实用肝脏病杂志2024，Vol.27Issue(3)：374-377,4.DOI:10.3969/j.issn.1672-5069.2024.03.014
泼尼松与泼尼松联合硫唑嘌呤治疗自身免疫性肝炎患者外周血MDSCs百分比、肝组织白细胞介素-35和血清CD38水平变化及其临床意义探讨
Changes of peripheral blood MDSCs,serum CD38 level and hepatic interleukin-35 expression in patients with autoimmune hepatitis receiving prednisone and azathioprine combination therapy
摘要
Abstract
Objective This clinical trial was conducted to observe the changes of peripheral blood myeloid inhibitory cells(MDSCs),serum leukocyte differentiation antigen 38(CD38)level and hepatic interleukin-35(IL-35)expression in patients with autoimmune hepatitis(AIH)undergoing prednisone and azathioprine combination therapy.Methods 56 patients with AIH were recruited in our hospital between March 2017 and March 2020,and were randomly divided into control(n=28)and observation(n=28)group,receiving prednisone acetate or prednisone acetate plus azathioprine combination therapy.The regimen lasted for 6 to 36 months.Serum immunoglobulin,CD38,complement 3(C3)and C4 levels were routinely detected.The percentage of peripheral blood MDSCs was measured by TCM,and hepatic IL-35 expression was determined by Western bloting from liver biopsy tissues.Results At the end of six month treatment,serum ALT and AST levels in the observation group were(54.6±7.1)U/L and(50.7±6.4)U/L,both significantly lower than[(90.7±11.9)U/L and(79.7±12.9)U/L,respectively,P＜0.05]in the control;serum IgG,IgM,C3 and C4 levels in the observation were(11.8±1.8)g/L,(2.4±0.8)g/L,(0.5± 0.2)g/L and(0.2±0.1)g/L,all significantly lower than[(19.8±3.0)g/L,(3.2±0.9)g/L,(0.7±0.3)g/L and(0.3±0.1)g/L,respectively,P＜0.05]in the control;the percentage of peripheral blood MDSCs and serum CD38 level were(0.6±0.2)％and(8.6±2.5)pg/mL,both much lower than[(0.9±0.3)％and(11.5±3.8)pg/mL,P＜0.05]in the control group,and the hepatic IL-35 expression became weaker as compared to that in the control,e.g.,[(0.4±0.2)vs.(0.6±0.1),P＜0.05].Conclusion The combination of prednisone and azathioprine therapy in the treatment of patients with AIH could improve liver function test normal,reduce serum cytokine and complement levels,and decrease the hepatic IL-35 expression,which needs further investigation.关键词
自身免疫性肝炎/泼尼松/硫唑嘌呤/髓样抑制细胞/白细胞分化抗原38/治疗Key words
Autoimmune hepatitis/Prednisone/Azathioprine/Myeloid suppressor cells/Leukocyte differentiation antigen-38/Interliukin-35/Therapy引用本文复制引用
徐秋萍,黄彬,陈敏,余静..泼尼松与泼尼松联合硫唑嘌呤治疗自身免疫性肝炎患者外周血MDSCs百分比、肝组织白细胞介素-35和血清CD38水平变化及其临床意义探讨[J].实用肝脏病杂志,2024,27(3):374-377,4.基金项目
四川省科技厅科研计划项目(编号:2022ZHY20015) （编号:2022ZHY20015）
