Comparative study of adefovir dipivoxil and lamivudine on serum IFN-γ and IL-4 in patients with chronic hepatitis B
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摘要: 观察阿德福韦酯和拉米夫定治疗前后慢性乙型肝炎(CHB)患者外周血清干扰素-γ(IFN-γ)和白细胞介素-4(IL-4)的变化,对照观察其抗乙肝病毒的免疫效应。214例CHB均为参加阿德福韦酯Ⅲ期临床试验的患者,用实时荧光聚合酶链反应(PCR)检测治疗前、治疗后4、12、24及48周末患者血清HBV DNA,其中40例患者利用双抗体夹心ELISA法检测相应时间点的血清中IFN-γ和IL-4的水平。结果显示:慢性乙肝患者ALT和AST治疗后两组间改善值基本相同;HBV DNA改善值拉米夫定(LAM)组从4周末起明显高于阿德福韦酯(ADV)组(P<0.05),在48周末两组改善值基本相同;LAM组IFN-γ水平在12周末达到高峰,而ADV组在48周末IFN-γ水平才明显上升,LAM组IFN-γ在4周末明显高于ADV组(P<0.05);ADV组IL-4在48周末与LAM组比增高有明显差异(P<0.05)。两种核苷类似药物抗病毒后均能使机体免疫部分恢复或增强,这种作用可能都是随着治疗后病毒载量下降和CD4+T淋巴细胞活性的重建而出现的。
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关键词:
- 阿德福韦酯 /
- 拉米夫定 /
- 病毒性肝炎、乙型、慢性 /
- 干扰素-γ /
- 白细胞介素-4
Abstract: To comparative the antiviral immunomodulatory effect of adefovir dipivoxil and lamivudine in patients with chronic Hepatitis B (CHB) .Two hundred and fourteen CHB patients who underwent a Phase Ⅲ clinical trial of adefovir were investigated.At different time (before therapy, and 4, 12, 24 and 48 weeks after therapy) , the serum HBV DNA values was quantified by real time fluorescent PCR.The serum level of IFN-γ and IL-4 of forty patients selected randomly was determined by specific-ELISA.No significant difference was observed in the serum level of ALT and AST between patients treated with adefovir dipivoxil and those with lamivudine.The serum HBV DNA level with lamivudine therapy decreased more quickly than that with adefovir therapy after 4 weeks (P<0.05) , but the gap vanished at the end point.Meanwhile, the level of serum IFN-γ with lamivudine therapy reached a sighificant peak at 12 weeks, but the level of serum IFN-γ with adefovir therapy improved slowly till the end point (48 weeks after therapy) , which was significantly higher than that before therapy (P<0.05) .The serum IFN-γ values of lamivudine group were higher than that of adefovir group at 4 weeks (P<0.05) , while serum IL-4 values of adefovir group were higher than that of lamivudine group at 48 weeks (P<0.05.The immunity of patients with CHB can be enhanced by the antiviral effect of adefovir or lamivudine, which may arise from the descent of viral load and the restoration of CD4+T cells activity.-
Key words:
- adefovir dipivoxil /
- lamivudine /
- chronic hepatitis B /
- IFN-γ /
- IL-4
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