自身免疫性肝炎患者血清细胞因子水平变化及其与治疗应答的关系研究

Serum IL-6,IL-8 and IL-10 levels and their impact on response to steroid therapy in patients with autoimmune hepatitis

目的分析自身免疫性肝炎(AIH)患者血清白细胞介素-6(IL-6)、IL-8和IL-10水平变化及其与治疗应答的关系。方法2020年1月~2023年12月我科收治的60例AIH患者和同期体检的60例健康人,给予所有AIH患者醋酸泼尼松治疗6个月。采用化学发光法检测血清细胞因子水平。应用受试者工作特征曲线(ROC)分析血清细胞因子水平预测治疗应答的效能。结果治疗前,AIH组血清IL-6和IL-8水平分别为(7.5±2.5)pg/mL和(70.2±26.7)pg/mL,均显著高于健康人【分别为(4.8±1.4)pg/mL和(42.4±13.2)pg/mL,P<0.05】,而血清IL-10水平为(4.2±1.1)pg/mL,显著低于健康人【(7.3±2.6)pg/mL,P<0.05】;治疗后,AIH患者血清IL-6和IL-8水平显著降低,而血清IL-10水平显著升高(P<0.05);在治疗6个月末,本组AIH患者治疗应答率为56.7%,未应答或不完全应答率为43.3%;入组时,治疗应答组血清IL-6和IL-8水平分别为(4.9±1.4)pg/mL和(47.4±15.2)pg/mL,均显著低于未应答组【分别为(9.9±2.8)pg/mL和(108.3±28.7)pg/mL,P<0.05】,而血清IL-10水平为(6.9±1.9)pg/mL,显著高于未应答组【(2.7±1.6)pg/mL,P<0.05】;分别以IL-6≤4.8 pg/mL、IL-8≤48.0 pg/mL和IL-10>6.8 pg/mL为截断点,ROC分析显示三个血清细胞因子联合预测治疗应答的曲线下面积(AUC)为0.816,其敏感度为100.0%,特异度为50.0%。结论AIH患者血清IL-6和IL-8水平异常升高,而血清IL-10水平降低,它们可能参与了疾病的发生发展过程,并对治疗应答产生影响,值得深入研究。

Objective The aim of this study was to investigate serum interleukin-6(IL-6),IL-8 and IL-10 level changes and their impact on response to steroid therapy in patients with autoimmune hepatitis(AIH).Methods 60 patients with AIH and 60 healthy individuals were recruited in our hospital between January 2020 and December 2023,and all patients received prednisone treatment for six months.Serum IL-6,IL-8 and IL-10 levels were measured by chemiluminescence method.Performance for predicting response to therapy was analyzed by using receiver operating characteristic(ROC)curves.Results At admission,serum IL-6 and IL-8 levels in patients with AIH were(7.5±2.5)pg/mL and(70.2±26.7)pg/mL,both significantly higher than[(4.8±1.4)pg/mL and(42.4±13.2)pg/mL,respectively,P<0.05],while serum IL-10 levels was(4.2±1.1)pg/mL,much lower than[(7.3±2.6)pg/mL,P<0.05]in healthy individuals;by end of six month treatment,serum IL-6 and IL-8 levels obviously decreased and serum IL-10 level increased(P<0.05)in patients with AIH;56.7%of patients with AIH in our series responded,while 43.3%of them didn’t completely responded to steroid therapy;at presentation,serum IL-6 and IL-8 levels in responders were(4.9±1.4)pg/mL and(47.4±15.2)pg/mL,both significantly lower than[(9.9±2.8)pg/mL and(108.3±28.7)pg/mL,respectively,P<0.05],while serum IL-10 level was(6.9±1.9)pg/mL,much higher than[(2.7±1.6)pg/mL,P<0.05]in non-responders;ROC analysis showed that AUC was 0.816,with sensitivity of 100.0%and specificity of 50.0%,when serum IL-6,IL-8 and IL-10(≤4.8 pg/mL,≤48.0 pg/mL and>6.8 pg/mL as cut-off-value,respectively)combination in predicting response to steroid therapy.Conclusion Serum IL-6,IL-8 and IL-10 levels in patients with AIH change abnormally,which might be involved in pathogenesis of the disease,and impact response to immunosuppression therapy.