Objective: To investigate the expression of programmed death-1 (PD-1) in liver tissue and its association with liver pathology in patients with autoimmune hepatitis (AIH). Methods: A total of 54 AIH patients (38 in the active stage and 16 in the remission stage) were enrolled, and 9 healthy volunteers were enrolled as control group. Immunohistochemistry combined with quantitative image analysis was used to measure the expression of PD-1 in liver tissue. The t-test, rank sum test, one-way analysis of variance, least significant difference t-test, Mann-Whitney U test, and Pearson relation analysis were used for statistical analysis of different types of data. Results: The AIH group had a significantly higher positive rate of PD-1 in liver tissue than the control group (13.57%±6.84% vs 2.22%±0.66%, P < 0.01), and the patients in the active stage of AIH had a significantly higher positive rate of PD-1 in liver tissue than those in the remission stage (16.53%±7.72% vs 6.56%±3.16%, P < 0.01). The positive rate of PD-1 in liver tissue was 6.56%±3.16% in G0 group, 14.33%±5.08% in G1-2 group, and 19.23%±5.41% in G3-4 group (P < 0.01), but there was no significant difference in the positive rate of PD-1 between S0, S1-2, and S3-4 groups (P > 0.05). In AIH patients, the positive rate of PD-1 in liver tissue was positively correlated with the levels of total bilirubin, alanine aminotransferase, aspartate aminotransferase, and IgG (r = 0.665, 0.721, 0.711, and 0.813, all P < 0.01). Conclusion: AIH patients have regulated PD-1 expression in liver tissue, which is closely associated with liver inflammation and is not associated with fibrosis degree, suggesting that PD-1 is involved in the development and progression of inflammation in AIH patients.
目的： 研究自身免疫性肝炎（AIH）患者肝组织中程序性死亡受体1（PD-1）的表达情况，并探讨其与肝脏病理的相关性。 方法： 收集54例AIH患者（活动期38例和缓解期16例），并选择9例健康者为对照组。采用免疫组织化学方法结合图像定量分析系统检测肝组织中PD-1的表达。据资料不同分别采用t检验、秩和检验、单因素方差分析及LSD-t检验、Mann-Whitney U及Pearson相关分析进行统计学分析。 结果： AIH患者肝组织PD-1阳性表达率高于对照组（13.57%±6.84%对比2.22%±0.66%，P < 0.01）；AIH活动期肝组织PD-1阳性表达率高于缓解期（16.53%±7.72%对比6.56%±3.16%，P < 0.01）。G0组、G1～2组及G3～4组AIH患者肝组织中PD-1阳性表达率逐渐升高，分别为6.56%±3.16%、14.33%±5.08%、19.23%±5.41%（P < 0.01），而S0组、S1～2组及S3～4组AIH患者肝组织中PD-1阳性表达率则无差异（P > 0.05）。AIH患者肝组织PD-1阳性表达率与总胆红素、丙氨酸氨基转移酶、天冬氨酸氨基转移酶及IgG水平均呈正相关（r分别是0.665、0.721、0.711、0.813，P < 0.01)。 结论： AIH患者肝组织PD-1表达上调，与肝组织炎症活动密切相关，但与纤维化分级无相关性，提示PD-1参与了AIH炎症的发生及发展。.
Keywords: Autoimmune hepatitis; Liver pathology; Programmed cell death receptor 1.