Published online Dec 28, 2014. doi: 10.3748/wjg.v20.i48.18354
Revised: June 8, 2014
Accepted: July 11, 2014
Published online: December 28, 2014
Processing time: 260 Days and 12 Hours
AIM: To investigate T helper 17/regulatory T cell alterations in early severe hepatitis B and the effect of glucocorticoids.
METHODS: The study included 20 patients in the early stage of severe hepatitis B (SHB) and 11 healthy controls. All patients had elevated T helper 17 (Th17) levels, decreased regulatory T (Treg) cell levels, and significant Th17/Treg ratios.
RESULTS: After glucocorticoid treatment, 16 patients showed improvement with significant decreases in Th17 levels, increases in Treg, and rebalanced Th17/Treg ratios. The four patients who showed no improvement had increases in both Th17 and Treg levels and an even higher Th17/Treg ratio than before.
CONCLUSION: Glucocorticoid treatment can rectify Th17/Treg dysregulation in patients with SHB.
Core tip: Severe hepatitis B (SHB) is a fast progressing form of hepatitis infection with a low eradication rate. Patients with SHB have dysregulated ratios of T helper cells, observed as elevated levels of T helper 17 cells and reduced regulatory T cells. This study demonstrates that these levels can be rebalanced with glucocorticoid treatment. However, failure to rectify the imbalance likely will results in the progression of SHB and eventually cause death.