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Host Immunological Effects of Partial Splenic Embolization in Patients with Liver Cirrhosis

机译:肝硬化患者部分脾栓塞的宿主免疫学作用

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Purpose. Restoration of the balance between T lymphocyte subsets and between Th1/Th2 cytokines together with improvement of antitumor immunity has been reported after hepatosplenectomy in patients with liver cirrhosis (LC) and hepatocellular carcinoma (HCC). However, the detailed effects of partial splenic embolization (PSE) on host immunity are unknown. Accordingly, this study evaluated host immunity in patients with cirrhosis receiving PSE for thrombocytopenia. Methods. Twenty-three adult Japanese patients with cirrhosis and thrombocytopenia underwent PSE using straight coils at our hospital between 2010 and 2015. Blood samples were collected before PSE and 4 weeks after PSE. Results. The platelet counts were significantly higher 4 weeks after PSE compared with before PSE. The white blood cell count (neutrophils, lymphocytes, and monocytes) also increased significantly after PSE. Furthermore, Th1 cells and Th2 cells showed a significant increase at 4 weeks after PSE compared with before PSE, although there was no significant change of Treg cells. Moreover, serum levels of TNF-alpha, soluble TNF receptor I, and soluble Fas were significantly increased after PSE. There was no significant change of the Child-Pugh score. Conclusions. In patients with cirrhosis and thrombocytopenia, PSE not only promoted the recovery of leukopenia and thrombocytopenia but also induced activation of host immunity.
机译:目的。肝硬化(LC)和肝细胞癌(HCC)患者肝脾切除术后,已恢复了T淋巴细胞亚群之间和Th1 / Th2细胞因子之间的平衡,并提高了抗肿瘤免疫力。但是,尚不完全脾栓塞(PSE)对宿主免疫的影响。因此,本研究评估了接受PSE的血小板减少症的肝硬化患者的宿主免疫力。方法。在2010年至2015年之间,对23例日本成人肝硬化和血小板减少症患者进行了直线线圈PSE检查。在PSE之前和PSE后4周采集血液样本。结果。 PSE后4周的血小板计数明显高于PSE前。 PSE后白细胞计数(中性粒细胞,淋巴细胞和单核细胞)也显着增加。此外,尽管Treg细胞没有显着变化,但与PSE前相比,PSE后第4周Th1细胞和Th2细胞显着增加。此外,PSE后血清TNF-α,可溶性TNF受体I和可溶性Fas水平显着增加。 Child-Pugh得分没有明显变化。结论。在肝硬化和血小板减少症患者中,PSE不仅可以促进白细胞减少症和血小板减少症的恢复,还可以诱导宿主免疫力的激活。

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