慢性丙型肝炎患者血清细胞因子水平的变化及意义

目的:检测慢性丙型肝炎患者血清细胞因子IL-2、IFN-г、IL-5、IL-6、IL-12P70和P40水平,探讨其与患者血清ALT水平、HVC RNA载量、HCV基因型及干扰素疗效的关系。方法:检测30例健康对照者和30例慢性丙型肝炎患者干扰素治疗前后血清IL-2、IFN-г、IL-5、IL-6、IL-12P70和P40的含量,比较干扰素治疗应答组和无应答组之间细胞因子水平的差异及上述细胞因子水平与血清ALT水平、HCV基因型、HCVRNA载量等的关系。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:与健康对照组相比,慢性丙型肝炎患者血清IL-2含量明显降低,IL-5和IL-12P40明显生高;血清IL-6含量与血清ALT水平呈正相关,与RNA载量呈负相关;HCV基因型1型患者血清IL-6含量明显高于2型,其他基因型和亚型之间细胞因子水平均无显著性差异;干扰素治疗的持续应答率为46.7%,应答组和无应答组治疗前血清细胞因子水平均无显著性差异,但应答组治疗结束时IFN-γ含量较治疗前明显升高。结论:血清Th1/Th2细胞因子水平失衡与丙型肝炎的慢性化和肝脏炎症活动相关;干扰素治疗前血清Th1/Th2细胞因子水平与干扰素治疗效果无关,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。

Cytokine levels in serum of patients with chronic hepatitis C and its sigificance

AIM: To investigate the relationship between the changes of cytokine levels in serum and ALT,HCV genotype,HCV RNA loading and the effectiveness of IFN treatment.The cytokines included IL-2,IFN-г,IL-5,IL-6,IL-12P70 and IL-12P40.METHODS: Contents of IL-2,IFN-г,IL-5,IL-6,IL-12P70 and IL-12P40 in serum of 30 patients with chronic hepatitis C and 30 healthy adults were detected.The relationship of cytokine level with ALT level,HCV genotype,HCV RNA load were analyzed.The differences of these cytokine levels in the groups of response and nonresponse to interferon treatment were compared.Serum cytokines were detected by the method of ELISA.HCV genotypes were classified by direct sequencing.HCV RNA loads were determined by fluorescence quantitative PCR.RESULTS: The content of IL-2 was decreased and the contents of IL-5 and I L-12P40 increased in the patients with chronic hepatitis C compared with normal control.The serum levelof IL-6 were directly proportional to the serum levels of ALT,while inversely proportional to that of HCV RNA load,and in HCV genotype 1 patients was significantly higher than that in genotype 2 patients,the other cytokine levels had no differences between two genotypes.The sustained response rate of IFN treatment was 46.7%.There were no difference of all cytokines detected between the groups of response and nonresponse before IFN therapy,but the level of IFN-γ were increased after interferon therapy in the response group.CONCLUSION: The imbalance of immune cytokines had correlation with the chronicity if HCV infection and the activity of liver inflammation.There are no correlation between the levels of Th1/Th2 cytokines in the serum before IFN treatment and the outcome of IFN therapy.Increasing IFN-γ in the serum induced by IFN treatment is associated with sustained response.