Bharat Ankit, Narayanan Kishore, Golocheikine Anjali, Steward Nancy, Crippin Jeffrey, Lisker-Melman Mauricio, Shenoy Surendra, Lowell Jeffrey, Chapman William C, Mohanakumar Thalachallour
Department of Surgery, Washington University School of Medicine, St. Louis, MO 63110, USA.
Transplantation. 2007 Dec 27;84(12):1704-7. doi: 10.1097/01.tp.0000295973.31877.7b.
Hepatitis C virus (HCV) recurrence after orthotopic liver transplantation (OLT) significantly accelerates progression to allograft cirrhosis. Current biochemical parameters to monitor progression of chronic HCV after OLT have yielded low specificity and sensitivity. Here we investigated the HCV-specific immunity and serum levels of soluble CD30 (sCD30), a novel marker of Th2 immunity, in patients with and without allograft cirrhosis. Patients with hepatic inflammation but no cirrhosis (HIN, n=20) revealed elevated serum interferon (IFN)-gamma and high frequency of IFN-gamma producing CD4 T(h1) cells compared to those with hepatic cirrhosis (HFC, n=20) that had high interleukin (IL)-5 and IL-5 producing CD4 T(h2) cells. Patients with HFC, but not HIN, were found to have significantly higher levels of sCD30. Therefore, we conclude that lack of optimal Th1-type CD4 T cells is associated with HCV-induced allograft cirrhosis. Further, sCD30 may represent a novel marker for surveillance of hepatic cirrhosis in transplant recipients with chronic HCV infection.
原位肝移植(OLT)后丙型肝炎病毒(HCV)复发会显著加速移植肝进展为肝硬化。目前用于监测OLT后慢性HCV进展的生化指标特异性和敏感性较低。在此,我们研究了伴有和不伴有移植肝肝硬化的患者的HCV特异性免疫以及可溶性CD30(sCD30,一种Th2免疫的新型标志物)的血清水平。与肝硬化患者(HFC,n = 20)相比,有肝脏炎症但无肝硬化的患者(HIN,n = 20)血清干扰素(IFN)-γ升高,产生IFN-γ的CD4 Th1细胞频率较高,而肝硬化患者IL-5及产生IL-5的CD4 Th2细胞水平较高。发现HFC患者而非HIN患者的sCD30水平显著更高。因此,我们得出结论,缺乏最佳的Th1型CD4 T细胞与HCV诱导的移植肝肝硬化相关。此外,sCD30可能是监测慢性HCV感染的移植受者肝肝硬化的一种新型标志物。