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Decreases in Activated CD8+ T Cells in Patients with Severe Hepatitis B Are Related to Outcomes

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Abstract

Background

Many studies on T helper (Th)1, Th2, T regulatory and Th17 cells have been carried out in acute-on-chronic liver failure (ACLF). However, CD8+ T cell, as a main participant in immune-mediated injuries and defense against microorganisms, has seldom been studied in ACLF.

Aims

The purpose of this study was to investigate the CD8+ T cell function, and the outcomes of patients with severe hepatitis [SH; serum bilirubin (SB) ≥10 mg/dl and prothrombin activity (PTA) <60 %].

Methods

Thirty-six patients with chronic HBV-associated SH were included. Twenty normal chronic hepatitis B (CHB) patients (2 < SB < 10 (mg/dl) and PTA ≥ 60 %) and 28 healthy volunteers were enrolled as control groups.

Results

Twenty-six patients with SH were diagnosed with ACLF (SB ≥ 10 mg/dl and PTA ≤ 40 %). The non-recovered ACLFs (NR-ACLF) had higher HBV DNA loads than recovered ACLFs (R-ACLF) (6.03 ± 1.79 vs. 4.36 ± 1.61 (log10, IU/L)). The NR-ACLFs had the highest neutrophil:lymphocyte ratios (5.10 ± 2.37) (all P < 0.001; a = 0.05). The CHBs had higher perforin+ and TCM (CD45RA−CD62LhiCCR7+) proportions [31.28 ± 19.51, 5.32 ± 3.57 (%)] compared to R-ACLFs (11.75 ± 15.35, 0.78 ± 0.76 (%); P = 0.004, 0.001, respectively), or NR-ACLFs (11.61 ± 5.79, 1.14 ± 0.67 (%); P = 0.006, 0.003). The non-ACLF SHs had higher CD38+ proportions than R-ACLFs or NR-ACLFs (25.46 ± 8.02 vs. 16.24 ± 7.77 or 16.81 ± 6.30 (%), P = 0.039, 0.023).

Conclusions

High neutrophil:lymphocyte ratios and a decrease in activated CD8+ T cells may be related to poor outcomes in patients with SH.

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Acknowledgments

We thank the staff of Professor L.M. Deng (President of the State Key Laboratory of Oncology in Southern China) for allowing access to flow cytometry testing.

Conflict of interest

None.

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Authors and Affiliations

  1. The Department of Infectious Diseases, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

    Yinong Ye, Jing Liu, Qing Lai, Qiyi Zhao, Liang Peng, Chan Xie, Genglin Zhang, Shaoquan Zhang, Yufeng Zhang, Jianyun Zhu, Yangsu Huang, Zhaoxia Hu, Dongying Xie, Bingliang Lin & Zhiliang Gao

  2. Key Laboratory of Tropical Disease Control, Sun Yat-Sen University, Ministry of Education, No. 600, Tianhe Road, Guangzhou, 510630, China

    Yinong Ye, Qiyi Zhao & Zhiliang Gao

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  1. Yinong Ye
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Correspondence to Zhiliang Gao.

Electronic supplementary material

Flow cytometry testing for CD8+ T cell subsets in PBMCs. CD69, CD38, CD45RO, and perforin levels were analyzed in CD3+CD8+ gates. CCR7 levels were analyzed in CD45RA- gates (HC: healthy control; N-LF: non-ACLF; R-LF: recovered ACLF; U-LF: non-recovered ACLF).

10620_2014_3297_MOESM1_ESM.jpg

Supplementary Fig. 1. Flow cytometry testing for CD8+ T cell subsets in PBMCs. CD69, CD38, CD45RO, and perforin levels were analyzed in CD3+CD8+ gates. CCR7 levels were analyzed in CD45RA− gates (HC healthy control, N-LF non-ACLF, R-LF recovered ACLF, U-LF non-recovered ACLF)

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Ye, Y., Liu, J., Lai, Q. et al. Decreases in Activated CD8+ T Cells in Patients with Severe Hepatitis B Are Related to Outcomes. Dig Dis Sci 60, 136–145 (2015). https://doi.org/10.1007/s10620-014-3297-x

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  • DOI: https://doi.org/10.1007/s10620-014-3297-x

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