[Clinical research on the treatment effect of autologous dendritic cell vaccine on the patients with chronic hepatitis B].
OBJECTIVE
To investigate the treatment effect of autologous HBsAg-loaded dendritic cells (DCs) on patients with chronic hepatitis B (CHB).


METHODS
Monocytes were isolated from fresh peripheral blood of 19 CHB patients by Ficoll-Hypaque density gradient centrifugating and cultured with plastic -adherence method. DCs were induced and proliferated from the monocytes with granulocyte-macrophage clony stimulating factor (GM-CSF) and interleukin-4 (IL-4) for seven days. After being incubated with HBsAg for two hours, DCs were injected to patients subcutaneously twice at the interval of two weeks. HBV DNA level, alanine aminotransferase (ALT) level, and HBV markers in the serum of patients were tested every two months.


RESULTS
11 of the 19 (57.9%) patients responded to DC-treatment clinically. The rates of HBeAg clearance and HBeAg/anti-HBe seroconversion were 52.6% (10/19) and 26.3% (5/19) respectively, and the copies of HBV DNA decreased by 10(1.77 2.39) (t = 3.13, P < 0.01). Two patients who were treated in combination with lamivudine had complete clinical response. There was no difference in the trial effect between the DC treatment and the other two antiviral methods, and in the efficient rate between the patients whose ALT levels were high before treatment and those whose ALT levels were normal.


CONCLUSIONS
The autologous HBsAg-loaded DCs can effectively suppress HBV replication, reduce virus load in serum, eliminate HBeAg and promote HBeAg/ anti-HBe seroconversion. The patients whose ALT levels are high or normal can response clinically to DCs treatment. DCs in combination with lamivudine can eliminate virus more effectively.
Li
Yong-guo
YG
Liver Disease Center of Chongqing, Second Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing 400010, China.
Chen
Min
M
Zhang
Da-zhi
DZ
Wang
Zhi-yi
ZY
Zeng
Wei-qun
WQ
Shi
Xiao-feng
XF
Guo
Yuan
Y
Guo
Shu-hua
SH
Ren
Hong
H
D000276:Adjuvants, Immunologic / Q000008:administration & dosage / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002478:Cells, Cultured; D003713:Dendritic Cells / Q000166:cytology / Q000276:immunology* / Q000821:virology; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000494:pharmacology; D006514:Hepatitis B Surface Antigens / Q000276:immunology*; D017325:Hepatitis B Vaccines / Q000096:biosynthesis / Q000627:therapeutic use*; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D015847:Interleukin-4 / Q000494:pharmacology; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D014779:Virus Replication / Q000187:drug effects
D000276:Adjuvants, Immunologic; D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens; D017325:Hepatitis B Vaccines; D015847:Interleukin-4; D019259:Lamivudine; D016178:Granulocyte-Macrophage Colony-Stimulating Factor