重型乙型肝炎患者TNF和IL—1的检测及意义

检测３０例重型乙型病毒性肝炎（重型肝炎）患者血清和外周血单个核细胞培养上清中肿瘤坏死因子水平及ＰＢＭＣ诱生的白细胞介素１活性，结果：重型肝炎患者ＴＮＦ和ＩＬ－１水平均增高，且二者呈正相关。提示ＴＮＦ和ＩＬ－１在重型肝炎的发病机制中起重要作用。     

亚急性重型肝炎患者TNF-α和IL-1表达及IL-4对其的调控

目的：分析ＩＬ－４对亚急性重型肝炎（亚重肝）患者外周血单个核细胞（ＰＢＭＣＳ）ＴＮＦ－α和ＩＬ－１的调控作用,评价ＩＬ－４在亚重肝治疗中的潜在价值。方法：应用细胞生物学、免疫组化和ＲＴ－ＰＣＲ等方面测定ＰＢＭＣＳ ＴＮＦ－α、ＩＬ－１的表达。结果：亚重肝患者ＰＢＭＣＳ ＴＮＦ－α、ＩＬ－１表达水平均较正常人显著增高血糖素含量和虽然ＩＬ－４ ＭＲＮＡ及蛋白质的表达与正常人比较一差异无但ＩＬ－４ ＭＲ     

IL-4对治疗前后亚急性重型病毒性肝炎患者PBMCs TNF-α和IL-1αmRNA表达的影响

目的　了解白介素（ＩＬ）４ 对重型病毒性肝炎患者外周血单个核细胞（ＰＢＭＣｓ） 中肿瘤坏死因子（ＴＮＦ）α和ＩＬ１αｍＲＮＡ的表达的影响。方法　ＴＮＦα和ＩＬ１αｍＲＮＡ的表达水平采用半定量逆转录聚合酶链反应（ＲＴＰＣＲ） 进行检测。结果　ＩＬ４ 均以剂量依赖的方式抑制治疗前、后亚急性重型肝炎患者ＰＢＭＣｓ ＴＮＦα和ＩＬ１αｍＲＮＡ的表达,在发病初期,ＩＬ４ 于１ ０００Ｕｍｌ 时接近最大抑制效应;而恢复期患者,ＩＬ４ 于１００Ｕｍｌ 时即接近最大抑制效应,剂量－ 反应曲线明显左移。如以１００Ｕｍｌ 的ＩＬ４ 处理ＰＢＭＣｓ,恢复期亚急性重型肝炎患者ＰＢＭＣｓ ＴＮＦα和ＩＬ１αｍＲＮＡ的抑制率接近５０％ 。另外还发现,在发病初期,ＩＬ４ 对内毒素血症和ＨＢｅＡｇ 阳性患者ＰＢＭＣｓＴＮＦα和ＩＬ１αｍＲＮＡ表达的抑制作用低于阴性的患者。结论　ＩＬ４ 对发病初期患者ＰＢＭＣＴＮＦα和ＩＬ１αｍＲＮＡ 表达的抑制作用明显低于恢复期患者,其原因可能与内毒素血症和病毒血症有关     

病毒性肝炎患者血清sICAM-1、IL-6及TNF-α水平检测分析

应用酶联免疫吸附法检测了４３名对照组和１２９例各类病毒性肝炎患者血清ｓＩＣＡＭ－１、ＩＬ－６及ＴＮＦ－α水平含量。结果表明：急、慢性肝炎和肝硬化患者血清ｓＩＣＡＭ－１水平明显高于对照组（Ｐ〈０．０１）,慢性重型肝炎组明显高于中度和轻度肝炎组（Ｐ〈０．０１）,各类肝炎患者血清ｓＩＣＡＭ－１水平与ＡＬＴ、ＴＢｉｌ均呈明显正相关;各类肝炎及肝硬化患者血清ＩＬ－６和ＴＮＦ－α水平也较对照组显著升高（Ｐ〈０     

新生儿缺氧缺血性脑病细胞因子的变化及临床意义

目的：研究新生儿缺氧缺血性脑病（ＨＩＥ）患儿细胞因子ＩＮＦ－α、ＩＬ－１β和ＩＬ－６的变化及其与ＨＩＥ严重程度的关系和临床意义。方法：用ＥＬＩＳＡ方法测定了５０例ＨＩＥ患儿血浆及外周血单个核细胞（ＰＢＭＣ）体外培养产生的细胞因子ＴＮＦ－α、ＩＬ－１β和ＩＬ－６的水平。结果：ＨＩＥ患儿血浆及ＰＢＭＣ体外培养产生的ＴＮＦ－α、ＩＬ－１β水平均显著高于对照组；而且重度ＨＩＥ患儿急性期血浆及ＰＢＭＣ体外培养产生的ＴＮＦ－α、ＩＬ－β和ＩＬ－６水平均显著高于对照组和轻度ＨＩＥ组，其恢复期血浆ＴＮＦ－α、ＩＬ－１β则显著降低，但血浆ＩＬ－６水平仍明显高于对照组。结论：ＨＩＥ患儿血浆及激活的ＰＢＭＣ产生的ＴＮＦ－α和ＩＬ－１β水平与ＨＩＥ的严重程度有关，ＩＬ－６的产生可能与脑损伤后的修复机制有关，测定这些细胞因子对病情的监测具有一定意义。     

再生障碍性贫血患者免疫调节剂治疗前后TNF和IL—2水平变化及意义

为了探讨再生障碍性贫血（ＡＡ）的免疫发病机理及抗Ｔ淋巴细胞单克隆抗体（ＭｃＡｂ－Ｔ）的免疫调节治疗作用，采用放射免疫法检测３０例ＡＡ患者ＭｃＡｂ－Ｔ治疗前后血清肿瘤坏死因子（ＴＮＦ）和白细胞介素－２（ＩＬ－２）水平及其中１０例ＡＡ外周血核细胞（ＰＢＭＮＣ）体外诱生ＴＮＦ和ＩＬ－２水平的变化。结果表明，治疗前ＡＡ患者血清ＴＮＦ水平显著曾高（Ｐ〈０．０１），ＰＢＭＮＣ诱生的ＴＮＦ和ＩＬ－２水平均明显高     

慢性肝病患者血清细胞因子变化与临床意义

目的：为探讨慢性乙型肝炎病毒性肝病患者血清细胞因子ＴＮＦ－α、ＩＬ－１、ＩＬ－６、ＩＬ－８活性变化及其在慢性肝病发生发展中的作用及临床意义。方法：采用ＥＬＩＳＡ法对慢性乙型肝炎（ＣＨ）、慢性乙型重型肝炎（ＣＳＨ）、乙型肝炎性肝硬化（ＨＣ）患者血清中细胞因子ＴＮＦ－α、ＩＬ－１、ＩＬ－６、ＩＬ－８活性进行了测定。结果：慢肝患者血清ＴＮＦ－α、ＩＬ－１、ＩＬ－６、ＩＬ－８水平明显高于健康对照组（Ｐ〈０     

重型病毒性肝炎患者PBMCs中TNF-α、IL-1α和IL-4mRNA表达水平及其意义探讨

本实验应用半定量ＲＴ－ＰＣＲ检测了８例急重肝、１３例亚急重肝和１６例慢重肝患者ＰＢＭＣｓＴＮＦ－α、ＩＬ－１α和ＩＬ－４ｍＲＮＡ的表达水平并对其意义进行了探讨。结果表明，急重肝和亚急重肝患者ＰＢＭＣｓＴＮＦ－α和ＩＬ－１αｍＲＮＡ的表达水平较正常人明显增高，且与内毒素血症和病情轻重相关，而慢重肝仅ＴＮＦ－αｍＲＮＡ略增高，提示ＴＮＦ－α和ＩＬ－１α在急重肝和亚急重肝的发病机理中可能起重要的作用，而在慢重肝的作用可能不是主要的。虽然三型重型肝炎患者ＩＬ－４ｍＲＮＡ的表达水平与正常人比较无显著差异，但急重肝和亚急重肝患者ＩＬ－４ｍＲＮＡ／ＴＮＦ－αｍＲＮＡ和ＩＬ－４ｍＲＮＡ／ＩＬ－１αｍＲＮＡ的比值均明显低于正常人，表明急重肝和亚急重肝患者炎症细胞因子和抗炎症细胞因子调节网络严重失调，ＩＬ－４水平相对低下可能是急重肝和亚急重肝患者ＴＮＦ－α和ＩＬ－１α异常增高的原因之一。     

病毒性肝炎患者IL－1、IL－6和TNFα活性的检测

检测了甲、乙型病毒性肝炎患者外周血单个核细胞（ＰＢＭＣｓ）ＩＬ－１、ＩＬ－６和ＴＮＦα的诱生活性及其血清中活性。结果表明，乙型慢性活动性肝炎（ＣＡＨ）、乙型肝炎后肝硬化（ＨＣ）和乙型重型肝炎（ＳＨ）ＰＢＭＣｓ经脂多糖诱导后，ＩＬ－１活性分别为３５３１．１±８８２．７Ｕ／ｍ１、２７６９．７±７３０．４±Ｕ／ｍｌ和５３２９．３±１０８９．３Ｕ／ｍｌ，高于正常对照组（Ｐ＜０．０５或（０．０１）；ＩＬ－６诱生活性分别为３８．９０±１４．７５Ｕ／ｍ１、２．４５±１８．８５Ｕ／ｍｌ和７１．９５±２８．０５Ｕ／ｍｌ（与正常对照组相比，ｐ＜０．０５或＜０．０１）；ＴＮＦα诱生活性在乙型慢性迁延性肝炎（ＣＰＨ）、ＣＡＨ、ＨＣ和ＳＨ中分别为３３．２３±７．２５Ｕ／ｍｌ、６．９９±１．８４Ｕ／ｍ１、４．２９±２．１７Ｕ／ｍｌ和８６．７０±２４．１８Ｕ／ｍｌ，与对照组相比Ｐ＜０．０５或Ｐ＜０．０１。各型患者血清中ＩＬ－１、ＩＬ－６和ＴＮＦα活性均有不同程度的增高。文中对ＳＨ患者ＩＬ－１、ＩＬ－６和ＴＮＦα之间的相互关系进行了探讨。     

系统性红斑狼疮病人外周血中TNF和IL—1的检测

肿瘤坏死因子（ＴＮＦ）和白细胞介素１（ＩＬ－１）是一对介导炎性反应的主要细胞因子，用细胞生物法，ＥＬＩ０Ａ法和３Ｈ－ＴｄＲ渗入法对２０例系统性红斑狼疮（ＳＬＥ）患者的外周血单个核细胞（ＰＢＭＣ）培养上清和血清进行了ＴＮＦ和ＩＬ－１水平的检测。结果表明：ＳＬＥ病人的ＰＢＭＣ在体外对有丝分裂原的刺激不敏感。其上清液中的ＴＮＰ的活性和上清液及血清中ＴＮＦ－α蛋白含量的水平与疾病的活动性及是否合并感染均无相关性。ＳＬＥ病人ＩＬ－１的生物活性和健康人无明显差异。活动期病人ＩＬ－１的分泌水平低于恢复期患者，ＩＬ－１分泌能力的降低和病情活动有关。     

Enhancing the antihepatitis B virus immune response by adefovir dipivoxil and entecavir therapies

Chronicity of hepatitis B (CHB) infection is characterized by a weak immune response to the virus. Entecavir (ETV) and adefovir dipivoxil (ADV) are effective in suppressing hepatitis B virus (HBV) replication. However, the underlying immune mechanism in the antiviral response of patients treated with nucleoside or nucleotide analogs is not clearly understood. In this study, regulatory T cells (Tregs) and intracellular cytokines, including IL-2, interferon (IFN)-γ, tumor-necrosis factor (TNF)-α and IL-4, were measured prior to and at 12, 24, 36 and 48 weeks after treatment with ETV or ADV. The cytokines were increased from 24 to 48 weeks after treatment. Higher levels of Th1 cytokines were observed with ETV (n=29) versus ADV (n=28) treatment. By contrast, the numbers of Tregs in both groups were decreased. The altered cytokine profile and cellular component was accompanied by a decrease in HBV DNA levels in both groups, which may contribute to their therapeutic effect in CHB infection. Our findings suggest that the antiviral effect of the drugs may be attributed not only to their direct effect on virus suppression but also to their immunoregulatory capabilities.     

慢性重型乙型肝炎患者外周血单核细胞Toll样受体4的变化及其与IL-6的关系

目的： 探讨慢性重型乙型肝炎患者外周血单核细胞Toll样受体4（TLR4）的变化情况及其意义。 方法： 用流式细胞仪检测30例正常对照、31例慢性乙型肝炎患者和30例慢性重型乙型肝炎患者外周血单核细胞表面TLR4的表达，ELISA法检测上述患者血清白细胞介素6（IL-6）的水平。 结果： 正常对照组、慢性乙型肝炎组和慢性重型乙型肝炎组外周血单核细胞TLR4的平均免疫荧光强度分别为2.3±1.1、3.7±2.3 和6.9±4.1，慢性重型乙型肝炎组外周血单核细胞TLR4表达显著高于正常对照组和慢性乙型肝炎组（P<0.05），慢性乙型肝炎组与正常对照组比较无统计学差异；3组外周血清IL-6水平分别为(11.5±7.2) ng/L、(40.8±31.2) ng/L和(77.6±33.3) ng/L，各组间比较均具有显著差异（P<0.05）；慢性重型乙型肝炎组外周血单核细胞TLR4表达水平与血清IL-6表达水平呈显著正相关，相关系数γ=0.618，P<0.05。结论： TLR4可能与慢性乙型肝炎重型化有关。     

Interleukin-1 alpha enhances hepatotoxicity of tumor necrosis factor-alpha in galactosamine-sensitized mice.

The possible involvement of interleukin-1 alpha (IL-1 alpha) in the pathogenesis of murine hepatitis model induced with galactosamine and lipopolysaccharide (LPS) was investigated. The injection of 10 ng/mouse of LPS in combination with 10 mg/mouse of galactosamine into mice induced hepatic damage at 24 hours. Treatment with anti-mouse IL-1 alpha antiserum 30 min before galactosamine/LPS injection showed a tendency to reduce the liver injury, while pretreatment with anti-mouse tumor necrosis factor-alpha (TNF) antiserum significantly protected mice from liver injury. The use of recombinant murine TNF, instead of LPS, in combination with galactosamine could elicit hepatic damage, whereas recombinant murine IL-1 alpha could not substitute for LPS. However, recombinant murine IL-1 alpha enhanced the hepatotoxic effect of recombinant murine TNF in galactosamine-sensitized mice. These results suggest that TNF plays a major role in the pathogenesis of galactosamine/LPS hepatitis in mice and that IL-1 alpha acts synergistically with TNF in this hepatitis model.     

Tumor necrosis factor gene polymorphisms,leukocyte function,and sepsis susceptibility in blunt trauma patients

The tumor necrosis factor alpha (TNF-alpha) -308 G/A and TNF-beta NcO1 polymorphisms have been described to be associated with an increased risk for sepsis in critically ill patients. Functional consequences associated with these polymorphisms remain unclear. We compared the genotype distribution of these TNF polymorphisms with susceptibility to severe sepsis and leukocyte function in blunt trauma patients (n = 70; mean injury severity score, 24 points [range, 4 to 57). Severe sepsis was defined according to the American College of Chest Physicians-Society of Critical Care Medicine consensus conference criteria. Genotyping for the NcO1 polymorphism (alleles TNFB1 and TNFB2) was performed by PCR and digestion of the products with NcO1, and that for the TNF-alpha -308 G/A polymorphism (alleles TNF1 and TNF2) was performed by real-time PCR. Leukocyte function was assessed by measurement of the production of endotoxin-induced cytokines (TNF-alpha, interleukin-6 [IL-6], and IL-8) in whole blood. TNF-alpha, IL-6, and IL-8 were determined by enzyme-linked immunosorbent assay. For the genotypes of the TNF-alpha -308 G/A polymorphism, differences in the frequency of development of severe sepsis were not detectable. Patients developing severe sepsis after trauma were significantly more likely to possess a homozygous genotype of the TNF-beta NcO1 polymorphism. Compared with heterozygotes, the odds ratio for the TNFB2/B2 genotype for the development of severe posttraumatic sepsis was 11 (P = 0.01), and that for the TNFB1/B1 genotype was 13 (P = 0.014). TNF-alpha -308:TNF-beta NcO1 haplotype analysis showed that the TNFB2:TNF2 haplotype is significantly negatively associated with development of severe sepsis. Patients homozygous for the TNFB1 or TNFB2 allele showed a persistently higher cytokine-producing capacity during at least 4 to 8 days after trauma than the heterozygotes. In patients homozygous for the TNF1 allele, a higher TNF-alpha- and IL-8-producing capacity was found only at day 1 after trauma. Although the TNF-beta NcO1 polymorphism appears to be less likely to be causative for development of severe sepsis after trauma, it is thus far the only genetic marker identified which can be used as a relevant risk estimate for severe sepsis in trauma patients immediately after the injury.     

Interleukin-1 and -2 in sera of patients with chronic hepatitis (type B)

IL-1 beta and IL-2 values in serum from 28 patients with chronic hepatitis B diagnosed by liver biopsy and 23 healthy controls were measured by the radioimmunoassay (RIA) method. Though both values in patients seropositive for anti-HBe were slightly higher than those in patients seropositive for HBeAg, the differences between the two groups were not statistically significant. In contrast, the relationship between IL-1 beta and IL-2 in patients with chronic hepatitis was statistically significant (P less than 0.001). In general, high values of serum IL-1 beta and IL-2 were seen in patients with chronic persistent hepatitis and low values of serum IL-1 beta and IL-2 were seen in patients with chronic active hepatitis (severe) and in some of these with chronic persistent hepatitis. Serum IL-1 beta and IL-2 values of all patients with chronic hepatitis were higher than in healthy controls (P less than 0.001). Serum IL-1 beta and IL-2 in chronic hepatitis (B) are important indicators of the grade of the inflammatory state of the liver.     

Elevated plasma interleukin-6 and increased severity and mortality in alcoholic hepatitis.

Recent studies in alcoholic hepatitis have proposed a role for the cytokine tumour necrosis factor-alpha (TNF-alpha) a mediator of endotoxic shock in sepsis. In this study plasma levels of the closely related cytokine interleukin-6 (IL-6) were assayed in 96 samples from 58 patients with severe alcoholic hepatitis, and 69 patients in control groups (21 normal, 10 alcoholic without liver disease, 10 inactive alcoholic cirrhosis, 18 chronic liver disease, 10 chronic renal failure). Plasma IL-6 levels were markedly elevated in patients with alcoholic hepatitis when compared with all control groups (P less than 0.001). IL-6 levels were higher in patients who died (P = 0.04) and correlated with the features of severe disease including: increased grade of encephalopathy, increased neutrophil count, increased prothrombin ratio, hypotension, increased serum creatinine and increased serum bilirubin. Surprisingly, no correlation was found between levels of plasma IL-6 and plasma TNF-alpha or endotoxin, or the presence of infection; an inverse correlation was found between plasma IL-6 and serum globulins. These findings provide further evidence that the IL-6/TNF cytokine system is activated in severe alcoholic hepatitis and may mediate hepatic or extra-hepatic tissue damage.     

慢性重型乙型肝炎患者血清IL-23水平检测及其意义

目的 检测慢性重型乙型肝炎患者血清中IL-23表达,探讨IL-23水平与丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TBil)及HBV DNA载量的相关性.方法 用酶联免疫吸附法(ELISA)检测50例慢性重型乙型肝炎患者(重肝组)及18名健康人(对照组)血清中IL-23表达,并与患者ALT、AST、TBil、HBV DNA载量进行相关性分析.结果 重肝组患者血清中IL-23表达高于对照组,两组之间的差异有统计学意义(P＜0.05);IL-23水平与ALT、AST呈正相关(P＜0.05),与TBil、HBV DNA载量无相关性(P＞0.05).结论 慢性重型乙型肝炎患者血清中IL-23表达增高,与炎症程度相关,可能参与慢性重型乙型肝炎的发病.     

Genes for Interleukin-1, Interleukin-6, and Tumor Necrosis Factor are Expressed at Markedly Reduced Levels in the Livers of Patients with Severe Liver Disease

The genes for interferon (IFN) α, IFN γ IL-1 β, IL-6, and TNF α were transcribed at readily detectable levels both in liver biopsies from individuals with normal liver function and in samples of normal viable liver taken for transplantation. These results provided evidence for the concept that such multifunctional cytokines play a role in homeostasis in normal human tissues. In normal human liver, in situ hybridization studies showed that, in the absence of a detectable inflammatory response, both heptocytes and mononuclear cells exhibited a similar degree of expression of IL-6 mRNA in keeping with the finding that IL-6 is produced by cells of different lineages. The levels of IL-1, IL-6, and TNF mRNA were found to be markedly reduced in extracts of the livers of patients with primary biliary cirrhosis and other forms of autommune liver disease at a time when extensive liver lesions were apparent, compared to the levels of expression of these cytokines in the livers of normal individuals. The reduced expression of IL-1, IL-6, and TNF mRNAs appeared to be a specific effect and not due to a general reduction in RNA synthesis as the IFN α, IFN γ and actin mRNAs were expressed at similar levels in both normal and diseased livers. The levels of IL-1 β, IL-6, and TNF mRNAs were also reduced in samples of liver from a patient with a drug induced fulminant hepatitis suggesting that this specific pattern of altered cytokine gene expression was characteristic of the advanced stage of severe liver disease.     

Hepatitis B virus e antigen downregulates cytokine production in human hepatoma cell lines

Disease activities of hepatitis B are affected by the status of hepatitis B e antigen (HBeAg). The function of the hepatitis B virus (HBV) precore or HBeAg is unknown. We assumed that HBeAg blocks aberrant immune responses, although HBeAg is not required for viral assembly, infection, or replication. We examined the interaction of HBeAg and the immune system, including cytokine production. The inflammatory cytokine TNF, IL-6, IL-8, IL-12A, IFN-α1, and IFN-? mRNA were downregulated in HBeAg-positive HepG2, which stably expresses HBeAg, compared to HBeAg-negative HepG2 cells. The results of real-time RT-PCR-based cytokine-related gene arrays showed the downregulation of cytokine and IFN production. We also observed inhibition of the activation of NF-κB- and IFN-?-promoter in HBeAg-positive HepG2, as well as inhibition of IFN and IL-6 production in HBeAg-positive HepG2 cell culture fluids. HBeAg might modify disease progression by inhibiting inflammatory cytokine and IFN gene expression, while simultaneously suppressing NF-κB-signaling- and IFN?-promoter activation.     

Genes for interleukin-1, interleukin-6, and tumor necrosis factor are expressed at markedly reduced levels in the livers of patients with severe liver disease.

The genes for interferon (IFN) alpha, IFN gamma, IL-1 beta, IL-6, and TNF alpha were transcribed at readily detectable levels both in liver biopsies from individuals with normal liver function and in samples of normal viable liver taken for transplantation. These results provided evidence for the concept that such multifunctional cytokines play a role in homeostasis in normal human tissues. In normal human liver, in situ hybridization studies showed that, in the absence of a detectable inflammatory response, both hepatocytes and mononuclear cells exhibited a similar degree of expression of IL-6 mRNA in keeping with the finding that IL-6 is produced by cells of different lineages. The levels of IL-1, IL-6, and TNF mRNA were found to be markedly reduced in extracts of the livers of patients with primary biliary cirrhosis and other forms of autoimmune liver disease at a time when extensive liver lesions were apparent, compared to the levels of expression of these cytokines in the livers of normal individuals. The reduced expression of IL-1, IL-6, and TNF mRNAs appeared to be a specific effect and not due to a general reduction in RNA synthesis as the IFN alpha, IFN gamma and actin mRNAs were expressed at similar levels in both normal and diseased livers. The levels of IL-1 beta, IL-6, and TNF mRNAs were also reduced in samples of liver from a patient with a drug induced fulminant hepatitis suggesting that this specific pattern of altered cytokine gene expression was characteristic of the advanced stage of severe liver disease.