■慢性急性肝衰竭(ACLF)患者经历全身性炎症以及免疫功能障碍和疲惫。具有不同临床参数的ACLF患者中单核细胞衍生的树突状细胞的表型和功能尚未阐明。
■本研究包括37例ACLF,20例慢性乙型肝炎(CHB)患者,和12个健康对照。从登记的患者收集人口统计学和实验室参数。从参与者获得外周血样本。诱导培养单核细胞来源的树突状细胞,然后与患者的T细胞共培养。使用流式细胞术分析细胞表面标记和细胞内标记。比较了这些标志物与临床参数之间的关系。
■我们的研究发现ACLF患者的HLA-DR表达水平较低,与CHB患者和健康对照相比,单核细胞衍生的树突状细胞上的CD86和CD54。IL-4,GM-CSF,和酒精被发现促进HLA-DR的表达,单核细胞来源的树突状细胞上的CD86和CD54。在ACLF患者中,降钙素原(PCT)水平较高,白蛋白水平较低,凝血酶原活性降低和患者死亡与HLA-DR表达降低有关,单核细胞来源的树突状细胞上的CD86和CD54。外周血单核细胞(PBMC),去除贴壁细胞后,与单核细胞来源的DC共培养。我们的研究表明,感染和白蛋白水平低的患者PBMC中T细胞亚群的比例降低。此外,这些患者的T细胞显示Ki-67和干扰素-γ(IFN-γ)产生水平较低.
■ACLF患者表现出不同的临床状态,单核细胞衍生的树突状细胞的表型和刺激T细胞的能力不同。酒精可以刺激单核细胞衍生的树突状细胞的成熟。
Acute-on-Chronic Liver Failure (ACLF) patients experience systemic inflammation as well as immune dysfunction and exhaustion. The phenotype and functionality of monocyte-derived dendritic cells in ACLF patients with different clinical parameters have not been elucidated.
This study included 37 cases of ACLF, 20 cases of Chronic Hepatitis B (CHB) patients, and 12 healthy controls. Demographic and laboratory parameters were collected from the enrolled patients. Peripheral blood samples were obtained from the participants. Monocyte-derived dendritic cells were induced and cultured, followed by co-culturing with T cells from the patients. Cell surface markers and intracellular markers were analyzed using flow cytometry. The relationship between these markers and clinical parameters was compared.
Our study found that ACLF patients had lower expression levels of HLA-DR, CD86, and CD54 on monocyte-derived dendritic cells compared to both CHB patients and healthy controls. IL-4, GM-CSF, and alcohol were found to promote the expression of HLA-DR, CD86, and CD54 on monocyte-derived dendritic cells. In ACLF patients, higher levels of procalcitonin (PCT), lower levels of albumin, decreased prothrombin activity and deceased patients were associated with lower expression of HLA-DR, CD86, and CD54 on monocyte-derived dendritic cells. Peripheral blood mononuclear cells (PBMCs), after removing adherent cells, were co-cultured with monocyte-derived DC. Our study revealed that patients with infection and low albumin levels exhibited a decreased proportion of T cell subsets within PBMCs. Additionally, these patients\' T cells showed lower levels of Ki-67 and interferon-gamma (IFN-γ) production.
ACLF patients exhibit varying clinical states, with differences in the phenotype and the ability of monocyte-derived dendritic cells to stimulate T cells. Alcohol can stimulate the maturation of monocyte-derived dendritic cells.