CAJ | 학술논문

目的探讨干扰素α的疗效是否与调节Th1/Th2细胞因子的表达有关,并以此作为预测干扰素α疗效指标的可能性.方法采用双抗体夹心法和逆转录PCR方法,对应用干扰素治疗的23例慢性乙型肝炎患者外周血淋巴细胞中Th1/Th2细胞因子的表达水平进行动态检测.结果与正常对照组比较,慢性乙肝患者外周血淋巴细胞培养上清液中的IFN-γ水平较低,但无明显差异;IL-4水平则升高,差异有显著性.其外周血淋巴细胞中的mRNA表达水平亦如此.与治疗前比较,干扰素α治疗后3和6个月,在完全应答的患者中,IL-4水平下降;而IFN-γ水平在6个月时升高,差异均有显著性.结论 (1)慢性乙肝患者的外周血淋巴细胞中细胞因子表达可能以Th2类占优势.(2)慢性乙型肝炎患者的外周血淋巴细胞中Th1/Th2细胞因子的表达水平与干扰素α的疗效密切相关.(3)通过检测Th1/Th2细胞因子的变化,可以预测患者对干扰素α治疗的反应,对及时判断干扰素α治疗效果有一定作用.
목적탐토간우소α적료효시부여조절Th1/Th2세포인자적표체유관,병이차작위예측간우소α료효지표적가능성.방법채용쌍항체협심법화역전록PCR방법,대응용간우소치료적23례만성을형간염환자외주혈림파세포중Th1/Th2세포인자적표체수평진행동태검측.결과여정상대조조비교,만성을간환자외주혈림파세포배양상청액중적IFN-γ수평교저,단무명현차이;IL-4수평칙승고,차이유현저성.기외주혈림파세포중적mRNA표체수평역여차.여치료전비교,간우소α치료후3화6개월,재완전응답적환자중,IL-4수평하강;이IFN-γ수평재6개월시승고,차이균유현저성.결론 (1)만성을간환자적외주혈림파세포중세포인자표체가능이Th2류점우세.(2)만성을형간염환자적외주혈림파세포중Th1/Th2세포인자적표체수평여간우소α적료효밀절상관.(3)통과검측Th1/Th2세포인자적변화,가이예측환자대간우소α치료적반응,대급시판단간우소α치료효과유일정작용.
Objective　To investigate the relationship between the expression of Th1/Th2 type cytokines and the effect of interferon-α therapy. Methods　Th1/Th2 type cytokines were assayed by enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT-PCR) on 23 patients with chronic hepatitis B who were treated with interferon-α. Results　Levels of IFN-γ in the supernatant of peripheral blood mononuclear cells (PBMC) cultures from the patients with hepatitis B were slightly lower than those of controls (P=0.07). However, the levels of IL-4 were higher than those of controls (P=0.01). Cytokines measurements during IFN-α treatment showed a trend to decreaseing levels of IL-4 at 4, 12, and 24 weeks. Levels of IFN-γ were slightly increased following IFN-α treatment (P=0.09). In patients with a complete response to IFN-α, the levels of IFN-γ were higher at 24 weeks following IFN-α treatment than that of pre-treatment (P=0.04), and the levels of IL-4 decreased markedly at 12 and 24 weeks （P=0.02, 0.03, respectively）. mRNA expression positively correlated with the level of Th1/Th2 type cytokines in the supernatant. Conclusion　The expression of Th2 type cytokines is predominant in patients with chronic hepatitis B. Interferon-α therapy can modulate the balance of Th1/Th2 type cytokines, and this is related to its clinical effect. Levels of Th1/Th2 type cytokines could be a predictor of clinical response during Interferon -α treatment.