α-干扰素治疗慢性病毒性肝炎前后细胞因子的变化

Changes of immunoregulatory cytokines in patients with chronic viral hepatitis pre and post-treatment with interferon-alfa

目的 :观察α 干扰素治疗慢性病毒性肝炎前后免疫细胞因子的变化 ,探讨α 干扰素与细胞因子之间的关系 ,为干扰素治疗选择合适的适应症。方法 :用双抗体夹心ELISA法对 82例慢性病毒性肝炎患者α 干扰素治疗前后IL 2、γ IFN、IL 10进行了检测 ,同时观察了T细胞亚群的变化。结果 :82例乙丙肝患者 ,用α 干扰素治疗后 ,治疗有效 40例 ,有效率 48 78% ,随访 1～ 2年 ,10 98%复发。干扰素治疗前 :慢性病毒性肝炎患者CD+ 4/CD+ 8比值、血清IL 2、γ IFN水平降低 ,而IL 10水平明显升高。治疗有效组IL 10显著低于治疗无效组。治疗后 :有效组CD+ 4/CD+ 8比值、血清IL 2、γ IFN水平较治疗前显著升高 ,IL 10明显下降 (P <0 0 5 ) ,而治疗无效组 ,治疗后仅IL 2较治疗前增高 ,CD+ 4/CD+ 8比值、血清IL 10、γ IFN较治疗前无明显变化。结论 :用干扰素治疗慢性病毒性肝炎可以明显提高CD+ 4/CD+ 8比值 ,使T细胞活化 ,促进Th1因子的产生 ,抑制Th2细胞因子。干扰素治疗无效组治疗前IL 10水平显著高于治疗有效组 ,可能是部分慢性病毒性肝炎干扰素疗效差的原因之一。T细胞亚群、Th1/Th2细胞因子的检测可用于干扰素抗病毒治疗适应症的选择和疗效监测。

Objective:To observe the changes of cytokines in chronic hepatitis pre and post treatment with interferon(IFN) alfa,reveal the relation between cytokines and IFN alfa,and select proper indications for interferon treatment Methods:Serum IL 2、γ IFN、IL 10 levels were determined in 82 patients with chronic hepatitis prior to and at termination of IFN alfa treatment The changes of T subset were observed at a same time Results: 40 patients responsed completely in 82 patients after IFN treatment , effective rate was 48 78%,10 98% patients relapsed in the period of following 1～2 years The CD + 4/CD + 8 ratio,serum levels of IL 2,γ IFN were decreased ; IL 10 levels were increased significantly versus normal controls and serum IL 10 levels in non responders were significantly higher than those in responder in pre treatment with IFN IFN alfa treatment could elevate CD + 4/CD + 8 ratio and serum levels of IL 2,γ IFN, and decreased IL 10 levels in responders, only IL 2 levels were increased and other cytokines level were not changed significantly in non respond Conclusion: These findings indicate that an activated T cell response is present ,and Th1 cytokine response could be stimulated ,Th2 cytokine response could be diminished after IFN alfa treatment Thus,modulation of T cell function and cytokines production may be one mechanism whereby IFN alfa therapy results in reduced viral burden. The high serum IL 10 in pre treatment may be related to a poor response to IFN treatment in chronic hepatitis Detecting T subset 、Th1/Th2 cytokines can be used for selecting indications and inspecting curative effect of IFN treatment in chronic viral hepatitis