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用γ干扰素治疗慢性乙型肝炎患者时自身免疫现象的诱发

Induction of autoimmune phenomena in patients with chronic hepatitis B treated with gamma-interferon.

作者信息

Weber P, Wiedmann K H, Klein R, Walter E, Blum H E, Berg P A

机构信息

Department of Internal Medicine, University of Tübingen, Germany.

出版信息

J Hepatol. 1994 Mar;20(3):321-8. doi: 10.1016/s0168-8278(94)80002-2.

Abstract

All interferons display antiviral properties, but gamma-interferon especially has an immunomodulatory effect and may induce autoimmune phenomena. Therefore the formation of autoantibodies was investigated in patients with chronic hepatitis B treated with gamma-interferon. Eleven patients (all HBs-Ag and HBe-Ag positive) were treated for 6 months with recombinant gamma-interferon. The following antibodies were tested: anti-nuclear antibodies, smooth muscle antibodies, anti-actin, anti-mitochondrial antibodies of subgroup anti-M2 and anti-M9 as well as naturally occurring antibodies, antibodies to liver-kidney microsomes, vascular endothelial cell antibodies, sarcolemmal antibodies, parietal cell antibodies, thyroglobulin antibodies and antibodies to laminin and keratin. All patients produced autoantibodies during therapy. The maximum antibody formation and the highest titres were observed in the period between the 3rd and 6th month after therapy began. The cumulative frequencies of the different antibody specificities were as follows: n = 6 anti-nuclear antibodies, n = 7 smooth muscle antibodies, n = 1 anti-actin, n = 12 antibodies to laminin or keratin, n = 6 endothelial cell antibodies/sarcolemmal antibodies, n = 6 anti-mitochondrial antibodies, n = 1 antibodies to liver-kidney microsomes, n = 2 thyroglobulin antibodies, n = 4 parietal cell antibodies. Antibodies persisted in six patients over a period of 3 months (two cases of parietal cell antibodies and one case of antibodies to liver-kidney microsomes) and were still detectable in three patients 6 months after therapy. In three patients new antibody formation occurred 1 month after therapy. So far, clinical signs of an autoimmune disorder have not appeared in any of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

所有干扰素都具有抗病毒特性,但γ干扰素尤其具有免疫调节作用,且可能诱发自身免疫现象。因此,对接受γ干扰素治疗的慢性乙型肝炎患者的自身抗体形成情况进行了研究。11例患者(均为乙肝表面抗原和乙肝e抗原阳性)接受了重组γ干扰素治疗6个月。检测了以下抗体:抗核抗体、平滑肌抗体、抗肌动蛋白、抗线粒体抗体亚组抗M2和抗M9以及天然存在的抗体、肝肾微粒体抗体、血管内皮细胞抗体、肌膜抗体、壁细胞抗体、甲状腺球蛋白抗体以及层粘连蛋白和角蛋白抗体。所有患者在治疗期间均产生了自身抗体。在治疗开始后的第3至6个月期间观察到抗体形成的最大值和最高滴度。不同抗体特异性的累积频率如下:抗核抗体n = 6例,平滑肌抗体n = 7例,抗肌动蛋白n = 1例,层粘连蛋白或角蛋白抗体n = 12例,内皮细胞抗体/肌膜抗体n = 6例,抗线粒体抗体n = 6例,肝肾微粒体抗体n = 1例,甲状腺球蛋白抗体n = 2例,壁细胞抗体n = 4例。6例患者的抗体持续存在3个月(2例壁细胞抗体和1例肝肾微粒体抗体),治疗6个月后仍有3例患者可检测到抗体。3例患者在治疗1个月后出现新的抗体形成。到目前为止,所有患者均未出现自身免疫性疾病的临床症状。(摘要截取自250字)

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