目的: 观察中药二至-芪灵合剂通过PD-1/PD-L1信号通路对慢性乙型肝炎(CHB)患者的免疫调节作用。方法: 选取90例CHB患者,按随机数字表分为二至-芪灵颗粒剂联合恩替卡韦治研究1组(30例)和二至-芪灵汤剂联合恩替卡韦的研究2组(30例)单用恩替卡韦的对照组(30例),疗程48周。分别在基线、治疗第24周、48周检测外周血CD4+细胞PD-1/PD-L1表达水平、外周血IL-35水平及HBV,DNA载量。结果: 治疗48周后联合使用中药干预患者的PD-1/PDL-1表达水平显著低于单用恩替卡韦者,差异有统计学意义(P<0.01);同期HBV,DNA也持续降低(1.87±0.53,2.18±0.56),较基线差异显著(P<0.05),而IL-35表达水平变化趋势一致(P<0.01)。结论: 中药二至-芪灵合剂可以通过调节负向免疫因子PD-1/PDL-1、IL-35水平发挥免疫平衡再建作用,中药颗粒剂与草药煎汤剂对患者疗效作用相当。
Abstract
Objective: To observe the regulation of traditional Chinese medicine Erzhi-Qiling mixture on the immune disorder of chronic hepatitis B(CHB) patients through PD-1/PD-L1 signaling pathway.Methods: 90 patients with CHB were enrolled according to a random number table.The granules were divided into 3 groups, granules of Erzhi-Qiling and entecavir (30 cases), entecavir alone (30 cases) and decoction of Erzhi-Qiling combined with entecavir.Treatment was 48 weeks.Peripheral blood PD-1/PD-L1, IL-35 frequency and HBV DNA were measured at baseline, 24 weeks and 48 weeks of treatment, respectively.Results: After 48 weeks of treatment, the expression level of PD-1/PDL-1 in the Chinese medicine intervention group was significantly lower than that in the single-agent entecavir group (P<0.01).During the same period, HBV DNA also decreased (1.87±0.53, 2.18±0.56) significantly different from baseline (P<0.05); IL-35 expression level showed between the three A consistent correlation was obtained (P<0.01).Conclusion: The traditional Chinese medicine Erzhi-Qiling mixture can play an immune balance by regulating the levels of negative immune factors PD-1/PDL-1 and IL-35.It also proves that Chinese medicine granules and herbal decoction have similar effects on patients.
关键词
乙型肝炎 /
免疫 /
二至-芪灵合剂 /
PD-1/PDL-1 /
IL-35
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Key words
hepatitis B /
immunity /
Erzhi-Qiling mixture /
PD-1/PDL-1 /
IL-35
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中图分类号：
R575.1
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参考文献
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脚注
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基金
陕西省科技厅项目(No.2021FS-233),安康市科技局项目(No.2018AK03-03),安康市科技局项目(No.2019AK2019S-F-14),国家重点研发计划课题(No.2018YFC1344504),白求恩基金会课题(No.B19106BN)
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