IL-22对慢性丙型病毒性肝炎干扰素抗病毒治疗疗效的预测价值研究

Predictive value of IL-22 on the interferon therapy of chronic hepatitis C

目的探讨白细胞介素-22（IL-22）在慢性丙肝干扰素抗病毒治疗疗效预测中的价值。方法选取2013年10月-2015年3月深圳市人民医院感染内科慢性丙型肝炎住院患者60例,均给予聚乙二醇干扰素α-2a联合利巴韦林治疗,同时选取38例正常健康献血者作为参考,分别检测正常健康者、慢性丙型肝炎患者抗病毒治疗前、治疗4周、12周、24周、48周和停药后6个月的血清IL-10、IL-22和IL-28及mRNA水平,并同时检测患者肝功能和HCV RNA含量。结果经过48周抗病毒治疗后,60例慢性丙肝患者中完全应答41例、部分应答15例、无应答4例。治疗前患者血清中IL-10、IL-22、IL-28水平均显著高于正常健康献血者,差异具有统计学意义（P〈0.05）,与HCV病毒含量无显著相关关系。经过治疗,完全应答组患者血清IL-10、IL-22和IL-28水平逐渐降至并稳定至正常水平,部分应答组和无应答组患者血清IL-10、IL-22和IL-28水平在一段时间内降低,但又逐渐回升,IL-22较IL-10和IL-28回升更早。治疗后不同时间IL-10、IL-22、IL-28 mRNA表达水平,与血清中IL-10、IL-22、IL-28水平变化情况一致。结论 IL-22能够在早期有效预测慢性丙型病毒性肝炎干扰素抗病毒治疗效果。

Objective To explore the predictive value of IL-22 on the interferon therapy of chronic hepatitis C.Methods 60 chronic hepatitis C patients who were in the infection and internal medicine department of our hospital from October 2013 to March 2015 were selected and treated with pegylated interferon alpha-2a and ribavirin,meanwhile 38 healthy donors were selected as references.The serum IL-10,IL-22,IL-28,and mRNA of the patients before treatment,at 4 weeks of treatment,at 12 weeks of treatment,at 24 weeks of treatment,and 6 months after treatment were compared with that of healthy donors,meanwhile,the HCV RNA levels and liver functions of the patients were tested. Results After 48 weeks of treatment,among the 60 patients,there were 41 cases with complete response,15 cases with partial response,4 cases with none response.Before treatment,the serum IL-10,IL-22 and IL-28 of patients were obviously higher than those of the healthy donors（P〈0.05）,while they had no significant correlations with the HCV virus levels.After treatment,the serum IL-10,IL-22 and IL-28 of patients with complete response were gradually decreased and stabilized to normal levels,while those of some patients with partial response and patients with none response were firstly decreased and then increased,and the IL-22 rebounded earlier than the IL-10 and IL-28.After treatment,the expression levels of IL-28,IL-22,IL-10,and mRNA were consistent with the variations of those in serum. Conclusion IL-22 has a predictive value in the interferon therapy of chronic hepatitis C in early stage.