YingLi He, Shumei Lin, Qian Yang, Tianyan Chen, Yingren Zhao, Wei Chen
Infectious Diseases Department, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Clin Exp Med. 2009 Jun;9(2):173-8. doi: 10.1007/s10238-009-0041-5. Epub 2009 Feb 24.
Hepatitis C virus (HCV) infection is a major cause of chronic liver disease worldwide. In mainland of China, It was estimated the population of 1.3 billion infected with HCV. HCV is not cytopathic. Immune response that is essentially conducted by cytokines may play an important role in the pathogenesis of HCV infection. Interleukin (IL)-18, mainly produced by monocytes/macrophages, plays an important role in the immune system by enhancing T cell responses, regulating interferon-gamma (IFN-gamma) production and promoting the development of T helper cell Th1 immune responses. Raised serum levels of IL-18 have recently been reported in patients with chronic hepatitis C before antiviral therapy. Herein we report the IL-18 sequential changes in patients with hepatitis C during the period of pegylated interferon (PEG-IFN) alpha treatment for 48 weeks. We established the correlation of plasma IL-18 level and alanine aminotransferase (r = 0.77, P < 0.05). Hepatic inflammatory activity in chronic hepatitis C was shown to be closely associated with an increased amount of IL-18. HCV-infected patients had raised IL-18 levels (93.67 +/- 23.58 pg/ml versus 59.73 +/- 24.06 pg/ml; P < 0.001) comparing donor negativity for HCV. PEG-IFN alpha-2a treatment induces a marked decline in IL-18 and remission of hepatic inflammatory in responders at week 24 and week 48 follow-up time point, while increased levels persist in those in whom the HCV infection was not eliminated by the therapy. We proposed declined IL-18 levels favor for virus solution, while persistent raised IL-18 associated with PEG-IFN treatment failure.
丙型肝炎病毒（HCV）感染是全球慢性肝病的主要病因。在中国内地，据估计有13亿人口感染了HCV。HCV无细胞病变作用。主要由细胞因子介导的免疫反应可能在HCV感染的发病机制中起重要作用。白细胞介素（IL）-18主要由单核细胞/巨噬细胞产生，通过增强T细胞反应、调节γ干扰素（IFN-γ）产生以及促进辅助性T细胞Th1免疫反应的发展，在免疫系统中发挥重要作用。最近有报道称，慢性丙型肝炎患者在抗病毒治疗前血清IL-18水平升高。在此我们报告了丙型肝炎患者在聚乙二醇化干扰素（PEG-IFN）α治疗48周期间IL-18的动态变化。我们建立了血浆IL-18水平与丙氨酸氨基转移酶的相关性（r = 0.77，P < 0.05）。结果显示，慢性丙型肝炎的肝脏炎症活动与IL-18量的增加密切相关。与HCV阴性的供体相比，HCV感染患者的IL-18水平升高（93.67±23.58 pg/ml对59.73±24.06 pg/ml；P < 0.001）。在第24周和第48周的随访时间点，PEG-IFNα-2a治疗可使有反应者的IL-18显著下降，肝脏炎症缓解，而在那些HCV感染未被该治疗清除的患者中，IL-18水平持续升高。我们认为IL-18水平下降有利于病毒清除，而PEG-IFN治疗失败与IL-18持续升高有关。
