慢性乙型肝炎患者IFN-r、IL-2、IL-4、IL-10的活性测定及其相关性研究

DETERMINATION OF INF-r、IL-2、IL-4、IL-10 IN PATIENTS WITH CHRONIC HEPATITIS B AND THE CORRELATION STUDY

目的 :探讨慢性乙型肝炎 (CHB)患者外周血单个核细胞 (PBMC)Th1 、Th2 两类细胞因子的分泌情况及其对肝功能的影响。方法 :以夹心ELISA法检测 41例CHB患者PBMC经PHA刺激后 ,培养上清液中Th1类细胞因子 (IFN -r、IL -2 )和Th2 类细胞因子 (IL -4、IL -10 )的活性 ,PCR法检测患者外周血清HBVDNA。结果 :CHB患者无论血清HBVDNA阳性组还是阴性组 ,IL -2活性较对照组显著降低 (P <0 0 1) ,IFN -r降低 ,但差异不显著 (P >0 0 5 ) ;血清HBVDNA阳性组IL -2活性较HBVDNA阴性组显著增高 (P <0 0 1) ,IL -10显著降低 (P <0 0 5 ) ,IL -4降低但无显著性差异 (P >0 0 5 ) ;血清HBVDNA阳性组ALT与GGT活性显著高于阴性组 ( P <0 0 5 )。结论 :在CHB患者体内存在着Th1 、Th2 免疫应答失衡 ,Th1、Th2两类细胞因子水平的改变引起细胞免疫功能紊乱 ,由此造成HBV持续性感染及肝损伤。

Objective:To explore the secretion of Th 1-like cytokines and the Th 2-like cytokines produced by peripheral blood mononuclear cells (PBMC) of the patients with hepatitis B in vitro and the influence on the liver function.Methods:Forty-one patients with chronic hepatitis B were investigated in this study,the Th1-like cytokines (IFN-r Il-4) and the Th 2-like cytokines (IL-4 IL-10),produced by PBMC stimulated with phytohemagglutinin (PHA) in vitro ,were measured by sandwich ELISA .HBV DNA in serum was detected with polymerase chain reaction.Results:The production of IL-2 by PBMC from all the patients with CHB is lower than that from controls(P<0 01),IFN-r is lower than that from controls ,but there was no significant difference between them. Compared with patients who have no HBV DNA in serum ,the IL-2 activity is higher in patients who have HBV DNA in serum (P<0 01),the activity of IL-10 is lower in patients who have HBV DNA in surem (P<0 05), the activity of ALT and GGT in patients who have HBV DNA in surem are higher than patients who have no HBV DNA in surem.Conclusion:It was concluded that immunological disorders of Th 1/Th 2 exists in patients with hepatitis B,the change of Th 1-like cytokines and Th 2-like cytokines caused the celluar immunoligical disorders ,this change also caused the continuous infection by HBV and may result in liver cell damage.