乙肝疫苗刺激后慢性乙肝患者外周血单个核细胞分泌γ-IFN和IL-4水平及临床意义

INTERFERON γ(γ-IFN) AND INTERLEUKIN 4(IL-4) LEVELS IN SERA ANDD IN HEPAATITIS B VACCINE STIMULATED CULTURE SUPERNATANTS OF PERIPHERAL BLOOD MONONUCCLEAR CE LLS FROM PATIENTS WITH CHRONIC HEPATITIS B

目的 :探讨慢性乙肝 (CHB)患者血清及经乙肝疫苗刺激后外周血单个核细胞 (PBMCs)培养上清γ干扰素 (γ -IFN)和白细胞介素 - 4 (IL - 4 )水平及临床意义。方法 :分离 13例CHB患者及 10名正常人PBMCs。PBMCs体外单独培养或与乙肝疫苗共培养 4 8小时后 ,检测血清及培养上清中γ -IFN和IL - 4水平。结果 :在血清、空白处理的PBMCs培养上清 ,以及乙肝疫苗处理后的PBMCs培养上清中 ,慢性乙肝患者的IL - 4水平均较对照组高 ,而γ -IFN水平均比对照组低 ;同时 ,经乙肝疫苗处理后病例组和对照组PBMCs培养上清中IL - 4水平都较空白处理组显著增高 ,尤以病例组明显 ;经乙肝疫苗处理后 ,病例组和对照组PBMCs培养上清中γ -IFN水平无明显增高。结论 :慢性乙肝患者Th1和Th2应答失衡 ,以Th2应答为优势 ;重组乙肝疫苗能够增强慢性乙肝患者Th2应答 ;慢性乙肝患者血清中可能存在抑制免疫应答的物质 ;

Objectives: To investigate the γ-IFN and I L-4 levels in seaa and in he epatitis B vaccine stimulated culture supernatants of peripheral blood mononuc lear cells(PBMCs) from the patients with chronic hepatitis B and their clinical significance. Methods: The levels of γ-IFN and IL-4 in sera and in he patitis B vaccine stimulated or not stimulated culture supernatants of PBMCs from 13 pat ients with chronic hepatitis B (CHB) and 10 normal controls were detected. Results: IL-4 levels in sera and in hepatitis B vaccine stimulated or non-stimulate d culture supernatants of PBMCs from patients with CHB were higher than those f rom the controls, while γ-IFN levels in sera and in hepatitis B vaccine stimu lated or non-stimulated culture supernatants of PBMCs from patients with CHB wer e lower than those from the controls. In supernatants, IL-4 levels increased bu t γ-IFN levels did not after PBMCs had been stimulated by hepatitis B vaccine. Conclusions: Th1/Th2 responses were unbalanced in the p atients with CHB, mayb e Th2 responses are dominant; hepatitis B vaccine could enhance Th2 response; so me substance inhibiting immune response may exist in sera of the patients with C H B; the recombinant hepatitis B vaccine used in this experiment may not include T h1 epitopes.