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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 2 3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。
Objective To investigate whether the therapeutic effect of interferon α is related to the regulation of Th1 / Th2 cytokines and to predict the efficacy of interferon α. Methods Th1 / Th2 cytokine expression in peripheral blood lymphocytes of 23 patients with chronic hepatitis B treated with interferon was detected by double antibody sandwich method and reverse transcription PCR. Results Compared with the normal control group, the level of IFN-γ in the peripheral blood lymphocyte culture supernatant of patients with chronic hepatitis B was lower, but there was no significant difference. The level of IL-4 was increased, the difference was significant. The same is true for the level of mRNA expression in peripheral blood lymphocytes. Compared with those before treatment, levels of IL-4 decreased at 3 and 6 months after IFN-alpha treatment in patients with complete response, while levels of IFN-gamma increased at 6 months, with significant differences. Conclusions (1) The expression of cytokines in peripheral blood lymphocytes of patients with chronic hepatitis B may be dominated by Th2. (2) The level of Th1 / Th2 cytokines in peripheral blood lymphocytes of patients with chronic hepatitis B is closely related to the efficacy of interferon α. (3) By detecting the change of Th1 / Th2 cytokines, we can predict the response of patients to interferon α therapy, and have a certain effect on judging the effect of interferon α in time.