Advances in the prevention and treatment of the high-risk population for hepatitis E / 临床肝胆病杂志

‍Hepatitis E virus （HEV） infection is one of the most common causes of acute viral hepatitis. Most patients with HEV infection are asymptomatic and the virus can be spontaneously eliminated. Pregnant women， the elderly， immunocompromised populations， patients with chronic liver disease， and individuals in close contact with HEV-infected animals are at a high risk for HEV infection. The recombinant hepatitis E vaccine HEV 239 is the only approved hepatitis E vaccine， with both short- and long-term protective efficacy. This vaccine has a favorable safety profile with few adverse events， and the high-risk populations should be given the priority to receive such vaccination. Immunocompromised individuals may develop chronic HEV infection. Ribavirin and interferon are currently the most commonly used antiviral drugs for the treatment of HEV infection； however， it still needs to develop safe and effective novel antiviral drugs for patients with contraindications to ribavirin or interferon or those who have no response to such therapy.

Research advances in hepatitis B virus and ubiquitination of related proteins / 临床肝胆病杂志

Protein ubiquitination is widely observed in cells and is a modification after protein translation. Hepatitis B virus (HBV) and ubiquitination of related proteins have attracted more and more attention. This article reviews HBV and the ubiquitination of related proteins, so as to provide a reference for further research on the regulation of HBV replication and the ubiquitination of related proteins, as well as new ideas and methods for curing chronic HBV infection.

Detection of telomerase reverse transcriptase mRNA in peripheral blood mononuclear cells of patients with liver failure.

BACKGROUND: Telomerase activity is closely associated with the expression of human telomerase reverse transcriptase (hTERT) mRNA; although it can be induced in hepatocytes during liver regeneration, its dynamic change in patients with liver failure has remained unclear. OBJECTIVES: We investigated the variation and significance of hTERT mRNA expression in peripheral blood mononuclear cells (PBMCs) of the patients with liver failure. PATIENTS AND METHODS: In this clinical experimental study, 76 Chinese patients were enrolled in the study between 2010 and 2012. The level of PBMCs hTERT mRNA was detected by relative quantitative real-time polymerase chain reaction (RT-PCR) in the samples taken before treatment and at seven-day intervals during a 28-day treatment period. The patients were divided into survivor and non-survivor groups according to the 3-months mortality after treatment. The dynamic variation of PBMCs hTERT mRNA was analyzed and its association with prognosis was assessed by the area under the receiver-operating characteristic curve. RESULTS: The median level of PBMCs hTERT mRNA in survivors increased with treatment time and was significantly higher than the corresponding level in non-survivors after 14 days of treatment (P < 0.001). Subgroup analyses showed that the levels of PBMCs hTERT mRNA were remarkably higher in patients with acute-on-chronic liver failure than in those with chronic liver failure (P < 0.05). In patients with the same clinical type of liver failure, the level was markedly higher in survivors than in non-survivors after 14 days of treatment (P < 0.05); however, the levels were not significantly different between subgroups with different clinical type but the same prognosis. The sensitivity and specificity of PBMCs hTERT mRNA was high in evaluating the prognosis at day 14 and became much higher at days 21 and 28 post treatment. The expression of PBMCs hTERT mRNA had high sensitivity and specificity in evaluating the prognosis as early as day 14 post treatment and was significantly superior to the prognostic value of serum alpha-fetoprotein. CONCLUSIONS: The expression of PBMCs hTERT mRNA is closely associated with patient outcome, which indicates that hTERT mRNA in PBMCs might be useful as a prognostic biomarker of liver failure.

Study on T helper cells in the patients of pulmonary tuberculosis and the clinical significance of Th polarization / 中国免疫学杂志

Objective:This study was to analyze the changes of CD4~+ T lymphocytes and their subtypes,Th1 and Th2 cells,in the peripheral blood of patients with pulmonary tuberculosis disease and to investigate their clinical significance in the pathologic process of pulmonary tuberculosis.Methods:For polarization measurement of T-helper cells,1∶100 diluted Ionomycin and 1∶10 diluted Monensin were added in sequence into the equivalent volume mixture of heparin anti-coagulated whole blood and RPMI-1640 culture liquid.After being well mixed,the mixture was incubated at 5% CO_2,37℃ for 4 hours or overnight.To 100 μl of the mixture and in sequence,the antibodies of CD3-PerCP,CD8-APC,mIgG1-FITC,Rat IgG1-PE,IL-4-PE or IFN-γ-FITC were added.The stained CD4~+ IL-4~+ (Th2) and CD4~+ IFN-γ~+ (Th1) were analyzed by flow cytometry.Results:Compared with those from healthy controls,the peripheral blood of pulmonary tuberculosis patients contained significantly fewer Th1 (P＜0.01) but significantly more Th2 cells (P＜0.05).Th1 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis were obviously fewer (P＜0.05) than in infiltrative pulmonary tuberculosis patients.The amount of Th2 cells in the peripheral blood of the patients with miliary pulmonary tuberculosis was significantly more (P＜0.05) than in either infiltrative pulmonary tuberculosis or tuberculous pleurisy patients.The ratio of CD4~+/CD3~+ tended to decrease in all these patients,and it was much lower (P＜0.05) in the patients of miliary pulmonary tuberculosis than in infiltrative pulmonary tuberculosis patients.Patients suffering from both pulmonary tuberculosis and diabetes had significantly lower levels of Th1 cells and CD4~+/CD3~+ (P＜0.05) and more Th2 cells,compared with those of pulmonary tuberculosis patients without diabetes.Levels of Th1 and Th2 cells restored significantly (P＜0.05) in 15 severe pulmonary tuberculosis patients after receiving tuberculosis chemotherapy and microcalorie theropy for three months.Patients with positive sputum examination tended to have decreased Th1 and CD4~+/CD3~+ (P＞0.05) and significantly increased Th2 (P＜0.05).Conclusion:Immunosuppression existed,in different extents,in patients of infiltrative pulmonary tuberculosis,tuberculous pleurisy,miliary pulmonary tuberculosis as well as patients with both pulmonary tuberculosis and diabetes.Analysis of Th1,Th2 and CD4~+/CD3~+ may be benefit for the judgments of disease conditions and therapeutic effects.

Influence of interferon alpha on the variation of Tc and Ts cells in the peripheral blood of patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the influence of interferon-alpha on the variation of cytotoxic T lymphocytes (Tc) and suppressor T lymphocytes (Ts) in the peripheral blood of 32 patients with chronic hepatitis B, and to analyse the relationship between the efficacy of interferon-alpha and the variation of Tc and Ts cells.</p><p><b>METHODS</b>The peripheral blood Tc and Ts cells were detected by the double-staining immunocytochemistry technique.</p><p><b>RESULTS</b>At the end of the treatment with interferon-alpha, there were 9 complete responders (CR), 12 partial responders (PR) and 11 non-responders (NR). Tc cells significantly increased and Ts cells markedly decreased in CR or PR group compared with the healthy control group. There was no significant difference in the level of Tc and Ts cells between CR and PR groups, and no significant difference in the level of Tc cells in NR, CR and PR groups, The Ts cells was significantly higher in NR group than in CR or PR group.</p><p><b>CONCLUSIONS</b>The treatment of interferon-alpha can result in the change of Tc and Ts cells in patients with chronic hepatitis B. The variation of Ts cells may play an important role in the efficacy of interferon-alpha against hepatitis B virus.</p>