Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University School of Medicine, 6-11-1 Omorinishi, Otaku, Tokyo 143, Japan.
Hepatol Res. 2006 Jan;34(1):15-22. doi: 10.1016/j.hepres.2005.09.039. Epub 2005 Nov 15.
This study was to investigate the immunomodulatory effects of ribavirin combined with interferon (IFN)-alpha 2b (R+IFN) compared with consensus IFN monotherapy (IFN-Con) in chronic hepatitis C (CHC) patients.
Thirty-four adult patients with biopsy-proven CHC, who were infected with HCV genotype 2a or 2b, were studied. A 24-week regimen of IFN-alpha 2b (6MU daily for 2 weeks followed by 6MU tiw for 22 weeks) and ribavirin (600-800mg/day for 24 weeks) was given to 17 patients. The other 17 patients were treated with a 24-week regimen of IFN-Con (18MU daily for 2 weeks followed by 18MU tiw for 22 weeks). Flow cytometric determination of cytoplasmic IFN-gamma and IL-4 expression in peripheral blood CD4+ T cells was performed, and the percentage of IFN-gamma+ and IL-4- (Th1), IFN-gamma- and IL-4+ (Th2) cells were calculated before and 3, 7, 14, and 28 days after the start of therapy.
In the R+IFN group, the percentage of Th1 cell peaked on day 3, and then decreased to near baseline by day 14, while the percentage of Th2 cell did not change. In the IFN-Con group, the percentage of Th1 cell peaked on day 14 and the percentage of Th2 cell peaked on day 3, and then decreased to near baseline by day 14.
Our results suggest that ribavirin induces an early immune response by peripheral blood CD4+ T cells in CHC patients.
本研究旨在探讨利巴韦林联合干扰素（IFN）-α2b（R+IFN）与普通干扰素（IFN-Con）单药治疗慢性丙型肝炎（CHC）患者的免疫调节作用。
对 34 例经肝活检证实的 CHC 成年患者进行了研究，这些患者感染 HCV 基因型 2a 或 2b。17 例患者接受 IFN-α2b（6MU 每日，连用 2 周，然后每周 3 次，连用 22 周）和利巴韦林（600-800mg/日，连用 24 周）的 24 周疗程。另外 17 例患者接受 IFN-Con（18MU 每日，连用 2 周，然后每周 3 次，连用 22 周）的 24 周疗程。在治疗开始前及 3、7、14 和 28 天，通过流式细胞术测定外周血 CD4+T 细胞胞质内 IFN-γ和 IL-4 的表达，并计算 IFN-γ+和 IL-4-（Th1）、IFN-γ-和 IL-4+（Th2）细胞的百分比。
在 R+IFN 组中，Th1 细胞的百分比在第 3 天达到峰值，然后在第 14 天降至接近基线水平，而 Th2 细胞的百分比没有变化。在 IFN-Con 组中，Th1 细胞的百分比在第 14 天达到峰值，Th2 细胞的百分比在第 3 天达到峰值，然后在第 14 天降至接近基线水平。
我们的结果表明，利巴韦林通过 CHC 患者外周血 CD4+T 细胞诱导早期免疫反应。
