rhGM-CSF作为成人乙肝疫苗无(弱)应答者免疫佐剂初探

目的 探讨重组人粒细胞.巨噬细胞集落刺激因子(rhGM-CSF)对提高成人乙肝疫苗无(弱)应答免疫的作用.方法 将两年内完成1～2个标准乙肝疫苗接种程序、复查HBV标志物均阴性的健康人群随机分为A、B两组.A组:33人,按标准免疫程序予10μg乙肝疫苗;B组:34人,先予rhGM-CSF 300μg皮下注射,次日始按A组方案予乙肝疫苗.接种首针后第1、2、8个月(T1、T2、T8)采血检测抗-HBs.结果 A、B组T8抗-HBs阳性率分别为39.39%和64.71%(P=0.038);A组三次抗体滴度检测结果 无显著性变化;B组升高明显,分别为(113.85±198.56)mIU/ml,(312.40±349.44)mIU/ml,(427.74±411.58)mIU/ml(P=0.001).A组和B组T8抗体水平差异有统计学意义(P=0.010).结论 rhGM-CSF联合乙肝疫苗复种对无(弱)应答者免疫效果优于单纯复种,GM-CSF具有提高机体对乙肝疫苗免疫应答的能力.

Study on rhGM-CSF as adjuvant in revaccination among adults of non-and hyporesponders to hepatitis B vaccine

Objective To investigate the effect of recombinant human granulocyte macrophage colony stimulating factor (rhGM-CSF) as adjuvant on immune response in adults of non-and hyporesponders to hepatitis B vaccine. Methods Those who were once immunized with recombined yeast gene hepatitis B vaccine more than one standard scheme in two years and negative for hepatitis B markers were randomly sorted as group A and group B. 33 adults of group A were given hepatitis B vaccine 10 μg each time. The immune procedure was O, 1 and 6month. 34 adults of group B were given rhGM-CSF 300 μg for the first day, then 10 μg each time for routine immune. The blood samples were collected before the first injection and in 1, 2 and 8 months (T1, T2, TS)following the first injection to test Anti-HBs. Results Anti-HBs positive conversion rates of group A and B at T8 was 39.39% and 64.71% respectively(P=0.038). Anti-HBs levels of group B at TI, T2, T8 were(113.85±198.56) mIU/ml, (312.40±349.44) mIU/ml, (427.74±411. 58) mIU/ml (P=0.001). There was significant difference between group A and B in T8 Anti-HBs levels(P=0.010). Conclusion Better immune response was found in the group of rhGM-CSF with hepatitis B vaccine. So rhGM-CSF can induce the immune respond to hepatitis B vaccine.