血清IL-35、IL-17与恩替卡韦治疗慢性乙型肝炎患者HBeAg阴转的相关性  

Correlations between serum IL-35,IL-17 and HBeAg clearance in chronic hepatitis B patients treated with entecavir

作　　者：张曹庚 张志峰 张红云 顾海蔚 刘红 倪菊平 施燕芬 徐瑞芳 ZHANG Cao-geng;ZHANG Zhi-feng;ZHANG Hong-yun;GU Hai-wei;LIU Hong;NI Ju-ping;SHI Yan-fen;XU Rui-fang(Department of Infectious Diseases,Shanghai Minhang District Central Hospital,Shanghai 201199,China)

机构地区：[1]上海市闵行区中心医院感染科,201199

出　　处：《肝脏》2018年第12期1073-1077,共5页Chinese Hepatology

基　　金：上海市闵行区中心医院院级课题基金(2016MHLC01)

摘　　要：目的观察恩替卡韦(ETV)治疗慢性乙型肝炎(CHB)患者血清IL-35、IL-17表达水平的动态变化,探讨其与HBeAg阴转的相关性。方法纳入HBeAg阳性CHB患者48例,给予ETV抗病毒治疗。分别于基线、治疗第12、24、36、48周检测HBeAg滴度、HBV DNA载量、ALT、血清IL-35、IL-17水平。根据48周时HBeAg状态将患者分为HBeAg阴转组和HBeAg未阴转组,进行对比分析。结果 ETV治疗48周时,48例患者中41例(85.42%)ALT复常,46例(95.83%)获得完全病毒学应答,2例(4.17%)获得部分病毒学应答,无患者发生病毒学突破,11例(22.92%)患者获得HBeAg阴转。HBeAg未阴转组与HBeAg阴转组基线血清IL-35、IL-17表达水平和IL-35/IL-17比值均高于健康对照组(均P<0.05),但两组间差异无统计学意义(均P>0.05);治疗中,两组患者的血清IL-35水平较基线均出现不同程度的下降(均P<0.05),至疗程第48周时,两组间的差异有统计学意义[(65.35±23.10)pg/mL对(45.64±19.77)pg/mL,P=0.0421];两组血清IL-17水平较基线无显著改变(均P>0.05),两组间差异均无统计学意义(均P>0.05);两组IL-35/IL-17比值和HBeAg滴度较基线也均出现不同程度的下降(均P<0.05),两组间差异有统计学意义(均P<0.05)。结论 ETV持续抗病毒治疗能够降低CHB患者血清IL-35水平。抗病毒治疗中血清IL-35表达水平和IL-35/IL-17比值的动态变化或许能预测HBeAg阴转。Objective To study the dynamic changes of serum levels of interleukin-35(IL-35)and interleukin-17(IL-17)during the 48-week entecavir(ETV)treatment and to investigate their relationship with hepatitis B e antigen(HBeAg)clearance.Methods A total of 48 HBeAg-positive chronic hepatitis B(CHB)patients receiving antiviral treatment of ETV were followed up.Laboratory indicators including HBeAg titer,hepatitis B virus(HBV)DNA load,alanine aminotransferase(ALT),serum IL-35,IL-17 and the ratio of IL-35/IL-17 were detected at baseline,week 12,week 24,week 36 and week 48,respectively.According to the HBeAg status at week 48,the patients were divided into HBeAg-negative and HBeAg-positive group for comparative analysis.Results At week 48,41 out of 48(85.42%)patients achieved ALT normalization,46(95.83%)patients achieved complete virological response,and 2(4.17%)patients achieved partial virological response.No patient had a virological breakthrough.A total of 11(22.92%)patients achieved HBeAg clearance.At baseline,serum levels of IL-35,IL-17 and IL-35/IL-17 ratio in HBeAg-negative and HBeAg-positive groups were higher than those of healthy controls(P<0.05).However,there was no significant difference between these 2 groups(P >0.05).During treatment,serum IL-35 level in 2 groups significantly decreased(P<0.05),and was significantly different between 2 groups at week 48(P=0.0421).Compared with that at baseline,serum IL-17 level showed no significant changes in 2 groups(both P >0.05),and no significant differences between 2 groups during treatment(P >0.05).Compared with those at baseline,the IL-35/IL-17 ratios and HBeAg titers of 2 groups showed different degrees of decline(P<0.05),with statistically significant differences between 2 groups(P<0.05).Conclusion ETV antiviral therapy can reduce the serum IL-35 level of CHB patients.The dynamic changes of serum levels of IL-35,IL-17 and IL-35/IL-17 ratio may predict HBeAg clearance during antiviral treatment.

关 键 词：慢性乙型肝炎 恩替卡韦 IL-35 IL-17 HBEAG 

分 类 号：R512.62[医药卫生—内科学]