Compartmentalization and its implication for peripheral immunologically-competent cells to the liver in patients with HBV-related acute-on-chronic liver failure.
OBJECTIVE
This study attempts to characterize the feature of immunologically competent cells (ICCs) and evaluate its clinical implication in patients with acute-on-chronic liver failure (ACLF) in relation to chronic hepatitis B virus (HBV) infection.


METHODS
Circulating ICCs were examined in ACLF patients (n = 75), as well as in patients with hepatitis B (CHB, n = 31), CHB-related liver cirrhosis (LC, n = 36), and normal controls (NC, n = 30). Intrahepatic ICCs in some patients were further analyzed via immunohistochemical and flow cytometric assays.


RESULTS
Total lymphocytes, CD4(+) T cells, CD8(+) T cells, and NK cells in circulation were numerically lower in the ACLF and LC groups compared to the CHB and NC groups. Importantly, the number of these cells was significantly lower in non-surviving ACLF patients compared with surviving ACLF patients. In comparison to NC, ACLF patients displayed a significantly higher ratio of liver-infiltrating CD4(+) T-cell frequency than its circulating counterpart, suggesting that the possiblility of the ICCs compartmentalization from the peripheral blood into the liver in ACLF. Immunohistochemical analysis showed that intrahepatic CD4(+) cells, CD8(+) cells, and CD56(+) cells were significantly higher in the ACLF group compared with the other three groups, suggesting a stronger cellular immune response-mediated inflammation in ACLF group than other patient groups.


CONCLUSIONS
The abnormal prevalence of circulating and intrahepatic ICCs possibly acts as an important factor that may drive the progression of HBV-related ACLF.
Beijing 302 Hospital, Beijing Institute of Infectious Diseases, eijing 302 Hospital, 100 Xi Si Huan Middle Road, Beijing 100039, China.
Zhengsheng
Z
Zou
Dongping
D
Xu
Baosen
B
Li
Shaojie
S
Xin
Zheng
Z
Zhang
Lei
L
Huang
Junliang
J
Fu
Yongping
Y
Yang
Lei
L
Jin
Jing-Min
JM
Zhao
Ming
M
Shi
Guangde
G
Zhou
Yanling
Y
Sun
Fu-Sheng
FS
Wang