High Serum IL-21 Levels after 12 Weeks of Antiviral Therapy Predict HBeAg Seroco

StephenW

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.





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StephenW

J肝胆病。 2011年12月12日。 [检索提前打印]
高血清IL - 21抗病毒治疗12周后水平预测HBeAg的
在慢性乙型肝炎源血清转换：
http://www.ncbi.nlm.nih.gov/pubmed/22173154马SW，黄X，李宜垠，唐LB，
孙XF，江XT，张榆霞，建小号，刘深航，雅培工作组，董跃红，Naoumov内华达州，
侯巨浪。 SourceHepatology单位和器官功能衰竭的研究重点实验室，
南方医院，南方医科大学，No.1838，广州北
大道，广州，510515，中国;传染病部，
解放军，昆明，650032，中国昆明总医院。

摘要
背景与目的：白细胞介素21（IL - 21）刺激T细胞和B细胞
反应，起着控制慢性病毒感染的作用。中的作用
IL - 21在慢性乙型肝炎病毒（HBV）感染是不理解。

酶免疫测定方法：血清IL - 21水平75
HBeAg阳性慢性乙型肝炎（CHB）患者接受替比夫定
治疗。从一个单独的调查结果，在103例患者验证
替比夫定的临床试验。一个完整的响应，以替比夫定
定义为HBeAg血清转换和血清HBV - DNA水平<300
拷贝/ ml，治疗52周。生产IL​​ - 21的T细胞的比例
和/或外周血单个核表达程序性死亡1（PD - 1）
治疗期间细胞内的细胞进行了评估纵向
细胞因子染色和流式细胞仪。

结果：在治疗12周的中位数血清IL - 21水平明显
较高的患者没有达到与病人谁没有实现
在初始（128.4比69.2皮克/毫升，P = 0.003）和完整的响应
验证试验（142.2与89.9皮克/毫升，P = 0.004）。血清水平
IL - 21水平在治疗12周（P = 0.005）或HBV - DNA（P = 0.003）
独立预测HBeAg血清转换的第一年
治疗。 PD - 1表达CD4 +和CD8 + T细胞减少
在第12周替比夫定治疗不与
在IL - 21浓度的变化。

结论：血清IL - 21水平可能是HBeAg的生物标志物
血清转换，并有可能导致抗病毒药个性化
在HBeAg阳性慢性乙型肝炎的治疗。 IL - 21也可能有免疫作用
对慢性乙型肝炎。