Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
Gut. 2013 Sep;62(9):1340-6. doi: 10.1136/gutjnl-2012-302553. Epub 2012 Nov 7.
Recent studies have demonstrated that genetic polymorphisms near the IL28B gene are associated with the clinical outcome of pegylated interferon α (peg-IFN-α) plus ribavirin therapy for patients with chronic hepatitis C virus (HCV). However, it is unclear whether genetic variations near the IL28B gene influence hepatic interferon (IFN)-stimulated gene (ISG) induction or cellular immune responses, lead to the viral reduction during IFN treatment.
Changes in HCV-RNA levels before therapy, at day 1 and weeks 1, 2, 4, 8 and 12 after administering peg-IFN-α plus ribavirin were measured in 54 patients infected with HCV genotype 1. Furthermore, we prepared four lines of chimeric mice having four different lots of human hepatocytes containing various single nucleotide polymorphisms (SNP) around the IL28B gene. HCV infecting chimeric mice were subcutaneously administered with peg-IFN-α for 2 weeks.
There were significant differences in the reduction of HCV-RNA levels after peg-IFN-α plus ribavirin therapy based on the IL28B SNP rs8099917 between TT (favourable) and TG/GG (unfavourable) genotypes in patients; the first-phase viral decline slope per day and second-phase slope per week in TT genotype were significantly higher than in TG/GG genotype. On peg-IFN-α administration to chimeric mice, however, no significant difference in the median reduction of HCV-RNA levels and the induction of antiviral ISG was observed between favourable and unfavourable human hepatocyte genotypes.
As chimeric mice have the characteristic of immunodeficiency, the response to peg-IFN-α associated with the variation in IL28B alleles in chronic HCV patients would be composed of the intact immune system.
最近的研究表明,白细胞介素 28B(IL28B)基因附近的遗传多态性与聚乙二醇干扰素α(peg-IFN-α)联合利巴韦林治疗慢性丙型肝炎病毒(HCV)患者的临床疗效相关。然而,IL28B 基因附近的遗传变异是否影响肝干扰素(IFN)刺激基因(ISG)诱导或细胞免疫反应,导致 IFN 治疗期间病毒减少尚不清楚。
对 54 例感染 HCV 基因型 1 的患者,在给予 peg-IFN-α联合利巴韦林治疗前、第 1 天以及治疗后 1、2、4、8 和 12 周时,检测 HCV-RNA 水平的变化。此外,我们制备了四条嵌合小鼠线,它们具有四条不同的人肝细胞,其中包含 IL28B 基因周围的各种单核苷酸多态性(SNP)。将感染 HCV 的嵌合小鼠皮下给予 peg-IFN-α治疗 2 周。
根据患者 IL28B SNP rs8099917,peg-IFN-α联合利巴韦林治疗后 HCV-RNA 水平降低存在显著差异,TT(有利)基因型与 TG/GG(不利)基因型之间;TT 基因型的第一天病毒下降斜率和每周第二阶段斜率明显高于 TG/GG 基因型。然而,在给予嵌合小鼠 peg-IFN-α时,有利和不利人肝细胞基因型之间 HCV-RNA 水平的中位数降低和抗病毒 ISG 的诱导没有观察到显著差异。
由于嵌合小鼠具有免疫缺陷的特点,与慢性 HCV 患者 IL28B 等位基因变异相关的对 peg-IFN-α的反应将由完整的免疫系统组成。