慢性乙型肝炎患者应用恩替卡韦治疗血清及外周血单核细胞分泌IFN-γ、IL-17的变化  

Serum IFN-γ and IL-17 secreted by peripheral blood mononuclear cells in chronic hepatitis B patients during ETV therapy

作　　者：宋春辉[1] 杨斌[1] 石峰[1] 陈黎明[1] 

机构地区：[1]解放军第302医院,北京100039

出　　处：《军医进修学院学报》2010年第12期1191-1193,共3页Academic Journal of Pla Postgraduate Medical School

摘　　要：目的研究恩替卡韦(ETV)治疗慢性乙型肝炎患者过程中血清及外周血单核细胞(PBMC)分泌γ干扰素(IFN-γ)及白细胞介素17(IL-17)变化的意义。方法在应用ETV治疗的不同时间点抽取HBV感染患者静脉血,分离血清及单核细胞,检测血清中乙型肝炎病毒表面标志物(HBV-M)、乙型肝炎病毒核酸定量(HBV-DNA)、丙氨酸转移酶(ALT)以及血清中和分别应用抗-CD3、抗-CD28和HBcAg刺激的外周血单核细胞(PBMCs)分泌上清中的IFN-γ和IL-17。结果应用ETV治疗后患者ALT及HBV-DNA从4周开始出现明显下降,而血清中及外周血单核细胞分泌的IFN-γ也从4周开始出现明显下降。而血清中及外周血单核细胞分泌的IL-17在第4周出现明显升高,其后逐渐下降。结论 ETV早期抑制病毒复制,能够打破免疫耐受,造成IL-17分泌的升高,其后随着病毒的进一步抑制,IL-17分泌下降,降低机体分泌IFN-γ的能力,减轻炎症反应的同时也可能削弱机体清除病毒的能力。Objective To study the change of IFN-γsecreted by peripheral blood mononuclear cells（PBMC） and interleukin-17（IL-17） in chronic hepatitis-B patients during ETV therapy.Methods PBMC isolated from venous blood taken from HBV-infected patients at different time points of ETV therapy,were cultured with anti-CD3,anti-CD28 and HBcAg to stimulate secretion of IFN-γand IL-17 by PBMC.Serum HBV-M,ALT,HBV-DNA,and ALT levels were measured.Results The ALT,HBV-DNA,and IFN-γlevels in chronic hepatitis-B patients were significantly lower 4 weeks after ETV therapy.The serum IL-17 level in supernatant was significantly higher 4 weeks after ETV therapy and then gradually decreased.Conclusion Early ETV therapy can suppress HBV replication by reducing immune tolerance and increasing IL-17 secretion.With the further suppression of HBV,the IL-17 and IFN-γlevel is decreased,thus improving inflammation reactions in the liver.However,it may impair the ability of body to clear HBV.

关 键 词：恩替卡韦 血清 外周血单核细胞 Γ干扰素 白细胞介素17 

分 类 号：R446.6[医药卫生—诊断学]