慢性丙型肝炎肝组织HCV特异性CTL活性对干扰素应答效果的影响  

Relationship between intrahepatic HCV-specific CTL activity and response to interferon therapy in chronic hepatitis C

作　　者：唐小平[1] 许毅玲 袁小珍[1] 姚集鲁[3] 

机构地区：[1]广州市第八人民医院传染病研究所,广州510060 [2]美国佛罗里达大学医学院肝病研究所 [3]中山医科大学第三附属医院传染科

出　　处：《中华实验和临床病毒学杂志》2001年第4期352-354,共3页Chinese Journal of Experimental and Clinical Virology

基　　金：广东省自然科学基金 (2 0 0 0 14 63 );广东省重点科技攻关项目 (2km0 5 3 0 3s);广东省医学科研基金 (A2 0 0 0 5 91);广州市重点科技攻关项目 (2 0 0 0 Z 10 7 0 4)联合资助

摘　　要：目的　了解肝组织丙型肝炎病毒 (HCV)特异性细胞毒性T淋巴细胞 (CTL)活性对慢性丙型肝炎患者干扰素治疗效果的影响。方法　用标准铬释放法对 45例拟接受α干扰素治疗的慢性丙型肝炎 (慢丙肝 )患者肝组织CD8+ HCV特异性细胞毒性T淋巴细胞 (HCV CTL)活性进行检测 ,观察CTL活性与干扰素疗效的关系。结果　 45例慢丙肝中 2 0例 (4 4 4% )肝组织HCV CTL活性阳性。在完成干扰素治疗的 42例中 ,19例HCV CTL活性阳性。经过 6个月的干扰素治疗 ,42例中共 18例(4 2 9% )获得治疗终点完全应答 (ETR) ;停药后随访 6～ 12个月 ,共 10例 (2 3 8% )呈持续应答 (SR)。19例HCV CTL活性阳性患者中 15例 (78 9% )为ETR ,而 2 3例HCV CTL活性阴性患者仅 3例(13 0 % )为ETR(P <0 0 1) ;10例持续应答者均为HCV CTL活性阳性患者。结论　机体细胞免疫 ,尤其是CD8+ HCVObjective To study the relationship between intrahepatic hepatitis C virus\|specific cytotoxic T lymphocyte (HCV\|CTL) activity and response to interferon (IFN) therapy in chronic hepatitis C.Methods 45 patients with chronic hepatitis C who received IFN\|α therapy were evaluated for HCV\|specific CTL in the liver before treatment with standard chromium release assay. The relationship between treatment response and HCV\|CTL activity was analyzed. Results HCV\|CTL activity was detected in 20(44 4%) of the 45 IFN\|treated patients. Of the 42 patients who completed a 6\|month course therapy, 19 had detectable HCV\|CTL activity, 23 had no detectable HCV\|CTL activity. After 6 months of IFN therapy, 18 of 42(42 9%) patients received an end\|of\|treatment complete response (ETR).After 6～12 months of follow\|up, 10 patients (23 8%) had a sustained response (SR). Of the 19 patients with detectable HCV\|CTL activity, 15 (78 9%) developed an ETR. In contrast, only 3 of the 23 patients with no detectable HCV\|CTL activity developed an ETR to IFN( P< 0 01). All the 10 patients who got a sustained response were those with detectable HCV\|CTL activity. Conclusion The host immune response, particularly that mediated by CD8\++ HCV\|CTL, may be very important in determining the outcome of IFN therapy for the patients with chronic hepatitis C.

关 键 词：丙型肝炎病毒 肝 T淋巴细胞 细胞毒性 干扰素Α 

分 类 号：R512.63[医药卫生—内科学]