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慢性丙型肝炎病毒感染患者的血清可溶性肿瘤坏死因子受体水平及干扰素治疗的效果

Serum levels of soluble tumor necrosis factor receptors and effects of interferon therapy in patients with chronic hepatitis C virus infection.

作者信息

Itoh Y, Okanoue T, Ohnishi N, Sakamoto M, Nishioji K, Nakagawa Y, Minami M, Murakami Y, Kashima K

机构信息

Third Department of Internal Medicine, Kyoto Prefectural University of Medicine, Japan.

出版信息

Am J Gastroenterol. 1999 May;94(5):1332-40. doi: 10.1111/j.1572-0241.1999.01083.x.

Abstract

OBJECTIVE

The aim of this study was to understand the significance of the tumor necrosis factor receptor (TNFR)-mediated signaling pathway in the pathophysiology of chronic hepatitis C.

METHODS

The serum levels of soluble TNFRs (sTNFRs; sTNFR p55 and sTNFR p75) were measured in 84 patients with chronic hepatitis C virus (HCV) infection (24 sustained responders and 25 nonresponders to interferon [IFN] therapy and 35 patients with persistent normal blood chemistries) and 20 healthy controls, then compared with clinical parameters.

RESULTS

The serum levels of sTNFRs increased in proportion to the severity of liver disease. The levels of sTNFRs revealed significant correlations with the serum levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and gamma-globulin, but not with the serum levels of HCV-core protein. In the sustained responder group, the levels of sTNFR p75 showed a significant decrease (p < 0.0002) 1 yr after IFN therapy, although the levels of sTNFR p55 did not. The levels of sTNFR p75 were correlated with the serum levels of macrophage-colony stimulating factor both before and after IFN therapy. In the nonresponder group, the levels of both sTNFRs were unaltered after IFN therapy.

CONCLUSIONS

The TNF alpha-TNFRs system, especially the TNFR p75-mediated pathway, is involved in the hepatic inflammation-fibrosis process in chronic hepatitis C. The serum levels of sTNFR p75, but not sTNFR p55, were correlated with the serum levels of macrophage colony stimulating factor in this process.

摘要

目的

本研究旨在了解肿瘤坏死因子受体(TNFR)介导的信号通路在慢性丙型肝炎病理生理学中的意义。

方法

检测84例慢性丙型肝炎病毒(HCV)感染患者(24例对干扰素[IFN]治疗持续应答者、25例无应答者以及35例血液生化指标持续正常者)和20例健康对照者血清中可溶性TNFR(sTNFR;sTNFR p55和sTNFR p75)水平,然后与临床参数进行比较。

结果

sTNFR血清水平随肝病严重程度成比例升高。sTNFR水平与丙氨酸转氨酶、天冬氨酸转氨酶、γ-谷氨酰转肽酶及γ-球蛋白血清水平显著相关,但与HCV核心蛋白血清水平无关。在持续应答组,IFN治疗1年后sTNFR p75水平显著下降(p < 0.0002),而sTNFR p55水平未下降。IFN治疗前后sTNFR p75水平均与巨噬细胞集落刺激因子血清水平相关。在无应答组,IFN治疗后两种sTNFR水平均未改变。

结论

肿瘤坏死因子α-TNFR系统,尤其是TNFR p75介导的通路,参与慢性丙型肝炎的肝脏炎症-纤维化过程。在此过程中,sTNFR p75而非sTNFR p55的血清水平与巨噬细胞集落刺激因子血清水平相关。

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