慢性乙型肝炎患者血清IL-12、IL-18水平和外周血单个核细胞FOXp3基因水平研究

Serum IL-12 and IL-18 levels as well as peripheral blood mononuclear cell FOXp3 in patients with chronic hepatitis B

目的探讨慢性乙型肝炎(CHB)患者血清白细胞介素-12(IL-12)、IL-18和外周血单个核细胞叉头蛋白P3(Foxp3)基因水平变化及其临床意义。方法2015年7月~2018年3月我院收治的CHB患者78例和同期健康体检者25例,采用ELISA法检测血清IL-12和IL-18水平,分离外周血单个核细胞,采用RT-PCR法检测细胞Foxp3 mRNA水平。结果在78例CHB患者中,经肝组织活检诊断G1组21例,G2组24例,G3组19例,G4组14例;CHB患者血清ALT和AST水平分别为(278.3±89.4)U/L和(305.3±84.6)U/L,显著高于健康人的[(25.3±7.6)U/L和(20.3±6.5)U/L,P<0.05];G4组血清ALT和AST水平分别为(563.5±132.4)U/L和(513.3±102.5)U/L,显著高于G1组[(113.2±67.4)U/L和(73.5±25.3)U/L]或G2组[(153.6±45.3)U/L和(113.8±35.2)U/L]或G3组[(240.5±56.6)U/L和(156.7±51.2)U/L,P<0.05];CHB患者血清IL-12和IL-18水平及单个核细胞Foxp3 mRNA水平分别为(198.3±19.6)pg/ml、(408.6±91.2)pg/ml及(4.5±0.7),显著高于健康人[(64.5±10.9)pg/ml、(127.3±15.7)pg/ml、(3.3±0.4),P<0.05];G4组血清IL-12、IL-18及Foxp3基因水平分别为(237.5±23.6)pg/ml、(431.5±106.3)pg/ml、(5.1±0.3)],显著高于G1组[(146.3±15.2)pg/ml、(390.2±90.3)pg/ml、(3.7±0.6)]或G2组[(185.2±13.6)pg/ml、(403.6±93.2)pg/ml、(3.9±0.5)pg/ml]或G3组[(203.2±18.3)pg/ml、(414.3±105.4)pg/ml、(4.3±0.7),P<0.05]。结论CHB患者外周血单个核细胞Foxp3基因及血清IL-12和IL-18水平显著升高,且肝组织炎症活动显著者,其水平更高,提示其参与了CHB的发病过程。及时检测这些指标可能对监测病情变化和判断治疗应答有帮助。

Objective The aim of this study was to explore the changes of serum IL-12(IL-12)and IL-18 levels as well as peripheral blood mononuclear cell(PBMCs)forkhead/winged helix transcription factor(FOXp3)in patients with chronic hepatitis B(CHB).Methods 78 patients with CHB and 25 healthy persons were recruited in our hospital,and all patients received liver biopsies.Serum IL-12 and IL-18 levels were detected by ELISA,and Foxp3 mRNA from PBMCs were assayed by RT-PCR.Results Out of the 78 patients with CHB,21 cases were found with G1,24 cases in G2,19 cases in G3 and 14 cases in G4 by histopathological examination;serum ALT and AST levels in patients with CHB were(278.3±89.4)U/L and(305.3±84.6)U/L,significantly higher than[(25.3±7.6)U/L and(20.3±6.5)U/L,P<0.05]in healthy control;serum level of ALT and AST in G4 group were(563.5±132.4)U/L and(513.3±102.5)U/L,significantly higher than[(113.2±67.4)U/L and(73.5±25.3)U/L in G1 group]or[(153.6±45.3)U/L and(113.8±35.2)U/L in G2 group]or[(240.5±56.6)U/L and(156.7±51.2)U/L in G3 group,P<0.05];serum IL-12 and IL-18 as well as PBMC Foxp3 in patients with CHB were(198.3±19.6)pg/ml,(408.6±91.2)pg/ml and(4.5±0.7),significantly higher than[(64.5±10.9)pg/ml,(127.3±15.7)pg/ml and(3.3±0.4),P<0.05]in healthy individuals;serum IL-12,IL-18 and Foxp3 mRNA in G4 group were(237.5±23.6)pg/ml,(431.5±106.3)pg/ml and(5.1±0.3),significantly higher than[(146.3±15.2)pg/ml],(390.2±90.3)pg/ml and(3.3±0.4)]in G1,[(185.2±13.6)pg/ml,(403.6±93.2)pg/ml and(3.9±0.5)]in G2 group,or[(203.2±18.3)pg/ml,(414.3±105.4)pg/ml and(4.3±0.7)P<0.05]in G3 group.Conclusion IL-12 and IL-18 might be involved in the pathogenesis of CHB,and early detection of IL-12,IL-18 and Foxp3 gene could be beneficial to predict the progress of the disease.