Abstract:【Objective】To explore the value of Peripheral Blood Beclin1, LC3 and Th1/Th2 balance in predicting liver damage in patients with autoimmune hepatitis (AIH). 【Methods】A total of 91 AIH patients admitted to our hospital from April 2017 to June 2020 were selected as the research objects. According to whether liver damage occurred, they were divided into the liver function injured group (27 cases) and the liver function uninjured group (64 cases). The clinical characteristics of the two groups were compared and the levels of Beclin1, LC3, and Th1/Th2 balance in peripheral blood e that affected the occurrence of liver damage in AIH patients were analyzed. The area under the receiver operating characteristic (ROC) curve (AUC) value was used to evaluate the value of Beclin1,LC3 levels and Th1/Th2 balance in predicting liver function damage in AIH patients. 【Results】The levels of C-reactive protein (CRP), alanine aminotransferase (ALT), aspartate aminotransferase (AST), serum total bilirubin (TBIL), glutamyl transferase (GGT), alkaline phosphatase (ALP), immunoglobulin protein IgG, interferon-γ (INF-γ), Beclin1, LC3 and Th1/Th2 in the liver function injured group were all higher than those in the liver function uninjured group, while the level of interleukin-4 (IL-4) in the injured group was lower than that in the uninjured group (P<0.05). Logistic regression analysis showed that Beclin1, LC3 and Th1/Th2 were the influencing factors of liver damage in AIH patients (P<0.05). ROC curve analysis results showed that Beclin1, LC3, Th1/Th2 alone and the combined AUC of the three were 0.773, 0.844, 0.751 and 0.896, respectively. And the combined AUC of the three was the largest. 【Conclusion】 The levels of Beclin1 and LC3 in the peripheral blood of AIH patients are overexpressed, and the balance of Th1/Th2 tends to Th1. The combined detection of Beclin1, LC3 and Th1/Th2 has a better predictive value for AIH liver damage.
郝艳霞, 白红艳. 自身免疫性肝炎患者外周血Beclin1、LC3水平及Th1/Th2平衡预测肝功能损伤的价值[J]. 医学临床研究, 2022, 39(2): 183-186.
HAO Yan-xia, BAI Hong-yan. Value of Peripheral Blood Beclin1, LC3 and Th1/Th2 Balance in Predicting Liver Function Damage in Patients with Autoimmune Hepatitis. JOURNAL OF CLINICAL RESEARCH, 2022, 39(2): 183-186.
[1] SUCHER E.Autoimmune hepatitis-immunologically triggered liver pathogenesis-diagnostic and therapeutic strategies[J].J Immunol Res,2019,20(5):9437043.
[2] SEBODE M, HARTL J, VERGANIu D, et al. Autoimmune hepatitis: From current knowledge and clinical practice to future research agenda[J].Liver Int,2018,38(1):15-22.
[3] 罗羽鸥,杨晓玲,李川. HBV-ACLF患者血清Beclin1、 LC3-Ⅱ的达水平及其临床意义[J].标记免疫分析与临床,2020,27(4):586-590.
[4] BEHFARJAM F, SANATI M H, NASSERI M S, et al. Role of Th1/Th2 cells and related cytokines in autoimmune hepatitis[J].Turk J Gas,2017,28(2):110-114.
[5] 赵龙凤.肝病的现代诊断与治疗[M].北京:中国医药科技出版社, 2001:64.
[6] 崔娜娜,王绮夏. 《2019年美国肝病学会实践指引和指南:成人和儿童自身免疫性肝炎的诊断与治疗》摘译[J].临床肝胆病杂志,2020,36(4):758-763.
[7] GORDON V, ADHIKARY R, APPLEBY V, et al. Diagnosis, presentation and initial severity of Autoimmune Hepatitis (AIH) in patients attending 28 hospitals in the UK[J].Liver Int,2018,38(9):1686-1695.
[8] 汪永强,李显勇,杨琳,等. 自身免疫肝炎患者外周血PBMCs自噬基因表达及Th17/CD4+CD25+CD127lowTreg细胞与肝脏功能相关性研究[J].中国实验诊断学,2020,24(6):934.
[9] WU J, GUO Y, LU X, et al. Th1/Th2 Cells and Associated Cytokines in Acute Hepatitis E and Related Acute Liver Failure[J].J Immunol Res,2020,2020(12):6027361.
[10] 李巧利,徐芸,保洁,等. 自身免疫性肝炎患者65例外周血T细胞、Th1/Th2比值及肝功能检测分析[J].医药论坛杂志,2019,40(10):89-92.
[11] LIANG M, LIWEN Z, YUN Z, et al. The Imbalance between Foxp3(+)Tregs and Th1/Th17/Th22 Cells in Patients with Newly Diagnosed Autoimmune Hepatitis[J].J Immunol Res,2018,37(5):30-38.
[12] DORING T, ZEYEN L, BARTUSCH C, et al. Hepatitis B Virus Subverts the Autophagy Elongation Complex Atg5-12/16L1 and Does Not Require Atg8/LC3 Lipidation for Viral Maturation[J].J Virol,2018,92(7):113.
[13] YANG Z. Autophagy in autoimmune disease[J].J Mol Med (Berl),2015,93(7):707-717.
[14] 陈崇高,符厚萱,王小智,等. Beclin1及miRNA-130a与HBV相关慢加急性肝衰竭患者预后的相关性[J].肝脏,2021,26(2):125-127.