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α-2b干扰素联合利巴韦林治疗对慢性丙型肝炎炎症和纤维化相关特定生长因子的影响

Effect of interferon alpha2b plus ribavirin treatment on selected growth factors in respect to inflammation and fibrosis in chronic hepatitis C.

作者信息

Anatol Panasiuk, Robert Flisiak, Danuta Prokopowicz

机构信息

Department of Infectious Diseases, Medical University of Bialystok, 15-540 Bialystok, Zurawia str. 14, Poland.

出版信息

World J Gastroenterol. 2005 Mar 28;11(12):1854-8. doi: 10.3748/wjg.v11.i12.1854.

Abstract

AIM

Growth factors (GF) that participate in regeneration and apoptosis have an important role in chronic liver diseases. We analyzed serum GF concentration during antiviral treatment and correlated it with morphological liver failure in chronic hepatitis C.

METHODS

The levels of GF were determined in sera by ELISA method in 0, 16, 32 and 48 wk of therapy in 40 patients treated with IFNalpha2b (9 MU sc/wk) and RBV (1.2 g/d) and in 25 healthy subjects. Blind liver biopsies were done before treatment with histological grading and staging examination.

RESULTS

The hepatocyte growth factor (HGF) and epidermal growth factor (EGF) were markedly elevated prior the treatment and decreased during the therapy, although they did not reach the normal level. In non-responding (NR) patients, HGF and EGF were higher than that in responders (R), however differences were not significant. Before the treatment thrombopoietin (TPO) level was significantly lower in R than in NR (P<0.03). Platelet-derived growth factor (PDGF) concentration was lower in chronic hepatitis C than in healthy subjects and decreased during the treatment. A significant positive correlation was observed between inflammatory activity in the liver tissue and the concentration of HGF (in R: r = 0.4, in NR: r = 0.5), TPO (R: r = 0.6), and a significant negative correlation between this activity and EGF (R: r = -0.6) and PDGF (R: r = -0.5). Serum HGF concentration was higher in more advanced fibrosis (R: r = 0.5, P<0.05; NR: r = 0.4, P<0.03).

CONCLUSION

The decrease in PDGF can be an effective prognostic marker of the treatment and HCV elimination. Decreasing HGF, EGF, and PDGF can influence the inhibition of inflammatory and fibrotic processes in the liver during the antiviral treatment.

摘要

目的

参与再生和凋亡的生长因子(GF)在慢性肝病中具有重要作用。我们分析了抗病毒治疗期间血清GF浓度,并将其与慢性丙型肝炎的形态学肝衰竭相关联。

方法

采用酶联免疫吸附测定(ELISA)法测定40例接受α2b干扰素(9 MU皮下注射/周)和利巴韦林(1.2 g/天)治疗的患者在治疗0、16、32和48周时血清中GF的水平,以及25名健康受试者血清中GF的水平。在治疗前进行盲法肝活检,并进行组织学分级和分期检查。

结果

肝细胞生长因子(HGF)和表皮生长因子(EGF)在治疗前显著升高,治疗期间降低,尽管未恢复到正常水平。在无反应(NR)患者中,HGF和EGF高于反应者(R),但差异不显著。治疗前,反应者的血小板生成素(TPO)水平显著低于无反应者(P<0.03)。慢性丙型肝炎患者的血小板衍生生长因子(PDGF)浓度低于健康受试者,且在治疗期间降低。肝组织炎症活动与HGF浓度(反应者中:r = 0.4,无反应者中:r = 0.5)、TPO(反应者中:r = 0.6)之间存在显著正相关,与EGF(反应者中:r = -0.6)和PDGF(反应者中:r = -0.5)之间存在显著负相关。在更严重的纤维化患者中,血清HGF浓度更高(反应者中:r = 0.5,P<0.05;无反应者中:r =

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