CAJ | 학술논문

目的：探讨干扰素抗病毒治疗对慢性乙型肝炎（CHB）患者外周血单个核细胞（PBMCs）端粒酶逆转录酶活性表达的影响。方法用淋巴细胞分离液分离37例干扰素治疗CHB患者（干扰素治疗组），36例CHB对照患者（患者对照组）和10例健康人（健康对照组）的PBMCs，用Real-time RT-PCR方法定量检测各组PBMCs表达的hTERT mRNA及其相应β-actin mRNA，计算出标化的hTERT mRNA（NhTERT mRNA）。结果干扰素治疗12个月时，治疗组PBMCs表达NhTERT mRNA的水平与正常对照组之间无统计学差异，但两组均显著高于患者对照组（P＜0.001；P＝0.001）。hTERT mRNA的水平与研究对象的年龄、患者基线ALT水平、HBV DNA载量及病毒基因型等均未见显著相关性关系（均为P＞0.05），但治疗12个月时，其水平与同期检测的CD3＋T淋巴细胞计数、CD4＋/CD8＋比值均呈显著正相关关系（P＜0.05）。并且发现，在干扰素治疗组中NhTERT mRNA的表达随治疗时间的延长而显著增加，在治疗12个月时获得完全应答的患者组NhTERT mRNA水平显著高于无应答组（P＜0.05）。结论 CHB患者PBMCs端粒酶活性表达低下，干扰素抗病毒治疗可以上调患者淋巴细胞端粒酶活性，这可能是干扰素促进患者免疫功能恢复的一种机制。
목적：탐토간우소항병독치료대만성을형간염（CHB）환자외주혈단개핵세포（PBMCs）단립매역전록매활성표체적영향。방법용림파세포분리액분리37례간우소치료CHB환자（간우소치료조），36례CHB대조환자（환자대조조）화10례건강인（건강대조조）적PBMCs，용Real-time RT-PCR방법정량검측각조PBMCs표체적hTERT mRNA급기상응β-actin mRNA，계산출표화적hTERT mRNA（NhTERT mRNA）。결과간우소치료12개월시，치료조PBMCs표체NhTERT mRNA적수평여정상대조조지간무통계학차이，단량조균현저고우환자대조조（P＜0.001；P＝0.001）。hTERT mRNA적수평여연구대상적년령、환자기선ALT수평、HBV DNA재량급병독기인형등균미견현저상관성관계（균위P＞0.05），단치료12개월시，기수평여동기검측적CD3＋T림파세포계수、CD4＋/CD8＋비치균정현저정상관관계（P＜0.05）。병차발현，재간우소치료조중NhTERT mRNA적표체수치료시간적연장이현저증가，재치료12개월시획득완전응답적환자조NhTERT mRNA수평현저고우무응답조（P＜0.05）。결론 CHB환자PBMCs단립매활성표체저하，간우소항병독치료가이상조환자림파세포단립매활성，저가능시간우소촉진환자면역공능회복적일충궤제。
Objective To investigate the impact of interferon alpha (IFNα) antiviral therapy on the expression of telomerase activity in peripheral blood mononuclear cells (PBMCs) in patients with chronic hepatitis B (CHB). Methods PBMCs were obtained from 37 CHB patients treated with IFNα (IFNα treated group), 36 CHB control patients (CHB control group) and 10 healthy individuals (healthy control group). The quantitation of hTERT mRNA andβ-actin mRNA in PBMCs was respectively detected by real-time RT-PCR, and the normalized hTERT mRNA (NhTERT mRNA) was calculated for each sample. Results NhTERT mRNA level at 12 months of IFNαtreatment was similar to that in healthy control group, but all were significantly higher than that in CHB control group (P<0.001 and P=0.001, respectively). The expression of NhTERT mRNA was not significantly correlated with subject's age, patient's baseline alanine aminotransferase, HBV DNA load and HBV genotypes, respectively (all P>0.05), but the level at 12 months of IFNαtreatment was significantly correlated with the count of CD3+T lymphocytes (P=0.001) and the ratio of CD4+/CD8+ lymphocytes (P=0.009) detected during the same period in IFNα treated group. In addition, the mean level was found to be significantly increased with treatment time, and the mean level at 12 months of IFNαtreatment in complete response subgroup was remarkably higher than that in non-complete response subgroup (P<0.05) in IFNα treated group. Conclusion A decreased telomerase activity is expressed in PBMCs of CHB patients, and IFNα therapy can up-regulate its expression, which may be a kind of mechanism for IFNαto improve patient's immune function.