KIR3DL1-HLA-Bw4组合及IL28B基因多态性可预测慢性丙型肝炎患者接受聚乙二醇干扰素联合利巴韦林治疗（无论是否联用特拉匹韦）的疗效。
KIR3DL1-HLA-Bw4 combination and IL28B polymorphism predict response to Peg-IFN and ribavirin with and without telaprevir in chronic hepatitis C.
作者信息
Umemura Takeji, Ota Masao, Katsuyama Yoshihiko, Wada Shuichi, Mori Hiromitsu, Maruyama Atsushi, Shibata Soichiro, Nozawa Yuichi, Kimura Takefumi, Morita Susumu, Joshita Satoru, Komatsu Michiharu, Matsumoto Akihiro, Kamijo Atsushi, Kobayashi Masakazu, Takamatsu Masato, Yoshizawa Kaname, Kiyosawa Kendo, Tanaka Eiji
机构信息
Department of Medicine, Division of Hepatology and Gastroenterology, Shinshu University School of Medicine, Matsumoto, Japan.
Department of Legal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
出版信息
Hum Immunol. 2014 Aug;75(8):822-6. doi: 10.1016/j.humimm.2014.06.003. Epub 2014 Jun 11.
Natural killer cells play a key role in the immune control of viral infections. Killer immunoglobulin-like receptors (KIRs) regulate natural killer cell activation and inhibition through the recognition of their cognate HLA class I ligands. We assessed the predictive factors of a sustained virological response (SVR) in 200 Japanese patients with chronic genotype 1b hepatitis C who were treated with telaprevir (TVR), pegylated-interferon-α2b (PEG-IFN), and ribavirin (RBV) triple therapy (92 patients) or PEG-IFN/RBV therapy alone (108 patients). Sixteen KIR genotypes, HLA-A, -B and -C ligands, and an interleukin (IL) 28B polymorphism (rs8099917) were analyzed. We observed that triple therapy, white blood cell count, hemoglobin value, hepatitis C viral load, a rapid virological response (RVR), IL28B TT genotype, and KIR3DL1-HLA-Bw4 genotype were associated with an SVR. In multivariate regression analysis, we identified an RVR (P < 0.000001; odds ratio [OR] = 20.95), the IL28B TT genotype (P = 0.00014; OR = 5.53), and KIR3DL1-HLA-Bw4 (P = 0.004, OR = 3.42) as significant independent predictive factors of an SVR. In conclusion, IL28B and KIR3DL1/HLA-Bw4 are independent predictors of an SVR in Japanese patients infected with genotype 1b HCV receiving TVR/PEG-IFN/RBV or PEG-IFN/RBV therapy.
自然杀伤细胞在病毒感染的免疫控制中发挥关键作用。杀伤免疫球蛋白样受体（KIRs）通过识别其同源的HLA I类配体来调节自然杀伤细胞的激活和抑制。我们评估了200例慢性1b型丙型肝炎日本患者持续病毒学应答（SVR）的预测因素，这些患者接受了特拉匹韦（TVR）、聚乙二醇化干扰素-α2b（PEG-IFN）和利巴韦林（RBV）三联疗法（92例患者）或单独的PEG-IFN/RBV疗法（108例患者）。分析了16种KIR基因型、HLA-A、-B和-C配体以及白细胞介素（IL）28B多态性（rs8099917）。我们观察到三联疗法、白细胞计数、血红蛋白值、丙型肝炎病毒载量、快速病毒学应答（RVR）、IL28B TT基因型和KIR3DL1-HLA-Bw4基因型与SVR相关。在多变量回归分析中，我们确定RVR（P < 0.000001；比值比[OR] = 20.95）、IL28B TT基因型（P = 0.00014；OR = 5.53）和KIR3DL1-HLA-Bw4（P = 0.004，OR = 3.42）是SVR的显著独立预测因素。总之，IL28B和KIR3DL1/HLA-Bw4是接受TVR/PEG-IFN/RBV或PEG-IFN/RBV治疗的1b型HCV感染日本患者SVR的独立预测因素。
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