Effect of oxymatrine on specific cytotoxic T lymphocyte surface programmed death receptor-1 expression in patients with chronic hepatitis B

摘要

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≥104 copies/ml,positive HBeAg,positive human leukocyte antigen (HLA)-A2,alanine aminotransferase (ALT) ＞2×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％;x2=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％; x2=7.27,P＜0.01).Conclusion 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.