标题: High Serum IL-21 Levels after 12 Weeks of Antiviral Therapy Predict HBeAg Seroco [打印本页] 作者: StephenW 时间: 2011-12-29 07:54 标题: High Serum IL-21 Levels after 12 Weeks of Antiviral Therapy Predict HBeAg Seroco
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J Hepatol. 2011 Dec 12. [Epub ahead of print]
High Serum IL-21 Levels after 12 Weeks of Antiviral Therapy Predict HBeAg
Seroconversion in Chronic Hepatitis B. Source:
http://www.ncbi.nlm.nih.gov/pubmed/22173154 Ma SW, Huang X, Li YY, Tang LB,
Sun XF, Jiang XT, Zhang YX, Jian S, Liu ZH, Abbott WG, Dong YH, Naoumov NV,
Hou JL. SourceHepatology Unit and Key Lab for Organ Failure Research,
Nanfang Hospital, Southern Medical University, No.1838, North Guangzhou
Avenue, Guangzhou, 510515, China; Department of Infectious Diseases,
Kunming General Hospital of PLA, Kunming, 650032, China.
Abstract
BACKGROUND & AIMS: Interleukin-21 (IL-21) stimulates T cell and B cell
responses and plays a role in control of chronic viral infections. The role
of IL-21 in chronic hepatitis B virus (HBV) infection is not understood.
METHODS: Serum IL-21 levels were measured by enzyme immunoassay in 75
HBeAg-positive chronic hepatitis B (CHB) patients undergoing Telbivudine
treatment. The findings were validated in 103 patients from a separate
clinical trial of Telbivudine. A complete response to Telbivudine was
defined as having both HBeAg seroconversion and serum HBV-DNA level < 300
copies/ml by treatment week 52. The proportions of T-cells producing IL-21
and/or expressing programmed death 1 (PD-1) in peripheral blood mononuclear
cells were assessed longitudinally during treatment by intracellular
cytokine staining and flow cytometry.
RESULTS: Median serum IL-21 levels at treatment week 12 were significantly
higher in patients who did achieve versus patients who did not achieve a
complete response in both the initial (128.4 vs. 69.2 pg/ml, p=0.003) and
the validation (142.2 vs. 89.9 pg/ml, p=0.004) trials. Serum levels of
IL-21 (p=0.005) or HBV-DNA (p=0.003) levels at treatment week 12
independently predicted HBeAg seroconversion in the first year of
treatment. The decrease in PD-1 expression on CD4(+) and CD8(+) T cells
during the first 12 weeks on Telbivudine treatment were not correlated with
changes in IL-21 concentrations.
CONCLUSIONS: Serum IL-21 levels may be a biomarker for HBeAg
seroconversion, and may contribute to individualisation of antiviral
therapy in HBeAg-positive CHB. IL-21 may also have a role in immunotherapy
for CHB.