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[转移因子(TF)治疗HBs - Ag阳性慢性活动性肝炎患者。一项前瞻性对照研究(作者译)]

[Transfer factor (TF) treatment of patients with HBs-Ag-positive chronic active hepatitis. A prospective, controlled study (author's transl)].

作者信息

Sodomann C P, Maerker-Alzer G, Havemann K, Dienst C, Schultz H, Mitrenga D, Schumacher K, Martini G A

出版信息

Klin Wochenschr. 1979 Sep 3;57(17):893-903. doi: 10.1007/BF01477028.

Abstract

It is a clinically and experimentally well supported working hypothesis that infection with hepatitis B virus may result in chronic active hepatitis in patients with suspected immune deficiencies. On this basis, a pilot study was performed in order to evaluate the effect of "specific" transfer factor (TF) in the treatment of HBS-Ag-positive chronic active hepatitis. From the leukocytes of 500 ml venous blood each of 40 volunteers that had completely recovered from acute virus hepatitis B within the last 6 months, a unique TF pool (40 units of TF) was prepared according to the method of Lawrence. Preexaminations indicated that this preparation was able to enhance cellular immune reactions in vitro. Thirteen patients with HBS-antigenemia and chronic active hepatitis (i.e., two liver biopsies within the last 6 or more months with the histological criteria of chronic aggressive hepatitis according to de Groote, elevated serum levels of bilirubin, alkaline phosphatase, transaminase activities, and/or gamma-globulines) were randomized: Seven received s.c. injections of two units of TF each on days 1 and 15, the other six saline. Conversion of skin reactions to some ubiquitous antigens occurred in the TF group, but no significant and constant drop of HBS-Ag serum titers was observed. Although some of the biochemical parameters seemed to ameliorate in the TF group, the differences versus the control group did not prove to be significant within the limited number of patients under observation. The in vitro reactivity of patients' lymphocytes to HBS-Ag, tested by means of the 3H-thymidine uptake, was never found enhanced after TF application. In the used doses, "specific" TF was not effective in the treatment of HBS-Ag-positive chronic active hepatitis; unfavorable side-effects were not observed.

摘要

乙肝病毒感染可能会导致疑似免疫缺陷患者出现慢性活动性肝炎,这是一个在临床和实验上都得到充分支持的工作假设。在此基础上,进行了一项试点研究,以评估“特异性”转移因子(TF)治疗HBs - Ag阳性慢性活动性肝炎的效果。从40名在过去6个月内已从急性乙型病毒性肝炎完全康复的志愿者每人500毫升静脉血的白细胞中,按照劳伦斯的方法制备了一个独特的TF库(40单位TF)。预先检查表明,该制剂能够在体外增强细胞免疫反应。13例HBs抗原血症和慢性活动性肝炎患者(即过去6个月或更长时间内进行了两次肝活检,组织学符合de Groote提出的慢性侵袭性肝炎标准,血清胆红素、碱性磷酸酶、转氨酶活性和/或γ-球蛋白水平升高)被随机分组:7例在第1天和第15天接受皮下注射,每次2单位TF,另外6例注射生理盐水。TF组对一些常见抗原的皮肤反应发生了转变,但未观察到HBs - Ag血清滴度有显著且持续的下降。尽管TF组的一些生化参数似乎有所改善,但在观察的有限患者数量内,与对照组的差异并不显著。通过3H - 胸腺嘧啶核苷摄取检测,从未发现TF应用后患者淋巴细胞对HBs - Ag的体外反应性增强。在所使用的剂量下,“特异性”TF对HBs - Ag阳性慢性活动性肝炎治疗无效;未观察到不良副作用。

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