慢性乙型肝炎湿证患者外周血TCRV β亚家族谱系表达及意义探讨

【作者】 张诗军； 陈泽雄； 李琼； 程永华； 林佑武； 郝尧坤； 胡斌；

【机构】 中山大学附属第一医院； 中山大学达安基因诊断中心；

【摘要】 目的:通过检测慢性乙型肝炎(CHB)湿证患者和健康人外周血T淋巴细胞受体β链V区(TCRVβ)亚家族的表达,从免疫识别的角度探讨湿邪致病"蒙蔽性"的特点。方法:CHB湿证患者组3例,正常组1例。对湿证组采用化湿治疗(藿朴夏苓汤加减)半年,观察湿证组治疗前与治疗取效后患者症状、体征、肝功能、HBV-DNA定量、乙肝病毒标志物和TCRVβ亚家族表达水平变化。结果:3例CHB湿证患者治疗后肝功能恢复到.正常水平,HBeAg均发生血清学转换;三者HBV-NDA定量均降低或转阴,同时,患者的症状明显改善,由湿证变为非湿证。3例治疗前TCRVβ表达偏低,经治疗后表达升高的亚家族是TCRVβ1(t=7.00,P<0.05)、TCRVβ6.1(t=25.39,P<0.01)、TCRVβ7(t=12.64,P<0.01)、TCRVβ8(t=5.36,P<0.05);3例治疗前TCRVβ表达均偏高,经治疗后表达降低的亚家族是TCRVβ12(t=5.87,P<0.05)、TCRVβ14(t=5.40,P<0.05)。结论:TCR Vβ的表达异常可能是湿邪的"蒙蔽性"所致,化湿中药对CHB湿证患者可能通过调节TCR Vβ的表达,改善免疫识别,激活有效免疫反应来清除病毒。同时TCRVβ1、TCRVβ6.1、TCRVβ7、TCRVβ8可能为识别HBV抗原或引发免疫应答的基因片段,在CHB发病中的作用值得进一步研究。更多还原

【Abstract】 Objective:To explore the "hoodwinks nature" of dampness evil by detecting the expression of TCRVβsubfamilies in peripheral blood mononuclear cell of chronic hepatitis B(CHB) patients with dampness syndrome and healthy people by F-Q PCR technique.Methods:Three patients with dampness syndrome and one healthy person were included,Three patients with dampness syndrome were treated by clearing dampness method(modified Huopuxialing decotion).The symptoms,signs and TCRVβ subfamilies expresssion were determined before and after being treated.Results:The liver function of three CHB patients with dampness syndrome recovered to normal levels after treatment,and the symptoms were improved in the same time.The levels of TCRVβ1、TCRVβ6.1、TCRVβ7、TCRVβ3 were increased(P<0.05,P<0.01,P<0.01,P<0.05,respectively) while the levels of TCRVβ12,TCRVβ14were decreased(P<0.05,P<0.05,respectively) after treatment.Conclusion:The expression quantities of TCR Vpsubfamilies of CHB patients with dampness syndrome were disordered,and the expression quantities of these subfamilies could be adjusted to a certain extent after clearing dampness treatment,which hinted that the abnormal expression of TCR Vβ subfamilies’ might be the cause of decreased immunity of CHB patients with dampness syndrome.更多还原