慢性丙型肝炎患者治疗前后血清中IL-18、IFN-γ及IL-4的表达及意义

The expression of IL-18, IFN-γ and IL-4 in the serum of patients with chronic hepatitis C before and after therapy

目的:研究慢性丙型肝炎患者治疗前后血清中白介素-18(IL-18)、干扰素-γ(IFN-γ)及白介素-4(IL-4)的表达情况,探讨IL-18、IFN-γ在及IL-4在慢性丙型肝炎发病中的作用及可能临床意义。方法:酶联免疫吸附法(ELISA)检测20例正常人,42例慢性丙型肝炎患者治疗前后血清中IL-18、IFN-γ在及IL-4水平。结果慢性丙型肝炎患者血清IL-18表达高于健康对照组(380.3±27.2pg/mlvs104.1±10.9pg/ml,P<0.05),血清IFN-γ表达也高于健康对照组(3.2±0.4IU/mlvs1.2±0.2IU/ml,P<0.05),而慢性丙型肝炎患者与健康对照组间IL-4表达无统计学差异(23.8±2.7pg/mlvs23.5±2.9pg/ml,P>0.05)。慢性丙型肝炎患者血清IL-18表达与谷丙转氨酶具有正相关性(r1=0.701,P<0.05);IFN-γ表达与谷丙转氨酶均具有正相关性(r2=0.629,P<0.05)。治疗前慢性丙型肝炎患者应对组血清中IL-18及IFN-γ表达高于无应答组(380.3±27.2pg/mlvs280.1±19.8pg/ml,P<0.05)(3.7±0.4IU/mlvs2.9±0.2IU/ml,P<0.05)。治疗后慢性丙型肝炎患者应答组血清中IL-18及IFN-γ表达较治疗前下调(380.3±27.2pg/mlvs150.6±11.4pg/ml,P<0.05)(3.7±0.4IU/mlvs1.8±0.1IU/ml,P<0.05),治疗后无应答组血清中IL-18及IFN-γ表达较治疗前无统计学差异(280.1±19.8pg/mlvs250.6±24.7pg/ml,P>0.05)(2.9±0.2IU/mlvs2.6±0.5IU/ml,P>0.05),而有无应答组间IL-4在治疗前后均无统计学差异(P>0.05)。结论:慢性丙型肝炎患者中,IL-18及IFN-γ表达增高,IL-4差异无统计学意义,且IL-18及IFN-γ表达与谷丙转氨酶水平有关。IL-18及IFN-γ可能在慢性丙型肝炎的发生发展、预测干扰素联合利巴韦林抗病毒疗效中有一定临床指导意义。

Objective：To explore the relationship between cytokines （IL- 18, IFN-γ , IL-4） and pathogenesis of chronic hepatitis C, we investigate the expression of interlukin-18（IL-18）, Interferon-gamma（IFN-γ ） and interlukin-4（IL-4） in patients with chronic hepatitis C before and after therapy. Methods：Enzyme-linked immunosorbant assay （ELISA） was used to measure the expression of IL-18 in the serum of 42 patients with chronic hepatitis C and 20 health individuals. Results：Patients of chronic hepatitis C showed higher levels of IL-18 and IFN-γ than the controls （380.3±27.2 pg/ml vs 104.1±10.9 pg/ml, P〈0.05） （3.2±0.4 IU/ml vs 1.2±0.2 IU/ml, P〈0.05）, The expression of IL-18 and IFN-γ in patients with chronic hepatitis C was positively related with the expression of alanine aminotransferase （rl=0.701 ,P〈0.05; r2=0.629,P〈0.05）. Before the therapy the level of IL-18 and IFN-V in the response group were higher than that in the non-response group（380.3± 27.2 pg/ml vs 280.1± 19.8 pg/ml, P〈0.05） （ 3.7±0.4 tU/ml vs 2.9±0.2 IU/ml, P〈 0.05）. After the therapy with Interferon-alpha and ribavirin, the level of IL-18 and IFN-18 decreased significantly in the response group （380.3±27.2 pg/ml vs 150.6±11.4 pg/ml, P〈0.05）（3.7±0.4 IU/ml vs 1.8± 0.1 IU/ml, P〈0.05）, but not in the non-response group （P 〉0.05）. The level of IL-4 showed no significant change （P 〉 0.05）. Conclusions：The IL-18 and IFN-γ is increased in patients with chronic hepatitis C, and may play a role in the pathogenesis and progress of chronic hepatitis C.