title: Effect of oxymatrine on specific cytotoxic T lymphocyte surface programmed death receptor-1 expression in patients with chronic hepatitis B.
abstract: BACKGROUND
  Oxymatrine has certain antiviral effects in the treatment of chronic hepatitis B (CHB), but its exact mechanism is unclear. The objective of the present study was to explore oxymatrine's antiviral mechanism by studying its effect on the hepatitis B virus (HBV) specific cytotoxic T lymphocyte (CTL) surface programmed death receptor-1 (PD-1) expression in CHB patients.
  
  
  METHODS
  Sixty-five CHB patients who had HBV DNA(3)10(4) copies/ml, positive HBeAg, positive human leukocyte antigen (HLA)-A2, alanine aminotransferase (ALT) > 2 x upper limit of normal value (ULN) were randomly divided into two groups: treatment group (n = 33), treated with an intravenous infusion of 600 mg oxymatrine in glucose solution once a day for a month, then with a 200 mg oxymatrine oral capsule three times a day, and a 200 mg silibin meglumine tablet three times a day; control group (n = 32) patients were treated only with silibin meglumine tablet, method and dosage were the same as those of treatment group. Three months later, peripheral blood HBV-specific CTL surface PD-1 expression, HBV-specific CTL level, HBV DNA, HBeAg, and results of liver function tests were analyzed and compared.
  
  
  RESULTS
  Three months post-treatment, in the treatment group, peripheral blood HBV-specific CTL surface PD-1 expression ((19.42 ± 15.94)%) decreased significantly compared to the pretreatment level ((31.30 ± 24.06)%; P < 0.05), and decreased significantly compared to that of control group three months after treatment ((29.45 ± 21.62)%; P < 0.05). HBV-specific CTL level ((0.42 ± 0.07)%) significantly increased compared with the pretreatment ((0.29 ± 0.15)%; P < 0.01), and the control group posttreatment level was (0.31 ± 0.15)% (P < 0.05). HBV DNA level in 11 cases became negative (HBV DNA < 500 copies/ml, 33.33%), which was higher than that of the control group after treatment (two cases, 6.25%; χ(2) = 7.45, P < 0.01), HBeAg of nine cases turned negative (27.27%), which was higher than that of the control group after treatment (one case, 3.13%; χ(2) = 7.27, P < 0.01).
  
  
  CONCLUSIONS
  Oxymatrine could downregulate peripheral blood HBV-specific CTL surface PD-1 expression in CHB patients, increase HBV-specific CTL level, which may be one of the possible mechanisms by which oxymatrine clears or inhibits HBV in CHB patients.
authors.affiliation: Department of Hepatology, Wuxi Hospital for Infectious Diseases, Wuxi, Jiangsu 214005, China. gxb188681@sina.com
authors.forename: Xi-bing
authors.initials: XB
authors.lastname: Gu
authors.forename: Xiao-juan
authors.initials: XJ
authors.lastname: Yang
authors.forename: Zhong
authors.initials: Z
authors.lastname: Hua
authors.forename: Zhong-hua
authors.initials: ZH
authors.lastname: Lu
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.forename: Yin-fang
authors.initials: YF
authors.lastname: Zhu
authors.forename: Hang-yuan
authors.initials: HY
authors.lastname: Wu
authors.forename: Yi-ming
authors.initials: YM
authors.lastname: Jiang
authors.forename: Hao-kun
authors.initials: HK
authors.lastname: Chen
authors.forename: Hao
authors.initials: H
authors.lastname: Pei
mesh_terms: D000328:Adult; D000470:Alkaloids / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006515:Hepatitis B virus / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000188:drug therapy* / Q000276:immunology; D006801:Humans; D008297:Male; D008875:Middle Aged; D061026:Programmed Cell Death 1 Receptor / Q000032:analysis*; D011807:Quinolizines / Q000627:therapeutic use*; D013602:T-Lymphocytes, Cytotoxic / Q000737:chemistry*; D000093842:Matrines
chemical_list: D000470:Alkaloids; D000998:Antiviral Agents; D004279:DNA, Viral; D061026:Programmed Cell Death 1 Receptor; D011807:Quinolizines; C105992:PDCD1 protein, human; C037573:oxymatrine; D000093842:Matrines