Evidence-Based Medicine
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World J Gastroenterol. Dec 28, 2014; 20(48): 18354-18359
Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18354
T helper cell dysregulation with hepatitis B and rebalance with glucocorticoids
Zhong-Hua Lu, Xiao-Ping Huang, Wei Sun, Yi-Ling Zhu, Juan-Juan Cui, Wei Chen, Li-Hua Huang, Shou-Gang Kuai, He-Juan Du, Zhao-Xia Ju, Jian-He Gan
Zhong-Hua Lu, Xiao-Ping Huang, Wei Sun, Yi-Ling Zhu, Juan-Juan Cui, Jian-He Gan, Department of Infectious Disease, The First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Zhong-Hua Lu, Wei Chen, Li-Hua Huang, Shou-Gang Kuai, He-Juan Du, Zhao-Xia Ju, Department of Liver Disease, Wuxi No. 5 People’s Hospital Affiliated to Jiangnan University, Wuxi 214005, Jiangsu Province, China
Author contributions: Gan JH and Lu ZH designed the research; Huang XP, Sun W, Zhu YL, Cui JJ, Chen W, Huang LH, Kuai SG and Ju ZX performed the research; Du HJ analyzed data; and Lu ZH wrote the paper.
Supported by 12th 5-year Plan National Science and Technology Key Project of China, No. 2012ZX10002-004
Correspondence to: Jian-He Gan, Professor, Chief, Department of Infectious Disease, The First Affiliated Hospital of Soochow University, No. 188 Shizi Street, Suzhou 215006, Jiangsu Province, China. ganjianhe@aliyun.com
Telephone: +86-510-80219555 Fax: +86-510-68918000
Received: April 8, 2014
Revised: June 8, 2014
Accepted: July 11, 2014
Published online: December 28, 2014
Abstract

AIM: To investigate T helper 17/regulatory T cell alterations in early severe hepatitis B and the effect of glucocorticoids.

METHODS: The study included 20 patients in the early stage of severe hepatitis B (SHB) and 11 healthy controls. All patients had elevated T helper 17 (Th17) levels, decreased regulatory T (Treg) cell levels, and significant Th17/Treg ratios.

RESULTS: After glucocorticoid treatment, 16 patients showed improvement with significant decreases in Th17 levels, increases in Treg, and rebalanced Th17/Treg ratios. The four patients who showed no improvement had increases in both Th17 and Treg levels and an even higher Th17/Treg ratio than before.

CONCLUSION: Glucocorticoid treatment can rectify Th17/Treg dysregulation in patients with SHB.

Keywords: Severe hepatitis B, T helper 17 cell, Regulatory T cell, Dysregulation, Glucocorticoid

Core tip: Severe hepatitis B (SHB) is a fast progressing form of hepatitis infection with a low eradication rate. Patients with SHB have dysregulated ratios of T helper cells, observed as elevated levels of T helper 17 cells and reduced regulatory T cells. This study demonstrates that these levels can be rebalanced with glucocorticoid treatment. However, failure to rectify the imbalance likely will results in the progression of SHB and eventually cause death.