Expression of myeloid-derived suppressor cells in peripheral blood in patients with HBV-related acute-on-chronic liver failure

Objective To investigate clinical significance of myeloid-derived suppressor cells(MDSCs) in peripheral blood in the progression of HBV-related acute-on-chronic liver failure(HBV-ACLF). Methods Totally 45 HBV-ACLF patients, 34 pa- tients with chronic hepatitis B(CHB) and 25 healthy controls(HC) were enrolled in the study. Flow cytometry was applied to detect the frequencies of MDSCs in peripheral blood. HBV-ACLF patients were given a three-week follow-up, and were divided into an improved group and an ineffective group according to the clinical efficacy. The changes of the frequencies of MDSCs in peripheral blood in the improved group and the ineffective group were observed dynamically. Results The frequencies of MDSCs in peripheral blood in HBV-ACLF group(1.53% ±1.15%) were significantly higher than those in CHB group(0.92% ±0.46%) and those in HC group(0.91%±0.47%)(P0.01). The frequency of MDSCs in peripheral blood in HBV-ACLF group was positively correlated with TBIL(r=0.434, P=0.003), CRE(r=0.343, P=0.021), international normalized ratio(INR)(r=0.505, P=0.000), model for end-stage liver disease(MELD) score(r=0.528, P=0.000) and MELD-Na score(r=0.451, P=0.002), and had a multiple linear relationship with INR and TBIL(the regression model: =-0.781+0.623×INR+0.003×TBIL). The HBV-ACLF patients who died within 3 weeks had higher frequencies of MDSCs in peripheral blood(2.09%±1.51%) than the improved group(1.15%±0.56%) and the ineffective group(1.17%±0.70%)(P0.05). The frequencies of MDSCs in peripheral blood had a weak rank correlation with the prognosis of the pa- tients(r=0.309, P=0.039). The follow-up showed the frequencies of MDSCs in peripheral blood were not significantly different in the improved group and the ineffective group. Conclusions The frequency of MDSCs in peripheral blood in HBV-ACLF patients in- creases significantly. It is correlated with the prognosis of HBV-ACLF patients. The higher the frequency of MDSCs in peripheral blood is, the poorer prognosis the HBV-ACLF patients have.