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作 者:邢同京[1] 章廉[1] 卢桥生[1] 侯金林[1] 冯筱榕[1] 骆抗先[1]
机构地区:[1]第一军医大学南方医院感染内科,广州510515
出 处:《Chinese Medical Journal》2001年第9期25-28,104,共5页中华医学杂志(英文版)
摘 要:Objective To investigate the relationship between the expression of Th1/Th2 type cytokines and the effect of interferon-α therapy. Methods Th1/Th2 type cytokines were assayed by enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) on 23 patients with chronic hepatitis B who were treated with interferon-α.Results Levels of IFN-γ in the supernatant of peripheral blood mononuclear cells (PBMC) cultures from the patients with hepatitis B were slightly lower than those of controls (P=0.07). However, the levels of IL-4 were higher than those of controls (P=0.01). Cytokines measurements during IFN-α treatment showed a trend to decreaseing levels of IL-4 at 4, 12, and 24 weeks. Levels of IFN-γ were slightly increased following IFN-α treatment (P=0.09). In patients with a complete response to IFN-α, the levels of IFN-γ were higher at 24 weeks following IFN-α treatment than that of pre-treatment (P=0.04), and the levels of IL-4 decreased markedly at 12 and 24 weeks (P=0.02, 0.03, respectively). mRNA expression positively correlated with the level of Th1/Th2 type cytokines in the supernatant. Conclusion The expression of Th2 type cytokines is predominant in patients with chronic hepatitis B. Interferon-α therapy can modulate the balance of Th1/Th2 type cytokines, and this is related to its clinical effect. Levels of Th1/Th2 type cytokines could be a predictor of clinical response during Interferon -α treatment.目的 探讨干扰素α的疗效是否与调节Th1/Th2细胞因子的表达有关 ,并以此作为预测干扰素α疗效指标的可能性。方法 采用双抗体夹心法和逆转录PCR方法 ,对应用干扰素治疗的 2 3例慢性乙型肝炎患者外周血淋巴细胞中Th1/Th2细胞因子的表达水平进行动态检测。结果 与正常对照组比较 ,慢性乙肝患者外周血淋巴细胞培养上清液中的IFN γ水平较低 ,但无明显差异 ;IL 4水平则升高 ,差异有显著性。其外周血淋巴细胞中的mRNA表达水平亦如此。与治疗前比较 ,干扰素α治疗后 3和 6个月 ,在完全应答的患者中 ,IL 4水平下降 ;而IFN γ水平在 6个月时升高 ,差异均有显著性。结论 (1)慢性乙肝患者的外周血淋巴细胞中细胞因子表达可能以Th2类占优势。 (2 )慢性乙型肝炎患者的外周血淋巴细胞中Th1/Th2细胞因子的表达水平与干扰素α的疗效密切相关。 (3)通过检测Th1/Th2细胞因子的变化 ,可以预测患者对干扰素α治疗的反应 ,对及时判断干扰素α治疗效果有一定作用。
关 键 词:chronic hepatitis B · Th1/Th2 type response · interferon α
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