慢性丙型肝炎病毒感染者外周血滤泡辅助T淋巴细胞的变化研究
Study on the changes in CD4⁺CXCR5⁺ follicular helper T lymphocytes in peripheral blood of patients with chronic hepatitis C

目的 研究滤泡辅助T淋巴细胞（TFH细胞）在慢性丙型肝炎病毒（HCV）感染者外周血的变化特点及其与疾病特征的相关性。方法 共纳入20名健康对照者和23例HCV感染者，其中4例接受聚乙二醇干扰素α联合利巴韦林治疗。流式细胞术检测外周血CD4+CXCR5+ TFH细胞比例变化。结果 慢性HCV感染者外周血CD4+CXCR5+ TFH细胞占单个核细胞的比例为5.845%（2.680%~14.200%），健康对照组为3.765%（1.200%~8.520%）（u=124.5, P=0.010 6）；占CD4+T淋巴细胞的比例，感染组和对照组分别为14.800%（8.440%~36.600%）和9.550%（2.700%~21.800%）（u=132.0,P=0.017 6）。CD4+CXCR5+ TFH细胞比例与HCV RNA载量呈负相关（r=-0.432 8,P=0.039 1)，与GPT和GOT无相关性。抗病毒治疗后HCV感染者TFH细胞比例降低。结论 CD4+CXCR5+ TFH细胞可能参与了慢性HCV感染机体抗病毒免疫应答。
： Objective To investigate changes in characteristics of CD4+CXCR5+ follicular helper T lymphocytes (TFH cells) in peripheral blood of patients with chronic hepatitis C virus (HCV) infection and its correlation with the disease characteristics. Methods Twenty-three patients with HCV infection and 20 healthy controls were enrolled and 4 patients received a pegylated interferon-α and ribavirin combination treatment. The changes in the proportion of peripheral blood CD4+CXCR5+ TFH cells were assessed by flow cytometry. Results The percentage of CD4+CXCR5+ TFH cells in peripheral blood mononuclear cells was 5.845% (2.680%-14.200%) for patients with chronic HCV infection and 3.765% (1.200%-8.520%) for healthy controls (u=124.5, P=0.010 6). The proportion of TFH cells in CD4+T cells was 14.800% (8.440%-36.600%) for patients and 9.550% (2.700%-21.800%) for healthy controls (u=132.0, P=0.017 6). The proportion of CD4+CXCR5+ TFH cells were negatively correlated to HCV RNA load (r=-0.432 8, P=0.039 1) and showed no correlation with serum glutamic pyruvic transaminase or glutamic oxaloacetic transaminase levels. The anti-HCV therapy decreased the proportion of CD4+CXCR5+ TFH cells in HCV-infected patients. Conclusion CD4+CXCR5+TFH cells may participate in the anti-viral immune response in the process of chronical infection with HCV