血清Th1/Th2细胞因子水平与慢性丙型肝炎临床及干扰素疗效关系的研究

目的 探讨血清Th1和Th2细胞因子水平与慢性丙型肝炎患者病情进展及干扰素疗效的关系.方法 血清细胞因子检测应用ELISA法,HCV基因分型应用直接测序法,HCVRNA载量采用荧光定量PCR法.结果 慢性丙型肝炎患者血清IL-2和TGF-β含量明显低于健康对照组,IL-5含量明显高于后者;血清IL-6含量与ALT水平呈正相关,与RNA载量呈负相关;HCV基因型1型患者IL-6含量明显高于2型,2a型IL-2含量低于2b型;随着感染时间的延长,血清IL-2呈下降趋势,IL-6呈升高趋势,而TGF-β则先升高之后逐渐下降.干扰素治疗应答组和无应答组治疗前血清细胞因子水平均差异无统计学意义,但应答组治疗结束时IFN-γ含量较治疗前明显升高.结论 慢性丙型肝炎患者存在Th1/Th2细胞因子失衡并与临床表现相关;治疗前血清Th1/Th2细胞因子水平不能对疗效进行预测,干扰素诱导的Th1细胞优势反应与持续应答有关.

Study on the relationship between the serum levels of Th1/Th2 cytokines and the clinical manifestations of chronic hepatitis C and the outcome of interferon therapy

Objective To investigated the relationship between the serum levels of Th1/Th2 cytokines and the progress of viral hepatitis C and the outcome of interferon therapy.Methods Serum cytokine detection used the method of ELISA.HCV genotypo were classified by direct sequencing.HCV RNA loads were determined by fluorescence quantitative PCR.Results The levels of IL-2 and TGF-β in sernm of patients with chronic hepatitis C were lower but IL-5 was higher than those of normal control.The level of IL-6 was positively related to the sera level of ALT and was negatively related to sera HCV RNA load.Patients of HCV genotype 1 had higher sera quantities of IL-6 than those of genotypo 2 and patients of genotype 2a had lower sets quantities of IL-2 than those of 2b.The levels of IL-2 had the tendency to decrease whereas IL-6 had the tendency to increase when time went on.The level of TGF-β increased at early phase but decrease later.There were no difference of all cytokines detected between the groups of response and nonresponse before interferon therapy,but the quantity of serum IFN-γ were increased after interferon therapy in the response group.Conclusion The tested cytokines co-participate in the pathogenesis of chronic hepatitis C and have the relationship with the clinical manifestations of the patients.There were no correlation between the levels of Th1/n12 cytokines in the serum before IFN treatment and the result of IFN therapy.Increasing IFN-γ in the serum induced by IFN treatment is associated with sustained virological response.