Fujimoto Tomoko, Tomimatsu Masahiko, Iga Daijiro, Endo Hitoshi, Otsuka Kuniaki
Department of Medicine, Tokyo Women's Medical University, Medical Center East, Tokyo, Japan.
J Gastroenterol Hepatol. 2008 Aug;23(8 Pt 2):e432-7. doi: 10.1111/j.1440-1746.2008.05320.x. Epub 2008 Feb 3.
It has been reported that immunological factors, such as the T-helper cell (Th)1/Th2 ratio, play a part in the mechanisms for the antihepatitis C virus (HCV) effect of the interferon (IFN) alpha-2b plus ribavirin combination therapy. By using flow cytometry, we examined this ratio during a 24-week course of combination therapy for patients with chronic hepatitis C.
We recruited 21 patients with chronic hepatitis C (16 males, five females, genotype 1b, 17 patients; genotype 2a or 2b, four patients) who had been treated by combination therapy. Flow cytometry was used to examine the Th1/Th2 ratio before and at the 4th and 24th week of therapy. Patients who were HCV-RNA negative 24 weeks after the treatment was completed were defined to show sustained virological response (SVR).
Among the 21 patients, 10 showed SVR, the overall SVR rate being 47.6%. Patients were classified into an 'increase group' (Th1/Th2 ratio at 4 or 24 weeks of therapy being higher than those before therapy) and a 'decrease group' (the ratio being lower than before therapy). After 24 weeks of therapy, the SVR rate was 66.7% for the Th2 'increase group' and 14.3% for the Th2 'decrease group'. The former showed a significantly higher SVR rate (P = 0.0361).
The significant changes in the Th2 level correlated with the therapeutic effect during the IFN alpha-2b plus ribavirin combination therapy. The increase of the Th2 level during therapy could be a predictor for achieving SVR.
据报道，免疫因素，如辅助性T细胞（Th）1/Th2比值，在干扰素（IFN）α-2b联合利巴韦林治疗丙型肝炎病毒（HCV）的机制中发挥作用。我们运用流式细胞术，对慢性丙型肝炎患者进行24周联合治疗期间的该比值进行了检测。
我们招募了21例接受联合治疗的慢性丙型肝炎患者（男性16例，女性5例，1b基因型17例；2a或2b基因型4例）。采用流式细胞术检测治疗前、治疗第4周和第24周时的Th1/Th2比值。治疗完成24周后HCV-RNA阴性的患者被定义为获得持续病毒学应答（SVR）。
21例患者中，10例获得SVR，总体SVR率为47.6%。患者被分为“升高组”（治疗第4周或第24周时的Th1/Th2比值高于治疗前）和“降低组”（该比值低于治疗前）。治疗24周后，Th2“升高组”的SVR率为66.7%，Th2“降低组”的SVR率为14.3%。前者的SVR率显著更高（P = 0.0361）。
在IFNα-2b联合利巴韦林治疗期间，Th2水平的显著变化与治疗效果相关。治疗期间Th2水平的升高可能是实现SVR的一个预测指标。
