乙型肝炎病毒感染孕妇IL-12、IL-18的表达与胎儿宫内感染的相关性研究

目的探讨白细胞介素-12(IL-12)及白细胞介素-18(IL-18)与干扰素-γ(IFN-γ)、白细胞介素-4(IL-4)的相关性在乙型肝炎病毒(HBV)宫内感染的意义。方法对105例血清乙肝表面抗原(HBsAg)阳性的孕妇(研究组,宫内感染13例,宫内未感染92例)和42例血清HBsAg阴性的正常孕妇(对照组)均采用酶联免疫吸附法(ELISA)测定孕妇外周血乙型肝炎5项指标和细胞因子IL-12、IL-18、IFN-γ、IL-4水平;测定新生儿脐血乙型肝炎5项和HBV-DNA水平。结果宫内感染组孕妇的IL-12、IL-18、IFN-γ水平显著低于宫内未感染组及对照组,IL-4水平则显著高于宫内未感染组及对照组(均P<0.01)。宫内未感染组的IL-12、IL-18、IFN-γ和IL-4水平与对照组比较差异均无统计学意义(P>0.05)。3组孕妇外周血IL-12、IL-18与IFN-γ呈显著正相关(r=0.956、0.927、0.885及r=0.926、0.943、0.856,均P<0.01),与IL-4水平呈显著负相关(r=-0.926、-0.921、-0.913及r=-0.935、-0.982、-0.939,均P<0.01)。结论IL-12、IL-18既可加强HBV感染的T细胞的反应和IFN-γ的生成,又能增强Th1介导的细胞免疫功能,有望成为HBV宫内感染免疫治疗的新靶位。

Relationship of Expression of Serum IL-12 and IL-18 to Intrauterine Infection in Pregnant Women with Hepatitis B Virus Infection

Objective To study the significance of relationships of IL-12 and IL-18 to IFN-γand IL-4 in pregnant women with hepatitis B virus （HBV）infection and intrauterine infection.Methods Serum HBV markers and levels of IL-12, IL-18, IFN-γand IL-4 in peripheral blood were determined by ELISA assay in 13 HBsAg-positive pregnant women with intrauterine infection （infected group）, 92 HBsAg-positive pregnant women without intrauterine infection （uninfected group）and 42 HBsAg- negative pregnant women（control group）.Results Compared with infected group,levels of IL-12, IL-18 and IFN-γsignificantly increased but levels of IL-4 obviously decreased in uninfected group or control group （P〈0.01）.There were no significant differences in levels of IL-12, IL-18, IFN-γ and IL-4 between uninfected group and control group （P〉0.05）.In infected group, uninfected group and control group, serum levels of IL-12 and IL-18 were positively correlated with IFN-γlevels （r=0.956, 0.927and 0.885 and r=0.926, 0.943 and 0.856, respectively;P〈0.01 ）, but negatively correlated with IL-4 levels （r =-0.926, -0.921 and -0.913 and r =-0.935, -0.982 and -0.939, respectively; P 〈0.01）. Conehmion IL-12 and IL-18 can promote HBV-infected T cell responses and IFN-γproduction and enhance Thl-mediated cellular immunity.Therefore, IL-12 and IL-18 may become the new targets for the therapy of intrauterine infection in pregnant women with HBV infection.