Bonetti P, Diodati G, Drago C, Casarin C, Scaccabarozzi S, Realdi G, Ruol A, Alberti A
Clinica Medica II, University of Padova, Milano, Italy.
J Hepatol. 1994 Mar;20(3):416-20. doi: 10.1016/s0168-8278(94)80018-9.
Patients treated with alpha-2a interferon for chronic hepatitis C may produce anti-interferon antibodies whose effect, if any, on the individual response to therapy has not been fully clarified. The prevalence and kinetics of anti-interferon, including those of neutralizing type, have been studied in 60 patients with chronic hepatitis C enrolled in a randomized controlled trial of recombinant alpha-2a interferon. Thirty patients received interferon while 30 were untreated controls. Two different methods, an enzyme immunoassay and an antiviral neutralization bioassay, were used and serial serum samples from each patient were analyzed. Enzyme immunoassay-positive anti-interferon appeared in 60.7% of treated patients within 6 months of therapy; antiviral neutralization bioassay-positive anti-interferon appeared in 52.9% of these enzyme immunoassay-positive patients, and was associated with high enzyme immunoassay reactivity and long-term persistence. Anti-interferon was detected in 75% of patients showing no response to interferon. Antibodies were also detected in three out of six patients who showed alanine aminotransferase normalization persisting up to the end of treatment and in 8 out of 14 patients who showed an initial marked reduction or even normalization of alanine aminotransferase, followed by reactivation of liver damage during treatment. Interestingly, patients who became anti-interferon positive before complete alanine aminotransferase normalization later showed reactivation of liver damage independently of interferon dose reduction, while patients who became positive for anti-interferon after complete alanine aminotransferase normalization either did not reactivate or did so only after interferon dose reduction.(ABSTRACT TRUNCATED AT 250 WORDS)
接受α-2a干扰素治疗慢性丙型肝炎的患者可能会产生抗干扰素抗体,其对个体治疗反应的影响(如果有)尚未完全阐明。在一项重组α-2a干扰素随机对照试验中,对60例慢性丙型肝炎患者的抗干扰素(包括中和型)的发生率和动力学进行了研究。30例患者接受干扰素治疗,30例为未治疗的对照。使用了两种不同的方法,即酶免疫测定和抗病毒中和生物测定,并对每位患者的系列血清样本进行了分析。酶免疫测定阳性的抗干扰素在治疗6个月内出现在60.7%的治疗患者中;抗病毒中和生物测定阳性的抗干扰素出现在这些酶免疫测定阳性患者的52.9%中,并且与高酶免疫测定反应性和长期持续存在相关。在75%对干扰素无反应的患者中检测到抗干扰素。在6例直至治疗结束丙氨酸转氨酶持续正常的患者中有3例也检测到抗体,在14例最初丙氨酸转氨酶显著降低甚至正常但在治疗期间肝损伤重新激活的患者中有8例检测到抗体。有趣的是,在丙氨酸转氨酶完全正常化之前抗干扰素呈阳性的患者后来出现肝损伤重新激活,与干扰素剂量减少无关,而在丙氨酸转氨酶完全正常化后抗干扰素呈阳性的患者要么没有重新激活,要么仅在干扰素剂量减少后才重新激活。(摘要截短于250字)