THE CORRELATION BETWEEN SMALL INTESTINAL BACTERIA OVERGROWTH AND DENDRITIC CELLS PHENOTYPE AND FUNCTION IN CIRRHOTIC PATIENTS WITH HEPATITIS B

Ying Jie

doi:10.15436/2471-0601.16.742

Abstract

Objective: To investigate the relationship between dendritic cells (DCs) and small intestinal bacteria overgrowth (SIBO) in cirrhotic patients with hepatitis B. Methods: Flow cytometry was used to analyze the phenotype of peripheral blood DCs in 47 cirrhotic patients with hepatitis B and 15 healthy controls. Small intestinal bacterial overgrowth was determined by lactulose hydrogen breath test (LHBT). A basal breath hydrogen >20 ppm or arise by >12 ppm above baseline following lactulose administration was taken as positive test. LHBT aggregate value, as another indicator to evaluate the growth of the small intestinal bacteria, is the sum of the LHBT within 90 min. Plasma total bilirubin and plasma albumin were measured in all subjects. Data analysis was using SPSS 17.0. Results: Of the 47 cirrhotics, 22 (46.8%) had SIBO, compared to healthy controls (6.7%; P= 0.005).The prevalence of SIBO increased with Child Pugh classification of cirrhosis (A18.2%, B 43.8% and C65.0%). The prevalence of SIBO in cirrhotic patients of Child Pugh class B and C was significantly higher than that of healthy controls (P=0.037; P=0.001). While the prevalence of SIBO in cirrhotic patients of Child Pugh class A was no statistically significant than that of healthy controls (P=0.556). The prevalence of SIBO in cirrhotic patients of de compensatory phase was significantly higher than that of compensatory phase (χ2 = 4.727, P=0.030). The plasma total bilirubin was positively correlated with LHBT aggregate value (r=0.907, P=0.000), While plasma albumin was negatively correlated (Ir= 0.810 P=0.000). The expressions of CD1a, CD80, CD83 on the surface of DCs in cirrhotic patients were all significant lower than that in healthy controls (P<0.05), while the expression of HLA DR was no statistically significant than that in healthy control. The expressions rate of CD80, CD83, CD1a and HLA DR on the DCs surface in SIBO positive cirrhotic patients were lower than those in SIBO negative [(17.22 ± 2.08) % vs (22.13 ± 2.34) %, (24.65 ± 1.47) % vs ( 34.52 ± 2.84) %, (14.05 ± 1.33) % vs (17.40 ± 3.22) %, (81.47 ± 7.56)% vs (70.15 ± 6.32) %; (P < 0.05)]. Conclusions: The prevalence of SIBO is correlated with severity of cirrhosis. The phenotype and function of peripheral blood DCs in cirrhotic patients with hepatitis B is associated with the presence of SIBO.

Highlights

dendritic cells (DCs) are sparsely, but widely distributed professional antigen presenting cells (APC)
The phenotype and function of peripheral blood DCs in cirrhotic patients with hepatitis B is associated with the presence of small intestinal bacteria overgrowth (SIBO)
The prevalence of SIBO and the severity of cirrhotic of the 47cirrhotics, 22 (46.8%) had SIBO, compared to healthy controls (6.7%; P = 0.005).The prevalence of SIBO increased with ChildP ugh classification of cirrhotic (A18.2%, B 43.8% and C65.0%)

Summary

Introduction

DCs are sparsely, but widely distributed professional antigen presenting cells (APC). The mature DCs slowly loss of the ability in capture, processing and deal with the antigen and obtain the ability presentation of antigens to T cells during immune response. Hepatitis B cirrhosis patients have different degrees, various forms of DCs anomalies. The study found that the number and functional of DCs decline and mature obstacles in patients with chronic hepatitis B, which lead to antigen presenting function of DCs defect. DCs couldn’t effectively present antigens to T cells during immune response. The research about the relationship between intestinal bacteria and DCs in cirrhotic patients with hepatitis B is rather little at present. We researched the correlation between small intestinal bacteria overgrowth and dendritic cells phenotype and function in cirrhotic patients with hepatitis B.

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Conclusion