Expression of nuclear factor-kappa B and inducible nitric oxide synthase in peripheral blood mononucleated cells and immune status in patients with different stages of chronic hepatitis B

Objective To investigate the expression of nuclear factor-kappa B( NF-κB) and inducible nitric oxide synthase( iNOS) in peripheral blood mononucleated cells( PBMCs) of patients with different stages of chronic hepatitis B( CHB),as well as the changes in natural killer( NK),T,and B lymphocytes in each stage. Methods A total of 80 patients with CHB-related diseases who were admitted to Nanping First Hospital Affiliated to Fujian Medical University from October 2017 to January 2019 were enrolled and divided into four groups according to disease stage: hepatitis group,liver failure group,liver cirrhosis group,and liver cancer group,with 20 patients in each group,and ten healthy volunteers were enrolled as control group. Flow cytometry was used to measure total lymphocyte count as well as the counts of lymphocyte subsets in peripheral blood in all five groups,Western blot was used to measure the protein expression of NF-κB and iNOS in PBMCs,and the nitrate reductase method and ELISA were used to measure the serum levels of nitric oxide( NO) and interleukin-6( IL-6). A one-way analysis of variance was used for comparison between multiple groups,and the least significant difference t-test was used for further comparison between two groups. Results Compared with the control group,the hepatitis group,the liver failure group,the liver cancer group,and the liver cirrhosis group had a significant reduction in total lymphocyte count( all P < 0. 05),and compared with the hepatitis group,the liver failure group,the liver cancer group,and the liver cirrhosis group had a significant reduction in total lymphocyte count( all P < 0. 05). The liver failure group,the liver cancer group,and the liver cirrhosis group had a significant reduction in CD3+T cells compared with the control group and the hepatitis group( all P < 0. 05),as well as a significant reduction in CD4+T cells compared with the hepatitis group( all P < 0. 05); the liver failure group had a significant increase in CD8+T cells compared with the liver cancer group,the liver cirrhosis group,and the control group( all P < 0. 05); the liver failure group had a significant reduction in CD4+/CD8+compared with the control group,the hepatitis group,the liver cirrhosis group,and the liver cancer group( all P < 0. 05); the liver failure group and the liver cirrhosis group had a significant increase in CD3-CD19+B cells compared with the hepatitis group and the control group( all P < 0.05); the liver failure group and the liver cancer group had a significant reduction in CD16+CD56+NK cells compared with the hepatitis group and the control group( all P < 0. 05). The liver cirrhosis group,the liver failure group,and the liver cancer group had significant increases in the protein expression of NF-κB and iNOS compared with the hepatitis group and the control group( all P < 0. 05). Compared with the control group,the liver failure group,the liver cancer group,the liver cirrhosis group,and the hepatitis group had significant increases in the serum levels of NO and IL-6( all P < 0. 05). Conclusion There are certain differences in immune status between patients with different stages of HBV infection,and NF-κB-iNOS-NO may be involved in the immune response of HBV-related diseases.