The Research Of Th17/Treg Variations In Patient With Chronic HBV-infected And Its Relationship With Liver Function And HBV Replication Level

Objective:In this research, we set the healthy adults (HC) as the control group, select the HBV-related liver diseases patients as experimental group, including asymptomatic carriers (AsC), chronic hepatitis B (CHB), liver cirrhosis (LC), hepatocellular carcinoma (HCC), investigate the Th17/Treg variations in the peripheral blood and its relationship with liver function and HBV replication level, to provide a theoretical basis to elaborate the mechanism of the chronicity about HBV infection and its progression.Methods:In this research, we selected 163 cases of HBV-related liver diseases patients, who came from inpatient or outpatient in infectious diseases department of our hospital from November 2013 to March 2015. Among them,24 cases were AsC,61 cases were CHB,34 cases were LC,22 cases were HCC, and selected 26 cases whose physical examination were normal in our hospital as the control group. The HBV-markers, including HBsAg, HBsAb, HBeAg, HBeAb, HBcAb, were determined by ELISA. The HBV-DNA were tested by real-time fluorescent quantitative PCR analyzer. The ALT, AST, TBil and other liver function indicators were detected by the automatic biochemical analyzer. The peripheral blood of Th17 cells and Treg cells were detected by flow cytometry. All of these data were analyzed by the SPSS 17.0 statistical software.Results:1. About the Th17/CD4+T:With the analysis of variance, these five groups have statistically significant (F=22.332, P<0.05). By further pairwise comparison, we find the group of LC(5.87±2.69) is higher than the group of HC(1.74±0.64), AsC(1.47±0.77), CHB(4.58±2.75), HCC(2.23±1.12), and the difference is statistically significant(p<0.05); the group of CHB(4.58±2.75) is higher than the group of HC(1.74±0.64), AsC(1.47±0.77), HCC(2.23±1.12), and the difference is statistically significant(p<0.05); the group among HC, AsC and HCC, there has no statistical significance(p>0.05).2. About the Treg/CD4+T:With the analysis of variance, these five groups have statistically significant (F=12.527, P<0.05). By further pairwise comparison, we find the group of HCC(3.70±2.07) is higher than the group of HC(1.21±0.56), AsC(1.43±0.73), CHB(2.45±1.39), LC(2.44±1.15), and the difference is statistically significant(p<0.05); the group of CHB(2.45±1.39) and LC(2.44±1.15) is higher than the group of HC(1.21±.56) and AsC(1.43±0.73), and the difference is statistically significant(p<0.05); the group between HC and AsC, CHB and LC, there has no statistical significance(p>0.05).3. The ratio of Th17/Treg:With the analysis of variance, these five groups have statistically significant (F=19.571, P<0.05). By further pairwise comparison, we find the group of LC(2.68±1.09) is higher than the group of HC(1.49±0.27), AsC(1.16±0.62), CHB(2.06±1.11), HCC(0.72±0.39), and the difference is statistically significant(p<0.05); The group of HCC(0.72±0.39) is lower than the group of HC(1.49±0.27), AsC(1.16±0.62), CHB(2.06±1.11), LC(2.68±1.09), and the difference is statistically significant(p<0.05); The group of CHB(2.06±1.11) is higher than the group of HC(1.49±0.27) and AsC(1.16±0.62), and the difference is statistically significant(p<0.05); the difference between the group of HC and AsC has no statistical significance(p>0.05)4. The correlation analysis of Th17 and Treg:Th17 has positively correlated with Treg in group of HC(r=0.624xx, p<0.05), CHB(r=0.738xx, p<0.05), LC(r=0.644xx, p<0.05); Thl7 show no correlation with Treg in group of AsC and HCC.5. The correlation analysis of Th17, Treg, Thl7/Treg and liver function:Thl7 is positively correlated with ALT in group of CHB(r=0.298xx, p<0.05), but has no correlation with AST and TB; Treg has no correlation with ALT, AST, TB; Thl7/Treg is positively correlated with TB in group of CHB(r=0.270xx, p<0.05), but has no correlation with ALT and AST. Th17 is positively correlated with ALT in group of LC(r=0.644xx, p<0.05), but has no correlation with AST and TB; Treg is positively correlated with ALT in group of LC(r=0.506xx, p<0.05), but has no correlation with AST and TB. The liver function has no correlation with Thl7, Treg, Th17/Treg in group HC, AsC and HCC.6. Th17, Treg, Th17/Treg show no correlation with HBV-DNA levels in group of HC, AsC, CHB,LC and HCC.Conclusion:Th17 and Treg in patients with chronic HBV-infected liver is in a relatively active state, to a certain extent, it is positively correlated with the liver function. Th17/Treg in group of LC is higher than the group of HC, AsC, CHB and HCC, at the same time, the group of CHB is higher than the group of HC, AsC and HCC, which show the inflammation make progress from CHB to LC. The peripheral blood of Th17, Treg have no correlation with the load of HBV-DNA, showing that Th17, Treg can not directly influence the replication of HBV. The peripheral blood of Treg, Th17/Treg in group of HCC is higher than the group of HC, AsC, CHB and HCC, indicating that Treg has closely relationship with the occurrence and progress of HCC.