IFN-α2b对慢性乙型肝炎患者外周血单个核细胞内HBV-DNA阴转和对CD25的诱导作用

Negative Effect of IFN-α2b on HBV-DNA in PBMC and Inducement to CD25 in Patients with Chronic Hepatitis B

目的探讨IFNα2b对慢性乙型肝炎患者HBVDNA的治疗效果及对CD25的诱导作用。方法将患者分为A(66例)、B(44例)两组,分别采用IFNα2b和常规治疗,PCR法动态检测患者外周血单个核细胞(PBMC)内和血清中HBVDNA,生物素链霉亲和素(BSA)法检测CD25表达水平,实时(realtime)PCR法检测CD25mRNA含量,动态检测抗IFNIgG水平。结果IFNα2b治疗24、48周后,患者PBMC内、血清中HBVDNA和HBeAg阴转率分别为36.36%、39.39%、40.91%和42.42%、51.52%、53.03%,与常规组相比差异有显著性(P<0.05～P<0.01);干扰素治疗后,ALT、AST、ALT/AST水平分别为(33.4±12.6)U/ml、(34.3±10.7)U/ml、(0.9±0.2)U/ml,与常规组相比差异有显著性(P<0.01);慢性乙型肝炎患者静息态和诱导态CD25水平均降低,干扰素治疗后,静息态和诱导态CD25水平显著升高,其CD25mRNA含量亦同步升高,与常规组相比差异有显著性(P<0.01);IFNα2b治疗48周抗IFNIgG阳性率仅6.06%,与常规组相比差异无显著性(P>0.05)。结论IFNα2b对PBMC、血清HBVDNA和HBeAg均有较好阴转效果,阴转率明显高于常规疗法;IFNα2b可诱导慢性乙型肝炎患者表达CD25,促进T细胞活化发挥抗病毒作用;IFNα2b自身免疫原性较弱,治疗过程中诱导机体产生低水平的抗IFNIgG,对IFNα2b的抑制作用较弱。

OBJECTIVE To study the therapeutic effect of IFN-α2b on HBV-DNA and inducement to CD25 of the patients with chronic hepatitis B. METHODS All of patients were divided into two groups （A=66, B=44）, and treated by IFN-α2b, or routine medicine, respectively. The levels of HBV-DNA in PBMC and serum were dynamically detected during the treatment. The expressions of CD25 and CD25 mRNA were respectively detected by method of biotin-streptavidin （BSA） and real-time PCR. The level of anti-IFN-IgG was also tested during the treatment. RESULTS After the treatment of IFN-α2b for 24 weeks or 48 weeks,the total negative rates of HBV-DNA in PBMC, serum and HBeAg in the patients treated with IFN-α2b were 36.36%, 39.39%, 40.91% and 42.42%, 51.52%, 53.03%, respectively. The levels of ALT, AST, ALT/AST in serum of the patients after treatment with IFN-α2b were （33. 4±12. 6） U/ml, （34. 3±10. 7） U/ml, 0. 9±0. 2. There was significant difference between two groups （P〈0.05, P〈0.01）. The level of CD25 either in silence or in inducement was low in chronic hepatitis B. However, the expression of CD25 could be induced by IFN-α2b and its mRNA obviously increased after treatment of IFN-α2b. There was significance difference between two groups （P〈0.01）. Only 4 （6. 06%） cases were with anti-IFN-IgG （＋） and little discrepancy between two groups （P 〉 0. 05）.CONCLUSIONS IFN-α2b has better therapeutic effect on HBV-DNA in PBMC, serum and HBeAg than that of routine therapy. CD25 in patients with chronic hepatitis B can be induced by IFN-α2b so that the active T cells play a key role against HBV-DNA in hosts. Few immunogenicity of IFN-α2b and low level of anti-IFN-IgG can be produced during the treatment so that the little inhibitory effect against IFN-α2b is existent.