慢性丙型肝炎患者血清IL-17A、FGF和IL-7水平与丙型肝炎病毒感染自发清除临床意义探讨*

doi:10.3969/j.issn.1672-5069.2019.06.016

摘要/Abstract

摘要： 目的探讨丙型肝炎病毒（HCV）感染自发清除的可能机制或与血清白细胞介素-17A（IL-17A）、成纤维细胞生长因子（FGF）和白细胞介素-7（IL-7）水平的关系。方法 2017年1月~2018年1月我院接收治疗的HCV感染者70例,其中慢性丙型肝炎患者52例,HCV感染自发清除者18例,另选择30名健康人作为对照组。采用全自动电化学发光免疫分析仪检测血清抗-HCV抗体,采用ELISA法检测血清IL-17A、FGF和IL-7水平;采用RT-PCR法检测血清HCV RNA。结果在本组慢性丙型肝炎患者中,感染HCV基因亚型以1b和2a型为主,分别占67.3%（35/52）和25%（13/52）;慢性丙型肝炎患者血清丙氨酸氨基转移酶和天冬氨酸氨基转移酶水平分别为（61.1±50.5） U/L和（57.0±42.8） U/L,显著高于HCV感染自发清除者[分别为（25.0±14.2） U/L和（25.5±9.4） U/L,P<0.01];慢性丙型肝炎患者血清IL-17A、FGF和IL-7水平分别为（0.25±0.13） ng/L、（0.51±0.13）ng/L和（0.49±0.12） ng/L,均显著低于HCV感染自发清除者[分别为（0.75±0.14） ng/L、（0.93±0.11） ng/L和（0.71±0.10） ng/L,P<0.01],也显著低于健康人[分别为（1.35±0.12） ng/L、（1.49±0.12） ng/L和（0.99±0.12） ng/L,P<0.01],HCV感染自发清除者血清细胞因子水平也显著低于健康人（P<0.01）。结论在HCV感染自发清除者中,血清 IL-17A、bFGF和IL-7水平显著高于慢性丙型肝炎患者,可能系清除病毒的原因之一,可能由于触发了主动免疫系统,导致病毒被清除,肝功能恢复正常,其真正的机制还需要进一步探讨。

关键词: 慢性丙型肝炎, 丙型肝炎病毒感染自发清除, 白细胞介素-17A, 成纤维细胞生长因子, 白细胞介素-7, 发病机制

Abstract: Objective The purpose of this study is to investigate the changes of serum interleukin-17A （IL-17A）,fibroblast growth factor （FGF） and IL-7 levels in patients with hepatitis C virus （HCV） infection and to explore the possible mechanism of clearance of viral infection. Methods 70 patients including 52 with chronic hepatitis C and 18 with spontaneous viral clearance of HCV infection were recruited in our hospital between January 2017 and January 2018. 30 healthy persons were selected at the same time in our hospital for control. Serum aspartate aminotransaminase （AST） and alanine aminotransaminase （ALT） levels were detected by automatic biochemical analyzer. Serum anti-HCV antibodies were detected by automatic electrochemiluminescence immunoanalyzer. Serum IL-17A,FGF and IL-7 levels were detected by ELISA,and serum hepatitis C virus RNA loads were detected quantitative detection kits purchased from the United States. Results In our series of patients with chronic hepatitis C,the infected HCV genotypes were mainly type 1b and type 2a,accounting for 67.3% （35/52） and 25.0% （13/52）,respectively;serum ALT and AST levels in patients with chronic hepatitis C were（61.1±50.5） U/L and（57.0±42.8） U/L,respectively,which were significantly higher than those in individuals with spontaneous HCV clearance [（25.0±14.2） U/L and（25.5±9.4） U/L,respectively,P<0.01];serum levels of IL-17A,FGF and IL-7 in patients with chronic hepatitis C were （0.25±0.13） ng/L,（0.51±0.13） ng/L and （0.49±0.12） ng/L, statistically significantly lower than 【（0.75±0.14） ng/L,（0.93±0.11） ng/L and （0.71±0.10） ng/L,respectively,P<0.01】 in individuals with spontaneous HCV clearance,or 【（1.35±0.12） ng/L,（1.49±0.12） ng/L and（0.99±0.12） ng/L,P<0.01】 in healthy persons and there were a significant differences as respect to the three cytokines between patients with spontaneous HCV clearance and healthy persons （P<0.01）. Conclusion In the individuals with spontaneous HCV clearance,serum IL-17A,FGF,and IL-7 levels significantly increased as compared to those in patients with chronic hepatitis C,hinting those cytokines might be involved in the immune response of human body to terminate the hepatitis C viral infection and the mechanisms needs further investigation.

Key words: Hepatitis C, Interleukin-17A, Fibroblast growth factor, Interleukin-7, Spontaneous HCV clearance, Mechanism

潘美民, 李文娟, 蒋芳清, 杨丽晖, 谭永卫, 何娟, 阮建文, 蔡春琳. 慢性丙型肝炎患者血清IL-17A、FGF和IL-7水平与丙型肝炎病毒感染自发清除临床意义探讨^*[J]. 实用肝脏病杂志, 2019, 22(6): 840-843.

Pan Meimin, Li Wenjuan, Jiang Fangqing, et al.. Changes of serum IL-17A,fibroblast growth factor and IL-7 levels in patients with hepatitis C virus infection[J]. Journal of Practical Hepatology, 2019, 22(6): 840-843.

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慢性丙型肝炎患者血清IL-17A、FGF和IL-7水平与丙型肝炎病毒感染自发清除临床意义探讨^*

Changes of serum IL-17A,fibroblast growth factor and IL-7 levels in patients with hepatitis C virus infection

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