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目的观察不同浓度白细胞介素４（ＩＬ－４）对亚急性重型病毒性肝炎（简称亚急重肝）患者和正常人外周血单个核细胞（ＰＢＭＣｓ）中肿瘤坏死因子（ＴＮＦ）－α和ＩＬ－１α表达的抑制情况，以比较两者ＰＢＭＣｓ对ＩＬ－４的应答性。方法应用Ｌ９２９细胞毒试验、免疫组织化学法和半定量逆转录－多聚酶链反应（ＲＴ－ＰＣＲ）检测ＴＮＦ－α和ＩＬ－１α的表达水平。结果ＩＬ－４均以剂量依赖的方式抑制亚急重肝患者和正常人ＰＢＭＣｓＴＮＦ－α和ＩＬ－１α蛋白质和ｍＲＮＡ的表达，然而两者的剂量－反应曲线明显不同。在正常人，ＩＬ－４于１００Ｕ／ｍｌ时对ＰＢＭＣｓＴＮＦ－α和ＩＬ－１α的抑制效应接近最大，而在亚急重肝，需１０００Ｕ／ｍｌ的浓度才达到相似的抑制效应，两者剂量相差１０倍以上，反应曲线明显右移。如以１００Ｕ／ｍｌ的ＩＬ－４处理ＰＢＭＣｓ，对正常人ＴＮＦ－α生物活性、单核细胞ＴＮＦ－α和ＩＬ－１α阳性率及ｍＲＮＡ表达水平的抑制率均超过５０％，而对亚急重肝患者的抑制率仅８．１９％～１９．３９％。结论亚急重肝患者ＰＢＭＣｓ对ＩＬ－４的应答性明显低于正常人，由此致使ＩＬ－４不能有效地发挥抑制ＰＢＭＣｓ分泌ＴＮＦ－α和ＩＬ－１α的作用，可能是重?
Objective To investigate the effects of interleukin-4 (IL-4) on the expression of tumor necrosis factor-α (TNF-α) and interleukin-4 (IL-4) in peripheral blood mononuclear cells (PBMCs) from patients with subacute severe hepatitis -1α expression of inhibition, to compare the two PBMCs response to IL-4. Methods L929 cytotoxicity assay, immunohistochemistry and semi-quantitative reverse transcription-polymerase chain reaction (RT-PCR) were used to detect the expression of TNF-α and IL-1α. Results IL-4 inhibited the expression of TNF-α and IL-1α protein and mRNA in PBMCs from patients with severe acute subgroups and normal controls in a dose-dependent manner. However, the dose-response curves of both groups were significantly different. In normal subjects, the inhibitory effect of IL-4 at 100 U / ml on PBMCs TNF-α and IL-1α was similar to that of IL-4 at the concentration of 1000 U / ml, but the difference was not obvious More than 10 times, the reaction curve significantly shifted to the right. For example, when PBMCs were treated with 100 U / ml IL-4, the inhibitory rates of TNF-α biological activity, TNF-α and IL-1α positive rate and mRNA expression of monocytes were over 50% The inhibition rate of liver patients was only 8.19% ~ 19.39%. Conclusion The response of IL-4 to PBMCs in patients with subacute severe hepatitis was significantly lower than that in normal subjects, which led to the fact that IL-4 could not effectively inhibit the secretion of TNF-α and IL-1α by PBMCs.