Mayet W J, Hess G, Gerken G, Rossol S, Voth R, Manns M, Meyer zum Büschenfelde K H
I. Medizinische Klinik, Universität Mainz, Federal Republic of Germany.
Hepatology. 1989 Jul;10(1):24-8. doi: 10.1002/hep.1840100106.
Recombinant human alpha-interferon is now under intensive investigation as therapy for chronic Type B hepatitis. Recent reports have suggested that prolonged alpha-interferon therapy may induce autoimmune reactions. We have evaluated the problem of autoimmunity related to alpha-interferon therapy by testing for 15 different antibodies in the sera of 31 patients treated with alpha-interferon. No patient had autoantibodies before treatment; 27 (87%) of 31 patients developed at least one autoantibody. Eleven patients had antinuclear antibodies and 21 had smooth muscle antibodies, both of which usually developed during alpha-interferon therapy. In contrast, antibodies to endocrine organs such as thyroid microsomal, thyroglobulin and parietal cell antibodies arose in 12 patients, but usually several months after alpha-interferon treatment. The appearance of these autoantibodies did not correlate with disease activity or response to alpha-interferon. No patient developed autoantibodies specifically associated with autoimmune liver diseases such as liver kidney microsomal antibodies, autoantibodies to soluble liver antigen and the primary biliary cirrhosis specific subtypes of antimitochondrial antibodies. These results suggest that prolonged alpha-interferon therapy can induce autoantibody production and, in susceptible patients, may lead to autoimmune disorders.
重组人α干扰素目前正作为慢性乙型肝炎的治疗方法进行深入研究。最近的报告表明，长期使用α干扰素治疗可能会诱发自身免疫反应。我们通过检测31例接受α干扰素治疗患者血清中的15种不同抗体，评估了与α干扰素治疗相关的自身免疫问题。治疗前没有患者存在自身抗体；31例患者中有27例（87%）至少产生了一种自身抗体。11例患者有抗核抗体，21例有平滑肌抗体，这两种抗体通常在α干扰素治疗期间出现。相比之下，12例患者出现了针对内分泌器官的抗体，如甲状腺微粒体抗体、甲状腺球蛋白抗体和壁细胞抗体，但通常在α干扰素治疗数月后出现。这些自身抗体的出现与疾病活动或对α干扰素的反应无关。没有患者产生与自身免疫性肝病特异性相关的自身抗体，如肝肾微粒体抗体、可溶性肝抗原自身抗体以及原发性胆汁性肝硬化特异性亚型的抗线粒体抗体。这些结果表明，长期使用α干扰素治疗可诱导自身抗体产生，在易感患者中可能导致自身免疫性疾病。
