Lobo-Yeo A, Mieli-Vergani G, Mowat A P, Vergani D
Department of Child Health, King's College School of Medicine and Dentistry, King's College Hospital, Denmark Hill, London.
Gut. 1990 Jun;31(6):690-3. doi: 10.1136/gut.31.6.690.
Children with uncontrolled autoimmune chronic active hepatitis have increased numbers of activated T lymphocytes expressing interleukin 2 receptors (IL2R). A soluble form of IL2R has recently been described whose proposed role is to downregulate T cell activation by competing for interleukin 2. We investigated whether a deficiency of soluble IL2R could account for the high concentrations of IL2R positive T lymphocytes in autoimmune chronic active hepatitis. Soluble IL2R was measured by enzyme-linked immunosorbent assay in the serum of 16 children with autoimmune chronic active hepatitis, eight with chronic liver disease due to hepatitis B virus infection, seven with Wilson's disease, nine with alpha 1 antitrypsin deficiency, and 15 healthy age matched controls. Soluble IL2R concentration was significantly higher in patients with autoimmune chronic active hepatitis than in healthy controls (mean (SEM) 475 (75) U/ml, 145 (8) U/ml respectively, p less than 0.01). Eleven patients who had active disease had significantly higher soluble IL2R concentrations (590 (89) U/ml) than the five cases with inactive disease (220 (36) U/ml, p less than 0.01). No difference was found between the controls and the patients with chronic liver disease due to hepatitis B infection, Wilson's disease, and alpha 1 antitrypsin deficiency. Percentages and absolute numbers of surface IL2R positive T cells as detected by immunofluorescence were significantly higher in the patients with autoimmune chronic active hepatitis (11.8% (1); 274/microliters (31)) than in controls (0.2% (0.1); 5/microliters (2), p less than 0.001), the highest values being found in those with uncontrolled disease. A significantly positive correlation was observed between concentrations of soluble IL2R and the percentage of T cells expressing IL2 receptors (r=0.67, p<0.001). These results indicate that the high levels of IL2R positive T lymphocytes characteristic of autoimmune chronic active hepatitis are not due to a deficiency of soluble IL2 receptors.
患有未得到控制的自身免疫性慢性活动性肝炎的儿童，表达白细胞介素2受体（IL2R）的活化T淋巴细胞数量增多。最近描述了一种可溶性形式的IL2R，其假定作用是通过竞争白细胞介素2来下调T细胞活化。我们研究了可溶性IL2R的缺乏是否可以解释自身免疫性慢性活动性肝炎中IL2R阳性T淋巴细胞的高浓度。通过酶联免疫吸附测定法测量了16例自身免疫性慢性活动性肝炎儿童、8例乙型肝炎病毒感染所致慢性肝病儿童、7例威尔逊氏病患者、9例α1抗胰蛋白酶缺乏症患者以及15名年龄匹配的健康对照者血清中的可溶性IL2R。自身免疫性慢性活动性肝炎患者的可溶性IL2R浓度显著高于健康对照者（分别为均值（标准误）475（75）U/ml和145（8）U/ml，p<0.01）。11例患有活动性疾病的患者的可溶性IL2R浓度（590（89）U/ml）显著高于5例非活动性疾病患者（220（36）U/ml，p<0.01）。在对照者与乙型肝炎感染、威尔逊氏病和α1抗胰蛋白酶缺乏所致慢性肝病患者之间未发现差异。通过免疫荧光检测，自身免疫性慢性活动性肝炎患者表面IL2R阳性T细胞的百分比和绝对数量（11.8%（1）；274/微升（31））显著高于对照者（0.2%（0.1）；5/微升（2），p<0.001），最高值见于疾病未得到控制的患者。可溶性IL2R浓度与表达IL2受体的T细胞百分比之间观察到显著正相关（r=0.67，p<0.001）。这些结果表明，自身免疫性慢性活动性肝炎特有的高水平IL2R阳性T淋巴细胞并非由于可溶性IL2受体缺乏所致。
