关键词: 自身免疫性肝炎, 泼尼松, 微小RNA-148a, 白细胞介素-6, 白细胞介素-17, 肿瘤坏死因子-α, 治疗

Abstract: Objective The aim of this study was to investigate the clinical implication of serum microRNA (miR)-148a, and interleukin (IL)-6, IL-17 and tumor necrosis factor-α (TNF-α) levels in patients with autoimmune hepatitis (AIH). Methods 61 patients with AIH, including mild degree in 28 cases and moderate-to-severe degree in 33 cases, were enrolled in our hospital between March 2022 and February 2025, and all received immunosuppressive therapy for six months. Serum immunoglobulin G (IgG) level was measured by immunoturbidimetry, serum miR-148a load was detected by real-time fluorescence quantitative PCR, and serum IL-6, IL-17 and TNF-α levels were detected by magnetic particle luminescence method. Multivariate binary Logistic regression was applied to analyze the factors affecting poor or non-complete response (NCR) to immunosuppressive therapy in patients with AIH. Results By the end of 6 months of treatment, serum ALT, AST and IgG levels in patients with moderate-to-severe degree were all much higher than in those with mild degree (P<0.05); serum miR-148a, IL-6, IL-17 and TNF-α levels in patients with moderate-to-severe degree were (2.3±0.4), (21.2±4.3)pg/mL, (16.0±3.3)pg/mL and (19.3±4.2)pg/mL, all significantly higher than [(1.9±0.3), (15.3±3.2)pg/mL, (13.5±2.7)pg/mL and (15.2±3.7)pg/mL, respectively, P<0.05] in those with mild degree; at end of 6 month treatment, 20 patients (71.4%) in mild group and 19 patients (57.6%) in moderate-to-severe degree obtained complete response (CR); serum miR-148a, IL-6, IL-17 and TNF-α levels in NCR patients in moderate-to-severe degree group were still much higher than in NCR patients in mild group (P<0.05); multivariate Logistic regression analysis showed that serum miR-148a(OR=1.439, 95%CI:1.160-1.785), IL-6(OR=1.701,95%CI:1.323-2.186), IL-17(OR=1.516,95%CI:1.191-1.929) and TNF-α(OR=1.640,95%CI:1.330-2.023) were all the independent risk factors for NCR in patients with AIH(P<0.05). Conclusion Serum miR-148a, IL-6, IL-17 and TNF-α are closely related to the disease severity in patients with AIH, which might impact response to immunosuppressive therapy, and needs further investigation.

Key words: Autoimmune hepatitis, Prednisone, MicroRNA-148a, Interleukin-6, Interleukin-17, Tumor necrosis factor-α, Therapy