Changes of Treg and Th17 cells balance in the development of acute and chronic hepatitis B virus infection Full Text
Xue–Song L et al. – T (Treg) cells and interlukin–17–producing T help cells (Th17) cells are involved in acute and chronic hepatitis B virus (HBV) infection, especially in acute HBV infection (AHB) and acute–on–chronic HBV–related liver failure (ACHBLF). chronic hepatitis B patients (CHB) and ACHBLF patients manifested obvious Treg/Th17 ratio imbalance, which might be linked to disease progression and the continuous HBV infection.Methods
- Ten patients with acute HBV infection (AHB) and forty–eight patients with chronic HBV infection, including 12 asymptomatic HBV carriers (HBV carriers), 18 chronic hepatitis B patients (CHB) and 18 acute–on–chronic HBV–related liver failure (ACHBLF) were enrolled.
- Treg and Th17 cells differentiation related cytokine levels were detected by using ELISA.
- Flow cytometry was employed to count the Treg and Th17 frequency in peripheral blood.
- Compared to health controls both AHB and ACHBLF patients favoured Th17 cell differentiation, accompanied by a higher proportion of peripheral Th17 cells (P < 0.01) and high level of interleukin–17A (IL–17A) (P < 0.01).
- However, asymptomatic HBV carriers and CHB were conducive to Treg cell differentiation.
- In AHB and ACHBLF, peripheral blood IL–17A + CD4 + T cell frequency increased significantly compared with healthy controls.
- Changes of Treg and Th17 cell frequency were not completely consistent.
- Both CHB and ACHBLF had lower level of Treg/Th17 ratio than in health control (P < 0.05).
- Both plasm IL–17A levels (r = 0.72, p<0.001) and Th17 frequency(r = 0.49, p = 0.0003) negatively correlated with plasma HBV DNA load in patients with chronic HBV infection.
- In addition, both Th17 frequency and plasm IL–17A levels positively correlated with ALT (r = 0.33,p = 0.01 Vs r = 0.29,p = 0.04) and total bilirubin levels (r = 0.72,p<0.0001 Vs r = 0.53,p = 0.0001) in these chronic HBV–infected subjects.
- However, for AHB there were positive correlation between both Th17 frequency (r = 0.64, p = 0.04) and plasm IL–17A levels (r = 0.69, p = 0.02) with serum ALT levels, but no significant correlation between both HBV DNA level and total bilirubin level with Th17 frequency or plasm IL–17A levels were found.
- Furthermore, Treg/Th17 ratio was negatively correlated with total bilirubin levels (r = 0.41, p = 0.004) in chronic HBV–infected patients, especially in patients with ACHBLF (r = 0.69,p = 0.001) and positively correlated with viral load in these chronic HBV–infected subjects (r = 0.55, p<0.0001).