Objective To investigate the influence of intestinal endotoxemia on Treg / Th17 imbalance in patients with chronic hepatitis B( CHB). Methods A total of 80 patients with CHB who were hospitalized and treated in The First Affiliated Hospital of Shanxi Medical University from December 2014 to October 2015 were enrolled as CHB group,and 20 healthy controls who underwent physical examination were enrolled HC group. According to the serum level of endotoxin( ET),the CHB group was further divided into ET-positive group and ET-negative group. The mRNA expression of Foxp3 and RORγt,percentages of Treg and Th17,serum level of alanine aminotransferase( ALT),and HBV DNA level in peripheral blood mononucleated cells were measured. The independent samples t-test was used for comparison of continuous data between any two groups,a one-way analysis of variance was used for comparison between multiple groups,and the SNK-q test was used for further comparison between any two groups; the chi-square test was used for comparison of categorical data between groups. Results Compared with the HC group,the CHB group showed significant increases in the percentages of Treg( 6. 51% ±1. 18% vs 5. 91% ± 1. 29%,P < 0. 05) and Th17( 4. 99% ± 1. 07% vs 4. 18% ± 0. 87%,P < 0. 05) and relative expression of Foxp3( 2. 12 ± 0. 83 vs 1. 60 ± 0. 70,P < 0. 05) and RORγt( 1. 56 ± 0. 77 vs 1. 09 ± 0. 59,P < 0. 05). Compared with the ET-negative group,the ET-positive group showed significant increases in the percentages of Treg( 6. 75% ± 1. 17% vs 6. 21% ± 1. 14%,P < 0. 05) and Th17( 5. 39% ± 1. 03% vs 4. 48% ± 0. 91%,P < 0. 05),relative expression of Foxp3( 2. 29 ± 0. 90 vs 1. 91 ± 0. 70,P < 0. 05) and RORγt( 1. 84 ± 0. 76 vs 1. 23 ± 0. 64,P < 0. 05),Th17 /Treg ratio( 0. 82 ± 0. 19 vs 0. 74 ± 0. 16,P < 0. 05),RORγt/Foxp3 ratio( 0. 95 ± 0. 38 vs 0. 74 ± 0. 54,P < 0. 05),and serum level of ALT( 220. 16 ± 115. 82 U / L vs 170. 86 ± 99. 69 U / L,P < 0. 05). The ET-positive group showed an increase in HBV DNA load compared with the ET-negative group,but there was no significant difference in HBV DNA load between the two groups. The correlation analysis showed that in CHB patients,ET was positively correlated with Th17,Treg,and ALT( r =0. 515、0. 438、0. 348,all P < 0. 05) and had no correlation with HBV DNA. Conclusion Intestinal endotoxemia in CHB patients may increase the mRNA expression of Foxp3 and RORγt and the percentages of peripheral Treg and Th17,cause Treg / Th17 imbalance,and thus result in difficult clearance of HBV and chronicity of HBV infection.
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