Abe Shintaro, Narita Ryoichi, Matsuhashi Toru, Oto Takeshi, Tabaru Akinari, Otsuki Makoto
Third Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Eur J Gastroenterol Hepatol. 2008 May;20(5):373-8. doi: 10.1097/MEG.0b013e3282f43aae.
Serum levels of soluble interleukin-2 receptor (sIL-2R) are known to serve as a marker for the activation of T lymphocytes. We measured serum levels of sIL-2R in patients with chronic hepatitis C (CHC) during interferon (IFN)-based treatment to determine the correlation between those levels and therapeutic efficacy, and to clarify whether there is a difference in the activation of T lymphocytes among HCV genotypes after the treatment.
Forty-four patients received IFN-alpha2b monotherapy (group IFN-M), whereas 82 patients received the combination therapy with IFN-alpha2b and ribavirin (group IFN+R). We measured serum sIL-2R levels in these patients before (T0) and 2 weeks (T2) after the treatment.
The sustained virologic response rates in genotype 2a/2b patients were significantly higher than those in genotype 1b patients in both groups (P<0.005). In sustained virologic responders, sIL-2R levels at T2 were significantly higher than those at T0 in both groups (P<0.001). In nonresponders, sIL-2R levels at T2 were not different from those at T0 in group IFN-M, but were significantly higher than those at T0 in group IFN+R (P=0.0072). In genotype 1b patients, sIL-2R levels at T2 were not different from those at T0 in group IFN-M, but were significantly higher than those at T0 in group IFN+R (P=0.0064). In genotype 2a/2b patients, sIL-2R levels at T2 were significantly higher than those at T0 in both groups (P<0.0005).
These findings suggest that the activation of T lymphocytes after IFN-based treatment contributes to a high-sustained virologic response rate, especially in genotype 2a/2b patients.
血清可溶性白细胞介素-2受体(sIL-2R)水平是T淋巴细胞激活的标志物。我们检测了慢性丙型肝炎(CHC)患者在基于干扰素(IFN)治疗期间的血清sIL-2R水平,以确定这些水平与治疗效果之间的相关性,并阐明治疗后不同丙型肝炎病毒(HCV)基因型之间T淋巴细胞激活是否存在差异。
44例患者接受干扰素-α2b单药治疗(IFN-M组),而82例患者接受干扰素-α2b与利巴韦林联合治疗(IFN+R组)。我们在这些患者治疗前(T0)和治疗后2周(T2)检测血清sIL-2R水平。
两组中2a/2b基因型患者的持续病毒学应答率均显著高于1b基因型患者(P<0.005)。在持续病毒学应答者中,两组T2时的sIL-2R水平均显著高于T0时(P<0.001)。在无应答者中,IFN-M组T2时的sIL-2R水平与T0时无差异,但IFN+R组T2时的sIL-2R水平显著高于T0时(P=0.0072)。在1b基因型患者中,IFN-M组T2时的sIL-2R水平与T0时无差异,但IFN+R组T2时的sIL-2R水平显著高于T0时(P=0.0064)。在2a/2b基因型患者中,两组T2时的sIL-2R水平均显著高于T0时(P<0.0005)。
这些发现表明,基于干扰素的治疗后T淋巴细胞的激活有助于获得较高的持续病毒学应答率,尤其是在2a/2b基因型患者中。