Observational Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 6, 2021; 9(7): 1619-1630
Published online Mar 6, 2021. doi: 10.12998/wjcc.v9.i7.1619
Elevated soluble 4-1BB is associated with serum markers of hepatitis B virus in patients with chronic hepatitis B
Meng-Ru Zhan, Xiu-Zhu Gao, Chang Wang, Fei Peng, Xiao-Mei Wang, Hong-Qin Xu, Jun-Qi Niu
Meng-Ru Zhan, Xiu-Zhu Gao, Chang Wang, Fei Peng, Xiao-Mei Wang, Hong-Qin Xu, Jun-Qi Niu, Department of Hepatology, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Xiu-Zhu Gao, Phase I Clinical Research Center, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
Author contributions: Niu JQ was the guarantor and designed the study; Zhan MR, Gao XZ and Peng F participated in the acquisition, analysis and interpretation of the data; Zhan MR drafted the initial manuscript; Wang C and Xu HQ revised the article critically for important intellectual content; All authors issued final approval for the version to be submitted.
Supported by Chinese Foundation for Hepatitis Prevention and Control—Tian-Qing Liver Disease Research Fund Subject, No. TQGB20200118.
Institutional review board statement: The study was reviewed and approved by the local medical ethics committee of the First Hospital of Jilin University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare no conflict of interest related to this article.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement— checklist of items, and the manuscript was prepared and revised according to the STROBE Statement— checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jun-Qi Niu, MD, PhD, Professor, Department of Hepatology, The First Hospital of Jilin University, No. 1 Xinmin Street, Changchun 130021, Jilin Province, China. junqiniu@jlu.edu.cn
Received: November 10, 2020
Peer-review started: November 10, 2020
First decision: December 8, 2020
Revised: December 13, 2020
Accepted: December 22, 2020
Article in press: December 22, 2020
Published online: March 6, 2021
Abstract
BACKGROUND

Previous studies have suggested that the costimulatory molecule 4-1BB plays pivotal roles in regulating immunity during chronic viral infection. However, up to now, there are few studies about 4-1BB in chronic hepatitis B (CHB).

AIM

To clarify this issue, we report our comprehensive study results on the expression levels of 4-1BB in patients with CHB.

METHODS

From September 2018 to June 2019, a total of 64 patients with CHB were recruited from the Department of Hepatology, The First Hospital of Jilin University. Peripheral blood samples were collected from 52 treatment-naïve and 12 entecavir-treated patients with CHB as well as 37 healthy donors (including 24 healthy adults and 13 healthy children). The levels of soluble 4-1BB (s4-1BB) in plasma were measured by ELISA. 4-1BB mRNA expression in peripheral blood mononuclear cells was detected by real-time quantitative PCR.

RESULTS

The s4-1BB levels in the plasma of patients with CHB were significantly higher than those in healthy adults (94.390 ± 7.393 ng/mL vs 8.875 ± 0.914 ng/mL, P < 0.001). In addition, the s4-1BB level in plasma was significantly increased in patients with a higher viral load and a disease flare up. However, there were no significant differences between treatment-naïve and entecavir-treated patients. Interestingly, among treatment-naïve patients with CHB, the levels of s4-1BB in plasma had a significant positive correlation with hepatitis B surface antigen, hepatitis B virus DNA, hepatitis B e antigen, and triglyceride levels (r = 0.748, P < 0.001; r = 0.406, P = 0.004; r = 0.356, P = 0.019 and r = -0.469, P = 0.007, respectively). The 4-1BB mRNA expression was higher in the peripheral blood mononuclear cells of patients with CHB than in the peripheral blood mononuclear cells of healthy adults, but the difference was not statistically significant.

CONCLUSION

These results suggest that the levels of s4-1BB may be associated with pathogenesis of hepatitis B virus and therefore may be a promising biomarker for disease progression.

Keywords: Hepatitis B virus, Hepatitis B, Chronic, 4-1BB, Soluble 4-1BB, Hepatitis B virus serum marker

Core Tip: Over 240 million people all round the world are chronically infected with hepatitis B virus, resulting in > 1 million deaths per year. Previous studies have suggested that the costimulatory molecule 4-1BB plays a pivotal role in regulating immunity during chronic viral infection. However, up to now, there is no study about 4-1BB expression in chronic hepatitis B to clarify the role of 4-1BB in the process of chronic hepatitis B clearly. Here, we report our comprehensive study on the expression levels of soluble 4-1BB in plasma and 4-1BB mRNA in peripheral blood mononuclear cells to further explain it.