慢性丙型肝炎患者肝组织中病毒和Fas抗原表达及其与干扰素应答的关系

目的 探讨丙型肝炎患者肝组织中HCV Ns5和Fas抗原表达及其与肝组织损伤和干扰素治疗反应的关系.方法 应用a干扰素对一组慢性丙型肝炎患者进行24周治疗,停药后随访6个月,以血清丙氨酸转氨酶(ALT)恢复正常及血清HCV RNA持续阴转为完全应答标准,采用免疫组化方法检测组织中病毒和Fas抗原表达状况.结果 29例慢性丙型肝炎患者肝组织中,HCV NS5和Fas抗原呈阳性者均为19例(65.5%),两者在肝组织中的表达显著相关;单因素相关分析时,两者均与组织病变程度有关,但多因素分析表明只有HCV NS5抗原表达水平与组织炎症活动度呈正相关.治疗和随访结束时分别有17例(58.6%)和15例(51.7%)患者表现为近期和远期完全应答.治疗前Fas表达水平与干扰素应答有关,但未见HCV NS5水平与干扰素应答有明显关系;5例随访结束时重复肝穿,3例完全应答者病毒表达显著受抑,但Fas抗原无明显改变,2例无应答者病毒表达无明显改变甚或增强,而Fas表达均增强.结论 慢性丙型肝炎肝组织中HCV Ns5表达在慢性丙型肝炎发病过程中有重要意义;Fas抗原表达水平与组织中病毒表达相关;治疗前肝组织Fas表达状况与干扰素治疗反应有一定联系.

Expression of viral and Fas antigens in the livers of patients with chronic hepatitis C between before and afterinterferontherapy

Objective To study the expression of viral and Fas antigens in the livers of patients with chronic hepatitis C(CHC)and their relationship tO liver damage and response tO interferon(IFN)therapy.Methods HCV NS5 protein and Fas antigen in the liver of patients with CHC were detected immunohistochemically before and after 24-week treatment of interferon.The complete response(CR)was defined as continu OUS HCV RNA seroconversion and sustained ALT level normalization.Results Among the 29 subjects with CHC,HCV NS5 protien and Fas antigen were both detected tO be positive in 19(65.5%)cases.There was a positive correlation between the expression of HCV NS5 and Fas antigen in liver.Both the expression of Fas antigen and the expression of HCV NS5 protein were correlated to liver inflammatory activity in the patients with CHC by univariate analysis,while only HCV NS5 protein had a correlation with liver inflammatory activity by multivariate analysis.There were 17(58.6%)and 15(51.7%)cases with short and long-term CR to IFN therapy in total Fas antigen expression level in liver was correlated tO the response of INF treatment,but no correlation was found between the expression of viral antigen and IFN treatment response.Conclusions There results showed that the expression of HCV NS5 protein in the liver of patients with CHC maybe take an important role in the pathogenesis of CHC.The expression of Fas antigen is correlated to HCV antigen expression and maybe an influential factor on the result of IFN therapy.