慢性乙型肝炎患者外周血单个核细胞IFN-γ、IL-6水平变化与拉米夫定疗效的关系

Correlation of IFN-γ and IL-6 levels produced by peripheral blood mononuclear cells with lamivudine treatment in patients with chronic hepatitis B

目的探讨慢性乙型肝炎(CHB)患者拉米夫定治疗前后外周血单个核细胞(PBMC)产生干扰素-γ(IFN-γ)、白细胞介素-6(IL-6)水平与血清乙型肝炎病毒(HBV)载量和丙氨酸氨基转移酶(ALT)的关系。方法采用荧光定量聚合酶链反应(FQ-PCR)和酶联免疫吸附试验(ELISA)分别检测拉米夫定治疗前后的CHB患者HBV DNA和PBMC经植物血凝素(PHA)刺激后分泌IFN-γ和IL-6的水平。结果CHB患者治疗前PBMC分泌IFN-γ水平显著低于正常对照组(P<0.01),分泌IL-6水平显著高于正常对照组(P<0.01);拉米夫定治疗后HBV高、中载量组分泌IFN-γ较治疗前显著升高(分别为P<0.01和P<0.05),分泌IL-6水平较治疗前显著降低(分别为P<0.01和P<0.05),治疗后中、低载量组分泌IFN-γ水平仍低于正常对照组(P<0.01),中、低载量组分泌IL-6的水平高于正常对照组(P<0.01);患者INF-γ水平变化与HBV DNA载量呈负相关(r=0.89,P<0.001),IL-6水平变化与HBV DNA载量和ALT呈正相关(分别为r=0.92,P<0.001;r=0.74,P<0.001)。结论CHB患者PBMC分泌IFNγ-、IL-6水平可作为判断拉米夫定治疗效果的参考指标。

Objective To investigate the correlation of interferon-γ(IFN-γ) and interleukin-6(IL-6) levels produced by peripheral blood mononuclear cells(PBMC) with serum hepatitis B virus(HBV) load and alanine aminotransferase(ALT) level in chronic hepatitis B(CHB) patients treated with lamivudine. Methods Fluorescence quantitative polymerase chain reaction(FQ-PCR) was used to detect the quantity of HBV load and enzyme-liked immunosorbent assay(ELISA) was used to determine the levels of INF-γ and IL-6 secreted by phytohemagglutinin(PHA) stimulated PBMC. Results IFN-γ level was lower but IL-6 level was higher than that of the control group(P<0.01) before lamivudine treatment.After lamivudine treatment,IFN-γ levels were significantly increased(P<0.01 and P<0.05 respectively),but IL-6 levels were significantly decreased(P<0.01 and P<0.05 respectively) in patients from HBV DNA high and middle level groups.However,in patients from HBV DNA middle and low level group,IFN-γ level was lower but IL-6 level was higher than that of control group(P<0.01).There was a negative correlation between IFN-γ level and the HBV DNA level(r=0.89,P<0.001),but IL-6 level positively correlated with HBV DNA level(r=0.92,P<0.001) and ALT level(r=0.74,P<0.001). Conclusions IFN-γ and IL-6 levels secreted by PBMC in CHB patients can be used for the judgment of therapeutic effects during lamivudine treatment.