慢性乙型肝炎患者应用恩替卡韦治疗血清及外周血单核细胞分泌IFN-γ、IL-17的变化

Serum IFN-γ and IL-17 secreted by peripheral blood mononuclear cells in chronic hepatitis B patients during ETV therapy

  • 摘要: 目的 研究恩替卡韦(ETV)治疗慢性乙型肝炎患者过程中血清及外周血单核细胞(PBMC)分泌γ干扰素(IFN-γ)及白细胞介素17(IL-17)变化的意义。方法 在应用ETV治疗的不同时间点抽取HBV感染患者静脉血,分离血清及单核细胞,检测血清中乙型肝炎病毒表面标志物(HBV-M)、乙型肝炎病毒核酸定量(HBV-DNA)、丙氨酸转移酶(ALT)以及血清中和分别应用抗-CD3、抗-CD28和HBcAg刺激的外周血单核细胞(PBMCs)分泌上清中的IFN-γ和IL-17。结果 应用ETV治疗后患者ALT及HBV-DNA从4周开始出现明显下降,而血清中及外周血单核细胞分泌的IFN-γ也从4周开始出现明显下降。而血清中及外周血单核细胞分泌的IL-17在第4周出现明显升高,其后逐渐下降。结论 ETV早期抑制病毒复制,能够打破免疫耐受,造成IL-17分泌的升高,其后随着病毒的进一步抑制,IL-17分泌下降,降低机体分泌IFN-γ的能力,减轻炎症反应的同时也可能削弱机体清除病毒的能力。

     

    Abstract: Objective To study the change of IFN-γ secreted by peripheral blood mononuclear cells(PBMC) and interleukin-17(IL-17) in chronic hepatitis-B patients during ETV therapy. Methods PBMC isolated from venous blood taken from HBV-infected patients at different time points of ETV therapy,were cultured with anti-CD3,anti-CD28 and HBcAg to stimulate secretion of IFN-γ and IL-17 by PBMC.Serum HBV-M,ALT,HBV-DNA,and ALT levels were measured. Results The ALT,HBV-DNA,and IFN-γ levels in chronic hepatitis-B patients were significantly lower 4 weeks after ETV therapy.The serum IL-17 level in supernatant was significantly higher 4 weeks after ETV therapy and then gradually decreased. Conclusion Early ETV therapy can suppress HBV replication by reducing immune tolerance and increasing IL-17 secretion.With the further suppression of HBV,the IL-17 and IFN-γ level is decreased,thus improving inflammation reactions in the liver.However,it may impair the ability of body to clear HBV.

     

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