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目的:分析慢性丙型肝炎(chronic hepatitis C,CHC)患者外周血髓系来源抑制细胞(myeloidderived suppressor cells,MDSCs)的特征及其与病毒复制的关系.方法:采用流式细胞术检测了61例CHC患者[包括14例快速病毒学应答(rapid virological response,RVR)患者、22例早期病毒学应答患者(early virological response,EVR)]和25例健康对照(healthy control,HC)的外周血MDSCs频率,并分析其与临床病毒载量和肝脏生化指标之间的相关性.结果:基线水平CHC组MDSCs的频率高于健康组(1.33%vs 0.7%,P<0.001),且与HCV RNA载量呈正相关(r=0.636,P<0.001),与谷丙转氨酶水平无关(r=0.156,P=0.229);CD8 T细胞表面的T细胞受体(T cell receptor,TCR)ζ链表达降低与CHC组MDSCs频率升高呈负相关(r=0.690,P<0.001),在体外加入L-精氨酸可使其恢复;抗病毒治疗后,MDSCs频率呈下降趋势,且RVR组基线水平的MDSCs频率高于EVR组(P=0.024).结论:CHC患者外周血MDSCs频率升高可能通过下调CD8 TCRζ链表达抑制机体的抗病毒应答,从而引起病毒的复制,抗病毒治疗可使CD8 TCRζ链的表达部分恢复.
OBJECTIVE: To analyze the characteristics of myeloid derived suppressor cells (MDSCs) in peripheral blood of patients with chronic hepatitis C (CHC) and their relationship with virus replication.Methods: Flow cytometry was used to detect 61 cases The frequency of MDSCs in peripheral blood of CHC patients (including 14 patients with rapid virological response (RVR), 22 patients with early virological response (EVR) and 25 healthy controls (HC) , And its correlation with clinical viral load and liver biochemical indicators were analyzed.Results: At baseline, the frequency of MDSCs in CHC group was higher than that in healthy group (1.33% vs 0.7%, P <0.001) (R = 0.636, P <0.001), and had no correlation with alanine aminotransferase (r = 0.156, P = 0.229). The decrease of ζ chain of T cell receptor (TCR) (R = 0.690, P <0.001). The addition of L-arginine in vitro could restore the MDSCs frequency. The frequency of MDSCs decreased after antiviral treatment and the baseline MDSCs frequency Higher than EVR group (P = 0.024) .Conclusion: The frequency of MDSCs in peripheral blood of CHC patients may increase Down CD8 TCRζ chain expression inhibition of the antiviral response of the body, resulting in virus replication, the expression of anti-viral treatment can partially restore CD8 TCRζ chain.