The effect of interferon therapy on serum soluble interleukin-2 receptor levels in patients with chronic active hepatitis-B and C

Kronik aktif hepatit B ve C'li hastalarda interferon tedavisinin serum solubl interlökin-2 reseptör düzeylerine etkisi

Ahmet BEKTAŞ,Selim KARAYALÇIN,Olcay AYDINTUĞ,Hülya ÇETİNKAYA,Hakan AKBULUT,Hüseyin TUTKAK,Özden UZUNALİMOĞLU

Abstract

In this study, serum transaminases and sol¬uble interleukin-2 receptor (sIL-2R) levels were deter¬mined in 10 CAH-B and 10 CAH-C patients, who were treated with IFN-a2a, and 10 control cases. Serum transaminases and soluble interleukin-2 reseptör levels were studied in certain time intervals (before treatment, 1st, 3rd and 6th month of treatment. In CAH-B group, at the and of 3 months, 2 patients had complete response (HBV DNA (-), AntiHBe (+), ALT normalisation), 3 pa¬tients had partial response (ALT decreased more than 50%) and 4 patients had no respnose. At the and of 6 months, 6 patients with CAH-C had complete response, whereas 4 patients had no response. In CAH-B and C patients who responded to therapy, ALT and AST pre-treatment levels were higher than the unresponsive pa¬tients but this had no statistical significance (p>0.05). Pretreatment serum sIL-2R levels were higher than the control group in both CAH-B and CAH-C patinets (p<0.01). With IFN treatment, sIL-2R level decreased but this was not statistically significant. Posttreatment SIL-2R values were also higher than the control group (p<0.01). In CAH-B and C patients responding to thera¬py, pretreatment serum sIL-2R levels were higher than the unresponsive group but statistical difference was not significant (p>0.05). There was significant positive cor¬relation between ALT and sIL-2R in both CAH-B and CAH-C patients (r= 0.42, p<0.05). The correlation be¬tween AST and sIL-2R was significant in CAH-B group (r=0.S7, p<0.05) but insignificant in CAH-C group (r-0.29, p>0.05). As a result, sIL-2R levels, being an indi¬cation of immune system activation, were high in both groups of patients. This suggests that similar immuno-logic mechanisms may act in the pathogenesis of chron¬ic hepatitis B and C.

Özet

Sağlık problemi olmayan on kişi ve IFN-alfa 2a tedavisi uygulanan 10 kronik aktif hepatit-B KAH-B ve kronik aktif hepatit-C 10 KAH-C vakasında belirli ara¬lıklarla (tedavi öncesi, 1., 3. ve 6. aylar) serum transa-minazlan ve solubl interlökin-2 reseptör (sIL-2R) düzey¬lerine bakılmıştır. Takip edilen vakalarda KAH-B grubunda üç ay sonunda 2 hastada tam cevap (HBV-DNA (-), anti-HBe (+), ALT'ın normal düzeye inmesi) 3 hastada parsiyel cevap (ALT'nin %50'den fazla azalma¬sı) elde edilirken 4 hastada cevap görülmemiştir. Altı ay tedavi sonucunda KAH-C'li 6 hastada tam cevap sağla¬nırken 4 hastada cevap elde edilememiştir. Tedaviye cevap veren KAH-B ve C'li hastalarda tedavi öncesi ALTve AST düzeyleri vermeyenlerden daha yüksek bu¬lundu, ancak istatistiki anlamı yoktu (P>0.05). Tedavi öncesi serum sIL-2R düzeyi hem KAH-B, hem de KAH-C'li hastalarda kontrol grubundan yüksek bulunmuş¬tur (p 0.01). Tedaviye cevap veren KAH-B ve C'li hastalarda tedavi öncesi serum sIL-2R düzeyi vermeyenlerden daha yüksektir, fakat istatistik¬sel farkı yoktur (p>0.05). ALT ve sIL-2R arasında hem KAH-B hem de KAH-C'li hastalarda anlamlı, pozitif bir korrelasyon saptanmıştır( r=0.42, p 0.05) bulunmuştur. Sonuç olarak immun sistem aktivasyonunun bir göstergesi olan sIL-2R düzeyinin her iki hasta grubunda da yüksek bulunması, kronik hepatit B ve C patogenezinde benzer immünolojik olay¬ların rol oynayabileceğini düşündürmektedir.