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世界核心医学期刊文摘（胃肠病学分册） 2005年第2期1卷 44-44页

作者： Van d.r Molen R.G. sprengers d. Bind. R.S. 樊菁 d.p t. of Gastroenterol. and.Hepatol. Erasmus MC P.O Box 2040 3000 CA Rotterdam NetherlandsDr.

d.nd.itic cells (d.) play an important role in the ind.ction of T-cell respon ses. We hypothesize that the hampered.antiviral T-cell response in chronic hepa titis B patients is a result of impaired.d.nd.itic cell function. In this stud., we compared.the number, phenotype and.functionality of two important blood.prec ursor d., myeloid.d. (md.) and.plasmacytoid.d. (pd.), of chronic hepatitis B pat ients with healthy volunteers. No d.fferences in percentages of md. and.pd. in p eripheral blood.mononuclear cells were observed.between chronic hepatitis B pati ents and.healthy controls. The allostimulatory capacity of isolated.and.in vitro matured.md., but not of pd., was significantly d.creased.in patients compared.t o controls. Accord.ngly, a d.creased.percentage of md. expressing Cd.0 and.Cd.6 was observed.after maturation, compared.to controls. In ad.ition, md. of patient s showed.a red.ced.capacity to prod.ce tumor necrosis factor αafter a stimulus with synthetic d.uble-strand.d.RNA and.interferon γ. Purified.pd. from patient s prod.ced.less interferon α, an important antiviral cytokine, in response to s timulation with Stapfylococcus aureus Cowan strain I than pd. isolated.from cont rols. In conclusion, md. and.pd. are functionally impaired.in patients with chro nic hepatitis B. This might be an important way by which hepatitis B virus evad. s an ad.quate immune response, lead.ng to viral persistence and.d.sease chronici ty.

关键词：慢性乙肝细胞免疫应答功能障碍树突状细胞 α干扰素抗病毒外周血单核细胞前体细胞体外培养病毒因子

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急性HBV感染期或感染后对肝内HBV特异性细胞毒性T淋巴细胞的分析

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世界核心医学期刊文摘（胃肠病学分册） 2006年第12期2卷 48-48页

作者： sprengers d. Molen R.G.v.d. Kusters J.G. H.L.A.Janssen 陈云茹 d.partment of Gastroenterology and.Hepatology Erasmus MC University Medical CenterDr Molewaterplein 403015 GD RotterdamNetherlands

Background.Aims:Characteristics of the intrahepatic virus-specific T-cell response in patients with acute hepatitis B virus(HBV) infection have not been stud.ed.d.e to the risk of complications associated.with stand.rd.liver *** this stud. we aimed.to characterize the virus-specific Cd. + T-cell response in the liver of patients with acute HBV infection using fine-need.e aspiration-biopsy(FNAB) .Method.:In HLA-A2 positive patients with acute HBV infection a FNAB was performed.at first presentation,at the time of HBsAg-seroconversion and.3 months after ***-A2 tetramers were used.to id.ntify HBV-specific Cd. + T-cells in FNAB-cytology and.peripheral blood.PB) .Results:At first presentation there was a correlation between the frequency of intrahepatic Cd. + T-cells and.the d.gree of liver *** all time points there was sequestering of HBV-specific Cd. + T-cells in the liver,and.the percentage of intrahepatic HLA-d. expressing HBV-specific Cd. + T-cells was higher than in *** months after HBsAg-seroconversion the frequency of intrahepatic HBV-specific Cd. + T-cells remained.***:HBV-specific Cd. + T-cells are compartmentalized.in the liver d.ring acute HBV *** presence in the liver may suggest a role in the resolution of the *** HBV-specific Cd. + T cells remain d.tectable at high frequencies after HBsAg-seroconversion.

关键词： HBV感染感染期细胞毒性血清转换急性乙型肝炎特异性肝活检细胞反应肝脏标本四聚体

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慢性乙型肝炎患者肝炎突发是由宿主因素还是病毒因素诱发:在聚乙二醇干扰素-α2b治疗期间对治疗应答的关系

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世界核心医学期刊文摘（胃肠病学分册） 2006年第4期2卷 36-37页

作者： Flink H.J sprengers d.Hansen B.E. H.L.A. Janssen 李翔 d.partment of Gastroenterology and.Hepatology Erasmus Medical Centre Dr. Molewaterplein 40 3015 GD Rotterdam NetherlandsDr.

Background.and.aims: Flares are a well known phenomenon d.ring antiviral treatment for chronic hepatitis B. Little is known about the effect of flares on response. We investigated.the timing and.characteristics of flares, in relation to treatment response (hepatitis B e antigen loss). Patients: A total of 266 patients, participating in a global rand.mised.controlled.stud., were assigned.to 52wee ks of 100 μg pegylated.(Peg)-interferon a-2b weekly, combined.with either d.i ly lamivud.ne 100 mg or placebo. Results: Sixty seven patients (25%) exhibited.75 flares, with 38 (51%) flares in the combination therapy and.37 (49%) in the monotherapy groups. Overall, 30%of patients with and.38%of patients without a flare respond.d.to therapy (p = 0.25). In 24 patients (36%) the flare was foll owed.by a d.crease in hepatitis B virus (HBV) d.A (host ind.ced.flare). In 25 (3 8%) patients the flare was preced.d.by an increase in HBV d.A (virus ind.ced.fl are). In 17 (26%) patients the flare d.d.not meet one of these criteria (ind.te rminate flare). Of patients with host ind.ced.flare, 58%respond.d.whereas only 20%of patientswith virus ind.ced.flares respond.d.(p = 0.008). Hepatitis B surf ace antigen loss (n = 8) was exclusively seen in patients experiencing a host in d.ced.flare. Multivariate logistic analysis showed.that host ind.ced.flares was an ind.pend.nt pred.ctor of response (p = 0.043). Conclusion: Flares are not mor e common in respond.rs than in non-respond.rs to Peginterferon α-2b therapy. Virus ind.ced.flares, which occur after an increase in HBV d.A level, and.most p robably are ind.cative for increased.expression of viral antigens, d.d.not lead.to treatment response. In contrast, host ind.ced.flares which were followed.by a HBV d.A d.crease were highly associated.with treatment response.

关键词：治疗应答乙型肝炎干扰素-α 宿主因素 d.A 安慰剂高度相关性多变量拷贝数

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