白细胞介素-10在慢性乙型肝炎患者中的表达及临床意义

Interleukin-10 is associated with immune phases of patients with chronic hepatitis B

目的探讨慢性乙型肝炎患者不同临床免疫分期白细胞介素（Interleukin，IL）-10及其相关细胞因子IL-6和肿瘤坏死因子（tumornecrosis factor，TNF）-α的表达规律及临床意义。方法采用回顾性方法共纳入慢性乙型肝炎患者197例，其中免疫耐受期40例、免疫清除期97例、低复制期26例和再活动期（HBeAg阴性慢性乙型肝炎）34例，选择18例健康志愿者为正常对照。酶联免疫吸附法（Enzyme-linked Immunosorbent Assay，ELISA）检测血浆IL-10、IL-6和TNF-α水平，实时荧光定量聚合酶链式反应（Real—time Polymerase Chin Reaction，RT-PCR）方法检测外周血单个核细胞（peripheral blood mononuclear cells，PBMCs）中IL-10、IL-6和TNF-α的mRNA水平。结果慢性乙型肝炎患者血浆和PBMCs中IL-10、IL-6和TNF-α表达水平均高于正常对照组（P〈0．05）。慢性乙型肝炎患者血浆IL-10蛋白及mRNA水平与血清ALT、AST和IL-6呈明显正相关（P〈0．05）．与TNF-α呈明显负相关（P〈0．05）。免疫清除期患者血浆IL-10水平和PBMCsIL-10mRNA水平明显高于免疫耐受期和低复制期患者（P〈0．05），再活动期患者PBMCsIL-10mRNA水平明显高于免疫耐受期（P〈0．05）。结论IL-10在慢性乙型肝炎的免疫病程中具有重要作用。

Objective To determine the expression of interleukin （IL）-10 and its associated cytokines in different immune phases of patients with chronic hepatitis B. Method A total of 197 patients with chronic hepatitis B were included, including 40 for immune tolerance（IT）phase, 97 immune clearance （IC） phase, 26 low replication （LR） phase, and 34 for HBeAg negative hepatitis B （ENH） phase. The level of IL-IO, IL-6 and TNF-α in plasma was determined using enzyme-linked immunosorbent assay （ELISA）. The level of IL-10, IL-6 and TNF-α in peripheral blood mononuclear cells （PBMCs） was determined using quantitative real-time polymerase chain reaction（RT-PCR）. Results The plasma levels of IL-10, IL-6 and TNF-α in chronic hepatitis B patients were significantly higher than healthy controls （all P 〈 0. 05 ）, as well as mRNA levels of these cytokines shared the same condition. The plasma level of IL-10 and IL-10 mRNA level in PBMCs were significantly correlated with ALT, AST and IL-6 （P 〈 0. 05 ）and negatively correlated with TNF-α （P 〈 0. 05 ）. The levels of plasma IL-10 and IL-10 mRNA in patients with immune clearance phase was significantly higher than patients with immune tolerance phase and low replication phase（P 〈 0. 05 ）. IL-10mRNA in patients with HBeAg negative hepatitis B phase was higher than that with immune tolerance phase （P 〈 0. 05 ）. Conclusion IL-10 might contribute to immune phases of chronic HBV infection.