Karino Y, Hige S, Matsushima T, Miyazaki T, Toyota J
Third Department of Internal Medicine, Hokkaido University School of Medicine, Sapporo, Japan.
Hokkaido Igaku Zasshi. 1994 Nov;69(6):1354-9.
Although the mechanisms of elimination of HCV by IFN have not been fully elucidated, the 2-5A system was reported to be one of the mechanisms of the anti-viral effect of IFN. Therefore, the relationship between HCV genotype, induction of 2-5AS and clinical effect was investigated. As for the anti-viral effect during IFN therapy, in type III or IV, most patients lost HCV-RNA regardless of serum 2-5AS induction even in high HCV-RNA concentration cases. In contrast, in type II, the negativity rate of HCV-RNA became high along with an increase of serum 2-5AS activity, but in patients with high HCV-RNA concentration, HCV-RNA was persistently positive. As for the long term clinical effect of IFN therapy judged 6 months after completion of IFN therapy, HCV genotypes were closely related to the effect; that is, the patients with type III or type IV HCV genotype showed a higher complete response rate compared with the patients with type II HCV genotype. However, the relationship between the long term clinical effects and induction of serum 2-5AS during IFN therapy was obscure. These results suggest that induction of 2-5AS is closely related to the anti-viral effect during IFN administration, but the viral factors appeared to be related to long term clinical effects after cessation of IFN therapy.
虽然干扰素清除丙型肝炎病毒(HCV)的机制尚未完全阐明,但据报道2-5A系统是干扰素抗病毒作用的机制之一。因此,对HCV基因型、2-5AS的诱导与临床疗效之间的关系进行了研究。关于干扰素治疗期间的抗病毒效果,在III型或IV型中,即使在高HCV-RNA浓度的情况下,大多数患者无论血清2-5AS是否诱导都会失去HCV-RNA。相比之下,在II型中,HCV-RNA的阴性率随着血清2-5AS活性的增加而升高,但在高HCV-RNA浓度的患者中,HCV-RNA持续呈阳性。关于干扰素治疗结束6个月后判断的干扰素治疗的长期临床疗效,HCV基因型与疗效密切相关;也就是说,与II型HCV基因型患者相比,III型或IV型HCV基因型患者的完全缓解率更高。然而,长期临床疗效与干扰素治疗期间血清2-5AS诱导之间的关系尚不清楚。这些结果表明,2-5AS的诱导与干扰素给药期间的抗病毒效果密切相关,但病毒因素似乎与干扰素治疗停止后的长期临床疗效有关。