Study On The Correlations Of HLA-A2,Specific CTL And PD-1 With Chronic HBV Infected Patients With Different TCM Constitutions Types

Objective:To investigate the changes in levels of HLA-A2 alleles,specific CTL and PD-1 in chronic HBV infected patients with different TCM constitutions,detect the levels of HLA-A2 allele,CTL and PD-1 and clarify the correlations of different TCM constitution types with specific CTL,HLA-A2 alleles,PD-1,HBeAg,HBV-DNA load in chronic HBV infected patients.Methods:TCM constitution types of 152 chronic HBV infected patients were determined using"TCM constitution classification and decision table "designed by Wang Qi,and the patients'general information(including sex,age,onset time,and history,etc.)were recorded.The liver function,HBeAg,HBV-DNA,HLA-A2 allele,specific CTL and PD-1 in patients were detected.The TCM constitution distribution characteristics of chronic HBV infected patients and the relationships of TCM constitution types with liver function,HBeAg,HBV-DNA,HLA-A2,CTLs and PD-1 were analyzed according to statistical data.Results:A total of 152 patients werein accordance with the inclusion criteria of chronic HBV infected patients,there were sixty patients with damp-heat constitution,accounting for 25.4%,there were fifty-four patients with constitutions of qi deficiency(22.9%),there were fifty-two patients with constitutions of qi stagnation,(22.1%)and there were forty patients with constitutions of phlegm dampness(17%),there were eighteen patients with constitutions of yin deficiency(4.2%),there were ten patients with constitutions of yang deficiency(0.8%)and there were two patients with constitutions of static-blood(7.6%),there were no patients with yin-yang harmony constitution and special constitution.The distributions of different TCM constitution types were correlated with sexes and ages of the patients,and the differences were statistically significant(P<0.05).The HBeAg positive rate and HBV-DNA load were different among patients with different TCM constitution types,and the differences were statistically significant.However,there was no significant difference in liver function index among patients with different TCM constitution types(P>0.05).In this study,HLA-A2 positive patients accounted for 95%,therefore,no detailed analyses on its relationships with indicators such as TCM constitution types and PD-1 were carried out.There was no significant correlation between specific CTL and liver function,and there was a positive correlation between PD-1 and HBV-DNA load.The distributions of specific CTL and PD-1 were different among 4 main constitution types,and the differences were statistically significant(P<0.05).Conclusion:TCM constitution types of chronic HBV infected patients are mainly constitutions of damp heat,qi deficiency,qi stagnation and phlegm dampness,followed by constitutions of static-blood,yin deficiency and yang deficiency.No yin-yang harmony constitution and special constitution are observed in this study,and there are more male patients than female patients.The TCM constitution types in young and middle-aged patientsmainly include constitutions of damp heat and phlegm dampness,while the TCM constitution types of the old and weak patients mainly include constitutionsof qi deficiency and qi stagnation.In the study,the distribution of TCM constitution types in chronic HBV infected patients has no obvious correlation with HLA-A2 allele,but has correlations with HBeAg,HBV-DNA,specific CTL and PD-1.In short,the TCM constitutions of chronic HBV infected patients are classified to achieve an in-depth understanding of the TCM constitution distribution characteristic and immune response condition in chronic HBV infected patients with different TCM constitutions,which has important theoretical and applied value in enriching and expanding the research connotation of combined traditional Chinese and western medicine treatment of liver diseases.