低水平血清免疫球蛋白 G 有益于聚乙二醇干扰素治疗无表面抗原携带者获得临床治愈。
Low Level of Serum Immunoglobulin G Is Beneficial to Clinical Cure Obtained With Pegylated Interferon Therapy in Inactive Surface Antigen Carriers.
机构信息
The Third Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
The First Unit, Department of Hepatology, Beijing Youan Hospital, Capital Medical University, Beijing, China.
出版信息
Front Immunol. 2022 Apr 22;13:864354. doi: 10.3389/fimmu.2022.864354. eCollection 2022.
PURPOSE
Our recent study showed a high rate of HBsAg clearance in inactive HBsAg carriers (IHCs) treated with pegylated IFN (PEG-IFN). To better understand the immune-mediated component of HBsAg clearance, this study investigated the role of serum immunoglobulin G (IgG) and its subclasses in predicting HBsAg clearance in IHCs with PEG-IFN therapy.
METHODS
In this study, IHCs received PEG-IFN for 96 weeks. Subjects who achieved clearance of HBsAg were considered responders (R group), and those in whom HBsAg was not cleared were considered non-responders (NR group). The HBsAg, ALT, and serum lgG subtypes (lgG1, IgG2, IgG3, lgG4) were tested at baseline, and at 12 and 24 weeks of treatment. To evaluate the factors in predicting HBsAg clearance, univariate and multivariate logistic regression analyses were performed. The receiver operator characteristic curves and the area under the receiver operator characteristic curve (AUROC) were used to evaluate prognostic values.
RESULTS
Our results showed that 39 cases obtained HBsAg clearance (group R), while 21 cases did not (group NR). There was no significant difference in age, ALT, and AST levels between the two groups. The serum levels of IgG1, lgG2, lgG3 and lgG4 at baseline, and at 12 and 24 weeks were significantly lower in IHC with HBsAg clearance than in the NR group. Univariate logistic regression analysis showed that serum IgG1, IgG2, IgG3, and IgG4 levels at baseline, and at 12, and 24 weeks were all strong predictors of HBsAg clearance. In all indicators, lgG2 had the highest AUROC at baseline and lgG3 the highest AUROC at week 12. A multifactor logistic analysis was performed with y=33.933-0.001BaselinelgG1-0.002BaselinelgG2. The area under the curve was 0.941 with 100% sensitivity and 76.19% specificity.
CONCLUSION
Together, our findings suggest that serum IgG has a higher predictive value compared to the convention predictors of HBsAg and ALT for HBsAg clearance and thus may be a better clinical predictor of HBsAg clearance in IHCs.
目的
我们最近的研究表明，聚乙二醇干扰素（PEG-IFN）治疗下的非活动 HBsAg 携带者（IHC）的 HBsAg 清除率很高。为了更好地了解 HBsAg 清除的免疫介导成分，本研究调查了血清免疫球蛋白 G（IgG）及其亚类在预测 PEG-IFN 治疗的 IHC 中 HBsAg 清除中的作用。
方法
在这项研究中，IHC 接受了 96 周的 PEG-IFN 治疗。获得 HBsAg 清除的受试者被认为是应答者（R 组），而 HBsAg 未被清除的受试者被认为是非应答者（NR 组）。在基线时以及治疗的 12 和 24 周时，检测了 HBsAg、ALT 和血清 IgG 亚型（IgG1、IgG2、IgG3、IgG4）。为了评估预测 HBsAg 清除的因素，进行了单变量和多变量逻辑回归分析。使用受试者工作特征曲线和受试者工作特征曲线下的面积（AUROC）来评估预后价值。
结果
我们的结果显示，39 例获得 HBsAg 清除（R 组），而 21 例未清除（NR 组）。两组间年龄、ALT 和 AST 水平无显著差异。与 NR 组相比，HBsAg 清除的 IHC 基线时以及治疗 12 和 24 周时血清 IgG1、lgG2、lgG3 和 lgG4 水平均显著降低。单变量逻辑回归分析表明，基线、治疗 12 和 24 周时的血清 IgG1、IgG2、IgG3 和 IgG4 水平均为 HBsAg 清除的强预测因子。在所有指标中，lgG2 在基线时具有最高的 AUROC，而 lgG3 在第 12 周时具有最高的 AUROC。使用 y=33.933-0.001BaselinelgG1-0.002BaselinelgG2 进行多因素逻辑分析。曲线下面积为 0.941，灵敏度为 100%，特异性为 76.19%。
结论
综上所述，我们的研究结果表明，与 HBsAg 和 ALT 的传统预测因子相比，血清 IgG 对 HBsAg 清除具有更高的预测价值，因此可能是预测 IHC 中 HBsAg 清除的更好的临床预测因子。
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