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血清细胞因子水平与聚乙二醇干扰素和利巴韦林治疗基因 1 型慢性丙型肝炎患者的治疗反应的相关性。

Association of serum cytokine levels with treatment response to pegylated interferon and ribavirin therapy in genotype 1 chronic hepatitis C patients.

机构信息

Department of Medicine, Division of Hepatology and Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.

出版信息

J Infect Dis. 2011 Apr 15;203(8):1087-95. doi: 10.1093/infdis/jiq165. Epub 2011 Mar 11.

Abstract

BACKGROUND

We sought to clarify the associations among serum cytokines, amino acid substitutions in the interferon sensitivity-determining region (ISDR) and core region, and treatment outcome of pegylated interferon and ribavirin therapy in genotype 1 hepatitis C virus (HCV)-infected patients.

METHODS

We quantified a total of 8 serum cytokines before, during, and after treatment in 79 genotype 1 chronic HCV patients. Viral ISDR and core region variants were determined by direct sequencing.

RESULTS

High levels of interleukin (IL)-12 and IL-18 and more than 2 mutations in the ISDR were associated with a sustained virological response (SVR). Conversely, high baseline IL-10 levels and glutamine at amino acid 70 of the HCV core protein (Gln70) were significantly associated with a nonresponse to treatment, and patients with Gln70 had significantly higher IL-10 levels. In multivariate analysis, low IL-10, high IL-12, and high IL-18 levels were independently associated with an SVR. These 3 cytokine levels were decreased from baseline levels 4 weeks into treatment and remained low in patients with an SVR.

CONCLUSION

Serum IL-10, IL-12, and IL-18 levels are predictive of the response to HCV treatment with pegylated interferon and ribavirin and are associated with amino acid substitutions in the ISDR and core region.

摘要

背景

我们旨在阐明血清细胞因子、干扰素敏感性决定区(ISDR)和核心区氨基酸替换与聚乙二醇干扰素和利巴韦林治疗基因型 1 丙型肝炎病毒(HCV)感染患者的治疗结果之间的关系。

方法

我们在 79 例基因型 1 慢性 HCV 患者中,于治疗前、治疗中和治疗后总共检测了 8 种血清细胞因子。通过直接测序确定病毒 ISDR 和核心区变异。

结果

高水平的白细胞介素(IL)-12 和 IL-18 以及 ISDR 中超过 2 个突变与持续病毒学应答(SVR)相关。相反,较高的基线 IL-10 水平和 HCV 核心蛋白第 70 位的谷氨酰胺(Gln70)与治疗无反应显著相关,Gln70 患者的 IL-10 水平显著更高。多变量分析显示,低水平的 IL-10、高水平的 IL-12 和高水平的 IL-18 与 SVR 独立相关。这些 3 种细胞因子水平在治疗 4 周时从基线水平下降,并在 SVR 患者中保持低水平。

结论

血清 IL-10、IL-12 和 IL-18 水平可预测聚乙二醇干扰素和利巴韦林治疗 HCV 的反应,并与 ISDR 和核心区的氨基酸替换相关。

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