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Bushen Formula promotes the decrease of HBsAg levels in patients with CHB by regulating Tfh cells and B-cell subsets.

Longshan Ji1, Jinghan Wei1, Rongjie Zhang1

  • 1Laboratory of Cellular Immunity, Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Key Laboratory of Liver and Kidney Diseases (Shanghai University of Traditional Chinese Medicine), Ministry of Education, Shanghai, 201203, China.

Journal of Ethnopharmacology
|March 20, 2024
PubMed
Summary

Bushen Formula (BSF) enhances chronic hepatitis B (CHB) treatment outcomes, particularly in patients previously treated with Peg-IFN-α. This traditional Chinese medicine modulates immune responses by promoting Tfh and B-cell interactions via the IL-21/IL-21R pathway.

Keywords:
B-cellBushen formulaChronic hepatitis BFollicular helper T cellsHBsAg

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Area of Science:

  • Immunology
  • Pharmacology
  • Hepatology

Background:

  • Bushen Formula (BSF) is an effective traditional Chinese medicine (TCM) for chronic hepatitis B (CHB).
  • Previous research highlights BSF's efficacy, but its effectiveness across different CHB stages and immunomodulatory mechanisms require further investigation.

Purpose of the Study:

  • To compare the therapeutic effects of BSF in treatment-naive and Peg-IFN-α-treated CHB patients.
  • To explore the potential immunomodulatory mechanisms of BSF in CHB treatment.

Main Methods:

  • A retrospective study of 266 CHB patients treated with BSF plus Peg-IFN-α or Peg-IFN-α monotherapy.
  • Analysis of serum HBV markers, HBV DNA, ALT/AST, TCM symptoms, peripheral follicular helper T (Tfh) cells, and B-cell subtypes.
  • Bioinformatics analysis and in vitro co-culture systems were used to investigate immunoregulatory mechanisms.

Main Results:

  • BSF combined with Peg-IFN-α significantly improved HBsAg decline and HBeAg seroclearance rates compared to Peg-IFN-α monotherapy, especially in previously treated patients.
  • BSF treatment increased Tfh cell frequencies and IL-21 levels, and enhanced IL-21R expression on B-cells.
  • In vitro studies showed BSF reduced HBsAg and HBeAg levels and modulated Tfh and B-cell populations.

Conclusions:

  • BSF demonstrates superior efficacy in improving serological markers for CHB, particularly in patients undergoing Peg-IFN-α therapy.
  • The immunoregulatory mechanism of BSF involves enhancing Tfh and B-cell interactions through the IL-21/IL-21R signaling pathway.