Abbate Isabella, Romano Mario, Longo Roberta, Cappiello Giuseppina, Lo Iacono Oreste, Di Marco Vito, Paparella Concetta, Spano Alberto, Capobianchi Maria Rosaria
Microbiology and Virology Service, S. Pertini Hospital, Rome, Italy.
J Med Virol. 2003 Aug;70(4):581-7. doi: 10.1002/jmv.10433.
To investigate the intra-hepatic activation of the IFN system in patients affected by chronic HCV-infection in comparison with that observed in a non-infectious liver disease such as non-alcoholic steatohepatitis, we measured the liver steady state mRNA levels of interferon-alpha, interferon-beta and interferon-gamma as well as of IFN-related genes (IFNAR-1, STAT1alpha, PKR, 2-5 AS, IRF-1, ICE and IL-18). In HCV-infected subjects, possible correlations of these parameters with viral load and liver injury were also analyzed. Twenty-four chronic untreated HCV-infected subjects and seven patients with non-alcoholic steatohepatitis were enrolled in the study. Liver biopsies were graded according to Knodell scores. Intra-hepatic mRNA levels of IFNs and related genes were assessed by semi-quantitative RT-PCR. In comparison with non-alcoholic steatohepatitis, in HCV-infected subjects IFN-alpha and -beta mRNA levels were significantly lower, whereas IFN-gamma, IFNAR-1, STAT1alpha IRF-1, and IL-18 mRNA were upregulated. Moreover, IFN-gamma mRNA steady state levels were correlated positively with those of IFNAR-1, IRF-1, and IL-18, suggesting a coordinated induction of these genes. Although plasma viral load was correlated inversely with IL-18-specific mRNA, viral load was not related to liver injury. IFN-gamma and IRF-1 mRNA levels were correlated positively with ALT, but not with the grading or staging. Conversely, IFN-alpha and -beta mRNA levels were higher in livers with lower staging scores. These findings support the hypothesis that in chronic HCV infection there is an imbalance between an upregulated IFN-gamma system and a downregulated IFN-alpha and -beta system, probably due to a mixed effect exerted by HCV-specific and inflammatory non-specific factors.
为了研究慢性丙型肝炎病毒(HCV)感染患者肝内干扰素(IFN)系统的激活情况,并与非酒精性脂肪性肝炎等非感染性肝病中的情况进行比较,我们检测了干扰素-α、干扰素-β、干扰素-γ以及IFN相关基因(IFNAR-1、STAT1α、PKR、2-5AS、IRF-1、ICE和IL-18)的肝脏稳态mRNA水平。在HCV感染的受试者中,还分析了这些参数与病毒载量和肝损伤之间的可能相关性。24例未经治疗的慢性HCV感染受试者和7例非酒精性脂肪性肝炎患者纳入本研究。肝活检根据Knodell评分进行分级。通过半定量逆转录聚合酶链反应(RT-PCR)评估肝内IFN及其相关基因的mRNA水平。与非酒精性脂肪性肝炎相比,HCV感染受试者中干扰素-α和-β的mRNA水平显著降低,而干扰素-γ、IFNAR-1、STAT1α、IRF-1和IL-18的mRNA上调。此外,干扰素-γ的mRNA稳态水平与IFNAR-1、IRF-1和IL-18的水平呈正相关,表明这些基因的协同诱导。虽然血浆病毒载量与IL-18特异性mRNA呈负相关,但病毒载量与肝损伤无关。干扰素-γ和IRF-1的mRNA水平与丙氨酸转氨酶(ALT)呈正相关,但与分级或分期无关。相反,在分期评分较低的肝脏中,干扰素-α和-β的mRNA水平较高。这些发现支持以下假设:在慢性HCV感染中,上调的干扰素-γ系统与下调的干扰素-α和-β系统之间存在失衡,这可能是由于HCV特异性和炎症非特异性因素的综合作用所致。