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目的 研究激活诱导细胞死亡 (AICD)在乙型肝炎发病机制中的意义。方法 分离 10名健康献血员的外周血单个核细胞 (PBMC) ,设置加HBVDNA阳性血清组与加健康人血清对照组(HBVDNA阴性血清组 ) ,在体外培养 72h ,采用碘化丙啶染色法经流式细胞仪检测凋亡情况并相互比较 ;分离 14例慢性乙型肝炎、6例慢性重型乙型肝炎患者与 10例健康献血员PBMC ,在植物血凝素刺激下培养 72h ,采用碘化丙啶染色法经流式细胞仪检测凋亡情况并相互比较。结果 加HBVDNA阳性血清组培养PBMC凋亡率高于加健康人血清组培养细胞凋亡率 [(39 5 6± 7 0 3) %vs(2 7 5 7± 7 78) % ,P <0 0 5 ]。慢性乙型肝炎组PBMC凋亡率 [(30 5 7± 13 4 3) % ]高于正常对照组PBMC凋亡率 [(11 4 5± 5 2 7) % ,P <0 0 1],高于慢性重型乙型肝炎组PBMC凋亡率 [(13 5 9±6 4 4 ) % ,P <0 0 1]。结论 HBV感染可能具有诱导PBMC凋亡的能力 ,AICD可能是形成HBV慢性感染免疫耐受的一个重要机制。
Objective To investigate the significance of activating induced cell death (AICD) in the pathogenesis of hepatitis B. Methods Peripheral blood mononuclear cells (PBMCs) were isolated from 10 healthy blood donors, and HBVDNA positive serum group and healthy human serum control group (HBVDNA negative serum group) were isolated and cultured in vitro for 72 hours. Propidium iodide staining Apoptosis was detected by flow cytometry and compared with each other. PBMC from 14 chronic hepatitis B patients, 6 chronic severe hepatitis B patients and 10 healthy blood donors were isolated and cultured for 72 hours after stimulation with phytohemagglutinin Apoptosis was detected by flow cytometry and compared with each other. Results The apoptosis rate of PBMC cultured in HBVDNA positive serum group was higher than that of healthy human serum group [(39 56 ± 703)% vs (2757 ± 788)%, P <0 0 5]. The apoptosis rate of PBMC in chronic hepatitis B group was higher than that in control group [(1145 ± 5227)%, P <0.01] The apoptosis rate of PBMC in chronic severe hepatitis B group was (13 5 9 ± 6 4 4)%, P 0 01. Conclusion HBV infection may have the ability to induce apoptosis of PBMC. AICD may be an important mechanism for the formation of immune tolerance in chronic HBV infection.