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目的探讨HBV感染的外周血单个核细胞(peripheral blood mononuclear cells,PBMC)在乙肝宫内传播中的作用及机理。方法12例血清HBV DNA(-)、PBMC HBV DNA(+)产妇分娩的新生儿血清HBV DNA(+)和/或PBMC HBV DNA(+)的胎盘作为实验组,10例乙肝标志物均为阴性产妇的胎盘作为对照。采用SP法在连续切片上检测HBsAg和HBcAg在胎盘CD68细胞及各类细胞中的表达。结果8例新生儿血清HBV DNA(-)、PBMCsHBV DNA(+)胎盘绒毛间质5例CD68细胞HBsAg阳性,6例CD68细胞HBcAg阳性;毛细血管内5例CD68细胞HBsAg阳性,8例CD68细胞HBcAg阳性;滋养层细胞和血管内皮细胞均未见HBsAg、HBcAg阳性信号;2例新生儿血清HBV DNA(+)、PBMCs HBV DNA(-)的胎盘滋养层细胞、绒毛间质、毛细血管内皮细胞均有HBsAg、HBcAg的表达,而绒毛毛细血管内CD68细胞未见表达。2例新生儿血清和PBMC HBV DNA均阳性的的胎盘滋养层细胞、绒毛间质、CD68细胞和毛细血管内CD68细胞均有HBsAg、HBcAg的表达,毛细血管内皮细胞无表达。10例乙肝标志物全阴性产妇胎盘中均无阳性信号。结论HBV感染的外周血单个核细胞可作为宫内传播的载体。
Objective To investigate the role and mechanism of HBV-infected peripheral blood mononuclear cells (PBMC) in the intrauterine transmission of hepatitis B virus (HBV). Methods Placenta of serum HBV DNA (+) and / or PBMC HBV DNA (+) from 12 neonates with serum HBV DNA (-) and PBMC HBV DNA (+) was used as the experimental group. All 10 HBsAg markers were negative Maternal placenta served as a control. SP method was used to detect the expression of HBsAg and HBcAg in placental CD68 cells and various types of cells on serial sections. Results Serum HBV DNA (-), PBMCs HBV DNA (+) placenta villi stroma in 5 cases of CD68 cells HBsAg positive, 6 cases of CD68 cells HBcAg positive; 5 cases of capillary CD68 cells HBsAg positive, 8 cases of CD68 cells HBcAg Positive, trophoblast cells and vascular endothelial cells were no HBsAg, HBcAg positive signals; 2 neonates serum HBV DNA (+), PBMCs HBV DNA (-) of the placental trophoblast cells, villus stria, capillary endothelial cells There HBsAg, HBcAg expression, while villus capillary CD68 cells were not expressed. Two cases of placental trophoblast cells, villus stroma, CD68 cells and intracerebral CD68 cells were positive for HBsAg and HBcAg in both neonatal serum and PBMC HBV DNA, and no expression of capillary endothelial cells. None of the 10 cases of HBV markers showed negative signals in the all-negative maternal placenta. Conclusion HBV-infected peripheral blood mononuclear cells can be used as a carrier for intrauterine transmission.