of the disease, its expression increased. The PD-1 expression were positively correlated with the degree of liver inflammation and fibrosis, ALT, AST, TBIL, HBV DNA levels, and with TCM syndrome also have certain relevance. The expression of PD-1 is closely associated with chronic disease progression. To detect the expression of PD-1 of liver tissue is expect to provide an objective basis for CHB TCM typing, clinical diagnostics, and other aspects of Integrative Medicine.