白介素-6和白介素-12在HBsAg阳性母亲婴儿乙肝疫苗免疫应答中的作用

Effect of interleukin-6 and interleukin-12 on immune response to hepatitis B vaccination in infants of HBsAg-positive mothers

目的探讨白介素-6（IL-6）和白介素-12（IL-12）在HBsAg阳性母亲婴儿乙型肝炎（乙肝）疫苗免疫应答中的作用。方法收集91例HBsAg阳性孕妇足月分娩的新生儿并对其随访至12月龄。采用荧光定量聚合酶链反应（FQ-PCR）和化学发光免疫试验（CLIA）检测新生儿及婴儿外周血HBVDNA及HBV血清学标志物；利用ELISA检测新生儿及婴儿外周血IL-6和IL-12的水平。结果91例婴儿中，乙肝疫苗无／弱应答率为35．16％（32／91）。无／弱应答组在新生儿期和婴儿期IL-6水平均低于强应答组，而IL-12水平均高于强应答组，差异均有统计学意义（均P〈0．01）。从新生儿期到婴儿期，无／弱应答组及强应答组的IL-6水平均升高，而IL-12水平均降低，其变化在两组间差异均有统计学意义（均P〈0．01）。进一步分析发现，婴儿抗-HBs水平与新生儿期及婴儿期IL-6呈正相关（^=0．70、0．79，均P〈0．叭），与IL-12呈负相关（n=-0．71、-0．72，均P〈0．01）。从新生儿期到婴儿期，IL-6升高程度与婴儿抗-HBs水平呈正相关（L=-0．74，P〈0．01），IL-12的降低程度与婴儿抗-HBs水平存在负相关（L=-0．42，P〈0．01）。新生儿期和婴儿期IL-6与IL—12间均呈负相关（ri=-0．68、-0．70，均P〈0．01）。结论IL-6可能促进HBsAg阳性母亲婴儿乙肝疫苗免疫应答，而IL-12则可能抑制免疫应答，IL-6与IL-12共同影响HBsAg阳性母亲婴儿对乙肝疫苗的免疫应答。

Objective To explore the effect of interleukin-6 （IL-6） and Interleukin-12 （IL-12） on immune response to hepatitis B vaccination in infants of HBsAg-positive mothers. Methods A total of 91 neonates whose mothers were HBsAg-positive were included and followed up for 12 months. HBV DNA and HBV serological markers in the peripheral blood of the neonates and infants were detected with fluorescence quantitative polymerase chain reaction （FQ-PCR） and chemiluminescence immunoassay （CLIA）, and the levels of IL-6 and IL-12 in the peripheral blood of the neonates and infants were detected with enzyme-linked immunosorbent assay （ELISA）. Results The non-/hypo-response rate to hepatitis B vaccination was 35.16% （32/91） in the 91 infants. In the neonatal period and infantile period, the level of IL-6 in non-/hypo-response group was lower than that in high-response group, while the level of IL-12 was higher than that in high-response group, and there was significant difference （P〈0.01）. From the neonatal period to the infantile period, the level of IL-6 increased, while the level of IL-12 descended in both groups, and there was significant difference （P〈0.01）. Furthermore, the level of anti-HBs of infants was positively correlated with the level of IL-6 （rs = 0.70, 0.79, P〈 0.01）, and was negatively correlated with the level of IL-12 （r, = -0.71, -0.72, P〈0.01） in the neonatal period and the infantile period. From the neonatal period to the infantile period, the increased level of IL-6 was positively associated with the level of anti-HBs （rs = -0.74, P〈0.01）, while the decreased level of IL-12 was negatively associated with the level of anti-HBs （r,=-0.42, P〈0.01）. The level of IL-6 was negatively correlated with the level of IL-12 in the neonatal period and the infantile period （r~：-0.68,-0.70, P〈0.01）. Conclusions IL-6 might promote the immune response to hepatitis B vaccination in infants whose mothers were HBsAg-positive, while IL-12 might inhibit the immune response. IL-6 and IL-12 would affect the immune response to hepatitis B vaccination in infants of HBsAg-positive mothers at the same time.