Fattovich G, Betterle C, Brollo L, Pedini B, Giustina G, Realdi G, Alberti A, Ruol A
Istituto Medicina Clinica, Cattedra Clinica Medica 2, Università di Padova, Italy.
J Med Virol. 1991 Jun;34(2):132-5. doi: 10.1002/jmv.1890340212.
The development of autoantibodies and autoimmune reactions has been reported during and after interferon (IFN) therapy. Thirteen different antibodies from the sera of 32 patients with chronic hepatitis B treated with alpha-interferon (alpha-IFN) were tested. Seventeen HBeAg-positive patients received 4.5 megaunits (MU) of recombinant IFN thrice weekly for 4 months, and 15 anti-HBe and HBV-DNA positive patients were treated with 5 MU/m2 of lymphoblastoid IFN thrice weekly for 6 months. Five patients (15%) had antinuclear antibodies (ANA) and one patient (3%) had smooth muscle antibodies before treatment. ANA appeared during IFN treatment in five (18%) of 28 previously negative patients. With discontinuation of treatment, the titer of ANA fell to undetectable levels in all patients. In contrast, none of the patients developed antibodies to endocrine organs, such as thyroid microsomal, thyroglobulin, parietal cells, pancreatic islet cell, and adrenal cortex antibodies or autoantibodies specifically associated with autoimmune liver disease such as liver kidney microsomal antibodies and antimitochondrial antibodies. There was no correlation between autoantibody positivity before therapy or autoantibody occurrence during treatment and response to IFN therapy. None of the patients developed clinical signs of autoimmune disease. These results indicate that these regimens of recombinant and lymphoblastoid IFN therapy of chronic hepatitis B are associated with a low risk of clinically significant autoimmunity.
在干扰素（IFN）治疗期间及之后，已有自身抗体和自身免疫反应产生的报道。对32例接受α干扰素（α-IFN）治疗的慢性乙型肝炎患者血清中的13种不同抗体进行了检测。17例HBeAg阳性患者每周三次接受450万单位（MU）重组IFN治疗，共4个月；15例抗-HBe和HBV-DNA阳性患者每周三次接受5 MU/m²淋巴母细胞IFN治疗，共6个月。5例患者（15%）在治疗前有抗核抗体（ANA），1例患者（3%）有平滑肌抗体。在IFN治疗期间，28例先前ANA阴性的患者中有5例（18%）出现了ANA。随着治疗的停止，所有患者的ANA滴度均降至检测不到的水平。相比之下，没有患者产生针对内分泌器官的抗体，如甲状腺微粒体、甲状腺球蛋白、壁细胞、胰岛细胞和肾上腺皮质抗体，也没有产生与自身免疫性肝病特异性相关的自身抗体，如肝肾微粒体抗体和抗线粒体抗体。治疗前自身抗体阳性或治疗期间自身抗体出现与IFN治疗反应之间没有相关性。没有患者出现自身免疫性疾病的临床症状。这些结果表明，这些慢性乙型肝炎的重组和淋巴母细胞IFN治疗方案与临床上显著的自身免疫风险较低相关。
