慢性乙型病毒性肝炎患者血清中IL-37的水平與HBeAg血清學(xué)轉(zhuǎn)換的關(guān)系研究
發(fā)布時(shí)間：2018-07-22 10:47
【摘要】：目的：IL-37是一種新型的抗炎癥因子，能限制感染過程中的炎癥反應(yīng)和免疫應(yīng)答從而避免組織過度損傷。本研究的目的是檢測(cè)慢性乙型肝炎患者和替比夫定治療后HBeAg血清學(xué)轉(zhuǎn)換患者IL-37的濃度變化，并且與肝功能進(jìn)行相關(guān)性分析，以探討IL-37在乙肝病毒感染后引起的免疫應(yīng)答中的作用。 方法：分別從40例HBeAg陽性的慢性乙型肝炎（CHB）患者，30例慢性丙型肝炎（CHC）患者，25例丙肝自愈患者（SR-HCV）和30例健康對(duì)照者（HC）的靜脈中抽取外周血。采用酶聯(lián)免疫吸附法（ELISA）定量檢測(cè)各組血清中IL-37的水平。采用微量樣本多指標(biāo)流式蛋白定量法（CBA）檢測(cè)各組血清中IL-2和IL-10的水平。采用熒光定量PCR方法檢測(cè)HBV DNA和HCV RNA；采用化學(xué)發(fā)光分析儀檢測(cè)HBsAg、HBeAg、HBsAb、HBeAb；采用全自動(dòng)生化分析儀檢測(cè)ALT和AST。 結(jié)果：CHB患者：1、HBeAg陽性的慢性乙肝患者血清中IL-37的濃度顯著高于健康對(duì)照組（P0.0001）；病毒定量較高的患者血清中IL-37的濃度較高（P0.05），但是IL-37的血清濃度與病毒定量之間沒有相關(guān)性；2、替比夫定治療24周和48周后，HBeAg轉(zhuǎn)陰的患者血清中IL-37的濃度較治療前明顯下降（P=0.0146，P0.0001）；但HBeAg轉(zhuǎn)陰患者的HBsAg與治療前相比沒有明顯變化；3、ALT、AST異常的患者血清中IL-37的濃度明顯高于ALT、AST正常的患者（P0.0001）；4、慢性乙型肝炎患者血清中IL-2和IL-10的濃度明顯低于健康對(duì)照組（P0.0001）；替比夫定治療48周后，IL-2的濃度較治療前顯著升高（P0.0001），但I(xiàn)L-10沒有明顯變化；5、患者血清IL-37的濃度與ALT呈正相關(guān)，患者血清IL-2的濃度與AST呈負(fù)相關(guān)。 CHC患者：1、慢性丙型肝炎和丙肝自愈患者血清中IL-37的濃度與健康對(duì)照組相比沒有明顯變化；2、ALT、AST異常的患者血清中IL-37的濃度明顯高于ALT、AST正常的患者（P=0.0379，P=0.0453）；3、慢性丙型肝炎患者血清中IL-2和IL-10的濃度明顯低于健康對(duì)照組（P0.0001）；丙肝自愈患者血清中IL-2和IL-10的濃度與慢性丙型肝炎患者相比沒有明顯變化。 結(jié)論：1、HBV的感染過程可能上調(diào)了IL-37的表達(dá)，替比夫定抑制病毒復(fù)制的同時(shí)影響了IL-37的表達(dá)；2、替比夫定治療后，，IL-37可能參與了HBeAg血清學(xué)轉(zhuǎn)換介導(dǎo)的免疫反應(yīng)。3、IL-37的水平可能反映了肝臟炎癥損傷的程度。4、未來IL-37可能成為HBV感染治療的一種有效手段。
[Abstract]:Objective\ The aim of this study was to detect the concentration of IL-37 in patients with chronic hepatitis B and in patients with HBeAg serological conversion after tibivudine treatment, and to analyze the correlation between IL-37 and liver function. To explore the role of IL-37 in the immune response after hepatitis B virus infection. Methods: peripheral blood was extracted from 40 patients with HBeAg positive chronic hepatitis B (CHB), 30 patients with chronic hepatitis C (CHC) and 25 patients with self-healing hepatitis C (SR-HCV) and 30 healthy controls (HC). The level of IL-37 in serum of each group was determined by Elisa. The levels of IL-2 and IL-10 in serum of each group were detected by flow protein quantitative assay (CBA). HBV DNA and HCV RNAs were detected by fluorescence quantitative PCR, HBeAg HBeAbs HBeAb HBeAbHBeAbs by chemiluminescence analyzer, alt and ASTby automatic biochemical analyzer. Results the serum levels of IL-37 in patients with 1: 1 + HBeAg were significantly higher than those in healthy controls (P0.0001), but the serum levels of IL-37 were higher in patients with higher viral quantification (P0.05), but there was no correlation between the serum concentrations of IL-37 and viral quantification. (2) after 24 weeks and 48 weeks of tibivudine treatment, the concentration of IL-37 in the serum of patients with HBeAg turned negative was significantly lower than that before treatment (P0. 0146, P0. 0001), but there was no significant change in HBsAg in patients with HBeAg turning to negative after treatment. 3The levels of IL-37 in serum of patients with abnormal alt were significantly higher than those of patients with normal alt (P0.0001) and the levels of IL-2 and IL-10 in patients with chronic hepatitis B were significantly lower than those in healthy controls (P0.0001). After 48 weeks of tibivudine treatment, the level of IL-2 was significantly higher than that before treatment (P0.0001), but IL-10 did not change significantly. The serum level of IL-37 was positively correlated with alt. The concentration of IL-2 in serum was negatively correlated with AST in CHC patients. The serum levels of IL-37 in patients with chronic hepatitis C and self-healing of hepatitis C were not significantly different from those in healthy controls. 2the level of IL-37 in serum of patients with abnormal alt was significantly higher than that of patients with normal alt (P0. 0379, P0. 0453). The serum levels of IL-2 and IL-10 in patients with chronic hepatitis C were significantly lower than those in healthy controls (P0. 0001). The levels of IL-2 and IL-10 in serum of patients with chronic hepatitis C did not change significantly compared with those of patients with chronic hepatitis C. Conclusion the expression of IL-37 may be upregulated in the process of infection with HBV. Tibivudine inhibits the replication of the virus and affects the expression of IL-37. After tibivudine treatment, IL-37 may be involved in the immune response mediated by serological transformation of HBeAg. The level of IL-37 may reflect the degree of liver inflammation injury. IL-37 may become an effective method for the treatment of HBV infection in the future.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R512.62
[Abstract]:Objective\ The aim of this study was to detect the concentration of IL-37 in patients with chronic hepatitis B and in patients with HBeAg serological conversion after tibivudine treatment, and to analyze the correlation between IL-37 and liver function. To explore the role of IL-37 in the immune response after hepatitis B virus infection. Methods: peripheral blood was extracted from 40 patients with HBeAg positive chronic hepatitis B (CHB), 30 patients with chronic hepatitis C (CHC) and 25 patients with self-healing hepatitis C (SR-HCV) and 30 healthy controls (HC). The level of IL-37 in serum of each group was determined by Elisa. The levels of IL-2 and IL-10 in serum of each group were detected by flow protein quantitative assay (CBA). HBV DNA and HCV RNAs were detected by fluorescence quantitative PCR, HBeAg HBeAbs HBeAb HBeAbHBeAbs by chemiluminescence analyzer, alt and ASTby automatic biochemical analyzer. Results the serum levels of IL-37 in patients with 1: 1 + HBeAg were significantly higher than those in healthy controls (P0.0001), but the serum levels of IL-37 were higher in patients with higher viral quantification (P0.05), but there was no correlation between the serum concentrations of IL-37 and viral quantification. (2) after 24 weeks and 48 weeks of tibivudine treatment, the concentration of IL-37 in the serum of patients with HBeAg turned negative was significantly lower than that before treatment (P0. 0146, P0. 0001), but there was no significant change in HBsAg in patients with HBeAg turning to negative after treatment. 3The levels of IL-37 in serum of patients with abnormal alt were significantly higher than those of patients with normal alt (P0.0001) and the levels of IL-2 and IL-10 in patients with chronic hepatitis B were significantly lower than those in healthy controls (P0.0001). After 48 weeks of tibivudine treatment, the level of IL-2 was significantly higher than that before treatment (P0.0001), but IL-10 did not change significantly. The serum level of IL-37 was positively correlated with alt. The concentration of IL-2 in serum was negatively correlated with AST in CHC patients. The serum levels of IL-37 in patients with chronic hepatitis C and self-healing of hepatitis C were not significantly different from those in healthy controls. 2the level of IL-37 in serum of patients with abnormal alt was significantly higher than that of patients with normal alt (P0. 0379, P0. 0453). The serum levels of IL-2 and IL-10 in patients with chronic hepatitis C were significantly lower than those in healthy controls (P0. 0001). The levels of IL-2 and IL-10 in serum of patients with chronic hepatitis C did not change significantly compared with those of patients with chronic hepatitis C. Conclusion the expression of IL-37 may be upregulated in the process of infection with HBV. Tibivudine inhibits the replication of the virus and affects the expression of IL-37. After tibivudine treatment, IL-37 may be involved in the immune response mediated by serological transformation of HBeAg. The level of IL-37 may reflect the degree of liver inflammation injury. IL-37 may become an effective method for the treatment of HBV infection in the future.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R512.62
【參考文獻(xiàn)】
相關(guān)期刊論文 前4條
1 ;Dysfunction of peripheral blood dendritic cells from patients with chronic hepatitis B virus infection[J];World Journal of Gastroenterology;2001年04期
2 ;Kinetics of phytohemaglutinin-induced IFN-γ and TNF-a expression in peripheral blood mononuclear cells from patients with chronic hepatitis B after liver transplantation[J];World Journal of Gastroenterology;2005年29期
3 Thomas F Baumert;Robert Thimme;Fritz von Weizs
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