白细胞介素17在乙肝肝纤维化中的表达及意义

Expression of interleukin-17 in hepatitis B related liver fibrosis

目的:探讨白细胞介素17(IL-17)与慢性乙型肝炎病毒(HBV)相关性肝病特别是乙肝肝纤维化发生的相关性。方法:酶联免疫吸附试验(ELISA)及逆转录-多聚酶链反应(RT-PCR)法分别测定36例慢乙肝、42例肝硬化(Child-pughA、B、C分别为15、12、15例)、34例原发性肝癌、30例慢性重型乙型肝炎及20例健康对照者血清中的IL-17和外周血单个核细胞(PBMC)中IL-17mRNA水平及肝硬化Child-pugh分级患者血清中的IL-17和肝纤维化指标IV型胶原(C-IV),层黏连蛋白(LN),透明质酸(HA)的浓度。结果:与正常对照组相比,血清IL-17和PBMC中IL-17mRNA水平在4组病人中表达升高(P<0.01);与其他各组相比,IL-17及mRNA水平在肝硬化中升高尤其明显(P<0.01)。肝硬化患者血清IL-17及肝纤维化指标水平在Child-pughC组高于Child-pughA和Child-pughB组,Child-pughB组高于Child-pughA组(P<0.01)。IL-17水平与Child-pugh分级评分及C-IV,LN,HA浓度均呈正相关(r=0.582、0.568、0.682、0.764,P<0.01)。结论:IL-17在慢性HBV相关性肝病尤其是乙肝肝硬化中表达明显升高,IL-17可能与慢性HBV相关性肝病尤其是乙肝肝纤维化的发生有明显的相关性。

AIM： To explore the role of interleukin-17 （IL-17） in the pathogenesis and progress of chronic hepatitis B virus （HBV） related liver diseases, especially in hepatitis B related liver fibrosis. METHODS： Whole vein blood was obtained from the patients with chronic hepatitis B （CHB） （ n = 36）, liver cirrhosis （LC） （ n = 42 ） including child-pugh A （ n = 1.5）, child-pugh B （ n =12）, child-pugh C （ n = 1.5 ）, primary hepatitis carcinoma （PHC） （ n = 34 ）, chronic severe hepatitis （ n =30） and normal control （ n = 20）. The level of serum IL-17 and the expression of IL-17 mRNA in peripheral blood mononuclear cell （PBMC） were analysed by ELISA and RT-PCR respectively. Serum IL-17 and liver fibrosis index （C-IV, LN, HA） concentration of LC classified by child-pugh scores were detected by ELISA. RESULTS： The level of serum IL-17 and the expression of IL-17 mRNA in PBMC in four HBV infectious groups were higher than that in control group （ P 〈 0, 01 ）. The level of serum IL-17 and the expression of IL-17 mRNA in PBMC in LC group was higher than that in other groups （ P〈0.01 ）. The level of serum IL-17 and liver fibrosis index in child-pugh C group in LC patients were higher than that in Child-pugh B group and that in child-pugh B group were higher than that in chiid-pugh A group （ P 〈 0.01 ）. The level of serum IL-17 in LC group positively correlated to child-pugh score and liver fibrosis index （C-IV, LN, HA） （r=0.582, 0.568, 0.682, 0.764, P 〈 0.01）. CONCLUSION： IL-17 is obviously increased in HBV related liver diseases, especially in hepatitis B related liver cirrhosis, indicating that IL-17 may play a part in the development of HBV related liver diseases, especially the pathophysiology of hepatitis B related liver fibrosis.