Reiser M, Marousis C G, Nelson D R, Lauer G, González-Peralta R P, Davis G L, Lau J Y
Department of Medicine, University of Florida, Gainesville 32610, USA.
J Hepatol. 1997 Mar;26(3):471-8. doi: 10.1016/s0168-8278(97)80409-6.
BACKGROUND/AIMS: Immune-mediated mechanisms are believed to play an important pathogenetic role in chronic hepatitis C virus infection. Interleukin 4 (IL-4) and IL-10 are secreted by T helper-2 type cells (Th2) which may downregulate cell-mediated immune effector mechanisms important in the host defense against intracellular pathogens. This study aimed to determine Th2 cytokine levels in chronic hepatitis C virus infection.
Serum IL-4 and IL-10 levels were measured in 74 patients with chronic hepatitis C virus infection and 20 healthy controls. The expression of CD30 in liver, a marker that is preferentially expressed in Th2 cells, was also determined by immunohistochemical staining in 37 patients.
Serum IL-4 and IL-10 were below the detection limit (5 pg/ml) in all 20 healthy controls. However, 36 patients (49%) had elevated serum IL-4 levels (range 5-106 pg/ml, p<0.001) and 23 patients (31%) had elevated serum IL-10 levels (range 5-37 pg/ml, p<0.05). There was no correlation between serum IL-4 and IL-10 levels. There was also no correlation between serum IL-4 and IL-10 levels and any of the clinical (age, gender, mode of acquisition), biochemical (serum alanine transaminase levels), virologic (viremia level, genotype), and histological parameters examined. Twenty of 37 liver biopsy specimens from patients with chronic hepatitis C virus infection showed occasional CD30+ lymphocytes, suggestive of Th2 phenotype. However, in 20 of the 37 patients with paired cryostat liver sections, IL-4 was not detected in any of these patients, suggesting that IL-4 was not produced in the liver in patients with chronic hepatitis C virus infection.
This study showed that serum Th2 cytokines are elevated (but at a low level) in a proportion of patients with chronic hepatitis C virus infection. However, the elevated Th2 cytokine levels may represent a systemic response and not a result of increased local production within the liver.
背景/目的：免疫介导机制被认为在慢性丙型肝炎病毒感染中发挥重要的致病作用。白细胞介素4（IL-4）和IL-10由辅助性T细胞2型（Th2）分泌，它们可能下调细胞介导的免疫效应机制，而这些机制在宿主抵御细胞内病原体的防御中很重要。本研究旨在确定慢性丙型肝炎病毒感染中Th2细胞因子水平。
检测了74例慢性丙型肝炎病毒感染患者和20名健康对照者的血清IL-4和IL-10水平。还通过免疫组织化学染色在37例患者中测定了肝脏中CD30的表达，CD30是一种在Th2细胞中优先表达的标志物。
所有20名健康对照者的血清IL-4和IL-10均低于检测限（5 pg/ml）。然而，36例患者（49%）血清IL-4水平升高（范围为5 - 106 pg/ml，p<0.001），23例患者（31%）血清IL-10水平升高（范围为5 - 37 pg/ml，p<0.05）。血清IL-4和IL-10水平之间无相关性。血清IL-4和IL-10水平与任何临床（年龄、性别、感染途径）、生化（血清丙氨酸转氨酶水平）、病毒学（病毒血症水平、基因型）及组织学参数之间也无相关性。37例慢性丙型肝炎病毒感染患者的肝活检标本中有20例偶尔可见CD30 +淋巴细胞，提示为Th2表型。然而，在37例有配对冰冻肝脏切片的患者中，有20例在这些患者中均未检测到IL-4，这表明慢性丙型肝炎病毒感染患者肝脏中未产生IL-4。
本研究表明，部分慢性丙型肝炎病毒感染患者血清Th2细胞因子升高（但水平较低）。然而，升高的Th2细胞因子水平可能代表一种全身反应，而非肝脏内局部产生增加的结果。
