medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2023-447medsovet-7953Research ArticleГАСТРОЭНТЕРОЛОГИЯGASTROENTEROLOGYСубпопуляционный состав Т-хелперов крови у больных гепатитом C с 1-м или 3-м генотипомSubpopulation composition of blood T-helpers in hepatitis C patients with genotype 1 or 3https://orcid.org/0000-0002-9980-2294ЦукановВ. В.TsukanovV. V.

Цуканов Владислав Владимирович - д.м.н., профессор, заведующий клиническим отделением патологии пищеварительной системы у взрослых и детей.

660022, Красноярск, ул. Партизана Железняка, д. 3г

Vladislav V. Tsukanov - Dr. Sci. (Med.), Professor, Head of the Clinical Department of the Digestive System Pathology of Adults and Children.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

gastro@impn.ruhttps://orcid.org/0000-0001-5829-672XСавченкоА. А.SavchenkoA. A.

Савченко Андрей Анатольевич - д.м.н., профессор, заведующий лабораторией клеточно-молекулярной физиологии и патологии.

660022, Красноярск, ул. Партизана Железняка, д. 3г

Andrei A. Savchenko - Dr. Sci. (Med.), Professor, Head of the Laboratory of Cellular and Molecular Physiology and Pathology.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

aasavchenko@yandex.ruЧерепнинМ. А.CherepninM. A.

Черепнин Михаил Александрович - младший научный сотрудник клинического отделения патологии пищеварительной системы у взрослых и детей.

660022, Красноярск, ул. Партизана Железняка, д. 3г

Mikhail A. Cherepnin - Junior Researcher of the Clinical Department of the Digestive System Pathology of Adults and Children.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

mikhail.cherepnin@yandex.ruhttps://orcid.org/0000-0002-6481-3196ВасютинА. В.VasyutinA. V.

Васютин Александр Викторович - к.м.н., старший научный сотрудник клинического отделения патологии пищеварительной системы у взрослых и детей.

660022, Красноярск, ул. Партизана Железняка, д. 3г

Alexander V. Vasyutin - Cand. Sci. (Med.), Senior Researcher of the Clinical Department of the Digestive System Pathology of Adults and Children, KSC of the Siberian Branch of RAS, SRI of Medical Problems of the North.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

alexander@kraslan.ruhttps://orcid.org/0000-0002-5988-1688КаспаровЭ. В.KasparovE. V.

Каспаров Эдуард Вильямович - д.м.н., профессор, директор НИИМП Севера; заместитель директора по научно-организационной работе, Красноярский научный центр Сибирского отделения РАН наук по научно-организационной работе.

660022, Красноярск, ул. Партизана Железняка 3г

Eduard V. Kasparov - Dr. Sci. (Med.), Professor, Director of the SRI of Medical Problems of the North; Deputy Director for Scientific and Organizational Work of the Krasnoyarsk Science Centre of the Siberian Branch of RAS.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

clinic@impn.ruhttps://orcid.org/0000-0003-2848-0846БеленюкВ. Д.BelenyukV. D.

Беленюк Василий Дмитриевич - к.м.н., младший научный сотрудник лаборатории молекулярно-клеточной физиологии и патологии.

660022, Красноярск, ул. Партизана Железняка, д. 3г

Vasiliy D. Belenyuk - Cand. Sci. (Med.), Junior Researcher of the Laboratory of Cellular and Molecular Physiology and Pathology.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

dyh.88@mail.ruhttps://orcid.org/0000-0001-7518-1895ТонкихЮ. Л.TonkikhJu. L.

Тонких Юлия Леонгардовна - к.м.н., ведущий научный сотрудник клинического отделения патологии пищеварительной системы взрослых и детей.

660022, Красноярск, ул. Партизана Железняка, д. 3г

Julia L. Tonkikh - Cand. Sci. (Med.), Leading Researcher of the Clinical Department of the Digestive System Pathology of Adults and Children.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

tjulia@bk.ruhttps://orcid.org/0000-0002-9026-2615БорисовА. Г.BorisovA. G.

Борисов Александр Геннадьевич - к.м.н., ведущий научный сотрудник лаборатории молекулярно-клеточной физиологии и патологии.

660022, Красноярск, ул. Партизана Железняка, д. 3г

Alexander G. Borisov - Cand. Sci. (Med.), Leading Researcher of the Laboratory of Cellular and Molecular Physiology and Pathology.

3g, Partizan Zheleznyak St., Krasnoyarsk, 660022

2410454@mail.ruКрасноярский научный центр Сибирского отделения Российской академии наук, Научно-исследовательский институт медицинских проблем СевераРоссияKrasnoyarsk Science Centre of the Siberian Branch of Russian Academy of Science, Scientific Research Institute of Medical Problems of the NorthRussian Federation202319012024023168176Copyright © Цуканов В.В., Савченко А.А., Черепнин М.А., Васютин А.В., Каспаров Э.В., Беленюк В.Д., Тонких Ю.Л., Борисов А.Г., 20242024Цуканов В.В., Савченко А.А., Черепнин М.А., Васютин А.В., Каспаров Э.В., Беленюк В.Д., Тонких Ю.Л., Борисов А.Г.Tsukanov V.V., Savchenko A.A., Cherepnin M.A., Vasyutin A.V., Kasparov E.V., Belenyuk V.D., Tonkikh J.L., Borisov A.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7953Введение

Введение. Несмотря на успехи в лечении, проблема хронического вирусного гепатита C (ХВГС) остается для России весьма актуальной. Существует дискуссия о том, какой генотип из наиболее часто встречающихся в нашей стране, 1-й или 3-й, имеет более агрессивное течение ХВГС. У больных ХВГС наблюдается дисфункция Т-клеточного иммунитета, многие аспекты которой остаются неясными.

Цель

Цель. Изучить субпопуляционный состав Т-хелперов крови у больных с 1-м и 3-м генотипами ХВГС в зависимости от выраженности клинико-морфологических проявлений.

Материалы и методы

Материалы и методы. Клиническое, лабораторное обследование и определение фиброза печени методом эластометрии по шкале METAVIR было проведено 297 пациентам с 1-м генотипом ХВГС, 231 лицам с 3-м генотипом ХВГС и 20 здоровым лицам контрольной группы. Исследование субпопуляционного состава Т-хелперов в крови методом проточной цитометрии (Navios, Beckman Coulter, USA) с определением маркеров CD3, CD4, CD45R0 и CD62L было проведено у 74 пациентов с 1-м генотипом ХВГС, у 70 лиц с 3-м генотипом ХВГС и у 20 человек контрольной группы.

Результаты

Результаты. Наивные Т-хелперы (СD3+CD4+СD45RO-CD62L+), Т-хелперы центральной (CD3+CD4+CD45R0+CD62L+) и эффекторной памяти (CD3+CD4+CD45R0+CD62L–) в крови снижались при увеличении выраженности фиброза и активности воспаления в печени в обеих обследованных группах. У больных с 3-м генотипом ХВГС содержание TEMRA Т-хелперов (CD3+CD4+CD45R0–CD62L–) в крови при указанных состояниях резко снижалось (критерий Краскэла – Уоллиса, p = 0,04 и p = 0,02 соответственно). У пациентов с 1-м генотипом ХВГС подобных закономерностей не регистрировалось (критерий Краскэла – Уоллиса, p = 0,8 и p = 0,87 соответственно).

Выводы

Выводы. Определена прямая зависимость ухудшения показателей субпопуляционного состава Т-хелперов крови у больных ХВГС при возрастании выраженности фиброза и активности воспаления в печени, которая имела некоторые отличия у пациентов с 1-м и 3-м генотипом.

Introduction

Introduction. Despite advances in treatment, the problem of chronic viral hepatitis C (CVHC) remains very relevant for Russia. There is a debate about which of the most common genotypes in our country: 1 or 3, has a more aggressive course of CVHC. Patients with CVHC exhibit dysfunction of T-cell immunity, many aspects of which remain unclear.

Aim

Aim. To research the subpopulation composition of blood T-helpers in patients with genotypes 1 and 3 of chronic viral hepatitis C (CVHC) depending on the severity of clinical and morphological manifestations.

Materials and methods

Materials and methods. Clinical, laboratory examination and determination of liver fibrosis by elastometry using the METAVIR scale were performed in 297 patients with CVHC genotype 1, 231 patients with CVHC genotype 3, and 20 healthy individuals in the control group. The study of the subpopulation composition of T-helpers in the blood by flow cytometry (Navios, Beckman Coulter, USA) with the determination of markers CD3, CD4, CD45R0 and CD62L was carried out in 74 patients with CVHC genotype 1, 70 patients with CVHC genotype 3 and 20 people in the control group.

Results

Results. Naive T-helpers (CD3+CD4+CD45RO-CD62L+), T-helpers of central (CD3+CD4+CD45R0+CD62L+) and effector memory (CD3+CD4+CD45R0+CD62L–) in the blood decreased with an increase in the severity of fibrosis and inflammation activity in the liver in both examined groups. In patients with CVHC genotype 3, the content of TEMRA T-helpers (CD3+CD4+CD45R0-CD62L-) in the blood under these conditions sharply decreased (Kruskal – Wallis test, respectively, p = 0.04 and p = 0.02). In patients with CVHC genotype 1, no such patterns were registered (Kruskal – Wallis test, respectively, p = 0.8 and p = 0.87).

Conclusion

Conclusion. A direct correlation was determined between the deterioration of the indicators of the blood T-helpers subpopulation composition with an increase in the severity of fibrosis and inflammation activity in the liver in patients with chronic hepatitis C, which had some differences in patients with genotypes 1 and 3.

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The authors declare that there are no conflicts of interest present.