慢性HCV感染者外周血单个核细胞IL-18和IFNAR1检测的临床意义

The significance of detection of interleukin 18 and interferon-α receptor 1 in peripheral blood mononuclear cells of patients with chronic hepatitis C

目的分析慢性丙肝(CHC)患者外周血单个核细胞(PBMC)白细胞介素18(IL18)mRNA的诱导表达及α干扰素受体1(IFNαreceptor1,IFNAR1)表达,评价慢性丙肝患者PBMC细胞免疫功能。方法脂多糖(LPS)体外刺激正常对照组和慢性丙型肝炎病毒(HepatitisCvirus,HCV)感染组病人PBMC,RTPCR检测干扰素治疗前后PBMCIL18mRNA水平的变化。同时RTPCR检测不同组PBMCIFNAR1mRNA水平的差异。结果治疗前干扰素应答组病人(n=12)和无应答组病人(n=26)PBMCIL18mRNA诱导表达水平显著低于正常对照组(P<0.01;P<0.01);治疗后,应答组病人IL18mRNA水平随治疗时间延长而升高,1个月时显著高于无应答组病人(P<0.01),无应答组病人IL18mRNA水平始终较低。IFNα2b治疗期间,干扰素应答组病人PBMCIFNAR1mRNA水平从治疗前的高表达而逐渐减少,正常对照和干扰素无应答组病人PBMCIFNAR1mRNA的表达始终较低(治疗前与应答组相比P<0.01)。结论慢性HCV感染病人的细胞免疫功能受损,不能正常表达IL18和IFNAR1,但应答组病人经干扰素治疗后表达能力逐渐恢复。慢性丙肝患者PBMCIL18mRNA和IFNAR1mRNA水平检测也许可以作为干扰素治疗预后的判断指标。

Objective To detect the expression ff interleukin 18 （IL-18） and intefferon-α receptor 1 （IFN-α receptor 1, IFNAR1） in peripheral blood mononuclear ceils （PBMC） of pafients with chronic hepatitis C virus （HCV） infection,and analysis cellular immune status of patients with chronic hepatitis C （CHC）.Methods PBMC of CHC patients were cultured,then ID18 mRNA from PBMC stimulated with LPS were measured by reverse transcription-polymerase chain reaction （RT-PCR）. IFNAR 1 mRNAs from PBMC of patients with chronic HCV infection were measured by RT-PCR. Results To the expression of ID18 mRNA in PBMC from stimulated with LPS, responder （ n = 12） were signitieanfly lower than that of normal control group （ n = 20） before IFN-α 2b therapy （ P 〈0.01） ,however,after IFN-α 2b therapy,the levd of IL-18 mRNA of responder sharply raised and non-responder kept low. The expression of IFNAR1 mRNA in PBMC from non-responder was inhibited,to contrast,responder present a high levd of expression of IFNAR1 mRNA before IFN-α therapy,and IFNAR1 mRNA expression decreased after treated with IFN-α. Conclusion The cellular immune function of patients with CHC is impaired.The expression of IL-18 geno and IFNAR 1 geno of non-responder of CHC patients was inhibited. The IL-18 levd and IFNAR 1 levd of PBMC perhaps can he markers for hepatitis C prognosis after IFN-α therapy for CHC patients.