The Clinical Significance Of Detection Of IL-12 And IL-18 Levels In Patients With Chronic Virus Hepatic Disease Infected By HP

Now people have allround comprehended to the epidemiology of theinfection of HP. But the reports of the dependablity between HP infection and cytokine levels in Serum of Chronic virus hepatic diseases are so differents. H. pylori infection is currently considered a chronic infection, the immune response is one of the main causes of pathogenic mechanism. And the resulting speculation the H pylori may stimulate some inflammatory mediators and / or cytokine production and then involve in the inflammatory and immune regulatory network which is formed by the infection of hepatitis virus, so as to be an independent or a complementary factor leading to liver disease. In this research, through the detection of IL-12. IL-18 levels to explore the relationship between the H. pylori infection and chronic liver disease.We detected the levels of IL-12 and IL-18 by double-sandwich ELISA in the sera of 100 patients with chronic hepatitis B and hepatocirrhosis. And the control group is comprised of 20 health people. Laboratory data were expressed as mean±standard deviation and scope. T test was used between the means,Х2 test was used between the rates, and T test was also used to test the coefficient of product. Detected the levels of IL-12,IL-18 in Serum of Anti-HP-CagA(+) patients with chronic liver disease and Anti-HP-CagA(-)patients. Correlation analysis was performed between bilirubin and IL-12 and IL-18.The IL-12 is main to be produced by B cell and mononuclear macrophage is with the cell; 2 second that its numerator is a kind of type two,40KD(P40) with 35 kDs(P35) pass two sulphur keys connect with each other to connect. The main function of IL-12 once were named aftered the mature factor(CLMF) of lymphoid cell of poison of cell to stimulate the factor with NK cell with the NK cell in the T cell.(NKSF)The IL-12 can stimulate to activate the type T the cell to propagate, promote the TH0 cell the cell direction the TH1 cell to divide;lnduce the CTL with the NK cell cell poison activity and promote its secrete the IFN-γ,TNF-α,GMCSF…etc; the cell factor; Promote the NK cell with the IL-2 R theα,TNF suffer the and expression of numerator CD56. and also the IL-12 can stimulate to activate the ICAM-1 and FasL to propagate. As an later found cytokines,in recent years the role of IL-18 cytokines is more attention in inflammatory liver injury. It can induce immune cells express IFN-γactivation of NK cells; Stimulate T cell proliferation,enhance the function of cytotoxic lymphocytes; promote the TH1 cells to produce cytokines IFN-γ, IL-2,GM-CSF and so on; enhanced the expression of cell adhesion molecule-1 (ICAM-1) and FasL. Therefore, these two cytokines play an important role in the regulation of cell differentiation of Th, and participate the chronic process of hepatitis B by regulating the Th1/Th2 balance .Sensitized by HBV,the body's immune system produces the humoral and cellular immune response. They not only clear the virus ,but also attacks the liver cells with HBV antigen on the surface and necrosisinduced damage. HBV replication in the body, result in the activation of macrophages and Kupffer cells secreting IL-18. lead to increased serum levels of IL-18. IL-18 promates immune cells secrete INF-r, induces Th1 cells produce Corresponding cytokines,promates the Th1/Th2 direction to Th1 cell. Now research shows that the maladjustment between Th1 and Th2 cells maybe the pathogenesis of chronic hepatic disease. All kinds of cytokines, such as IL-10, IL-12 and IL-18, participate in the course of chronic hepatic disease come into being by regulating the activity of Th1 and Th2. If Th1 cells are in dominance, it'll promote the course of cell immune and eliminate the virus. But it'll aggravate the damage of the hepatic cells to acute or limited infection. If Th2 cells are in dominance, the cell immune will be restrained, and it tends to have durative infection.When the H. pylori adhere to epithelial cells, the whole bacteria,flagella,proteins,lipopolysaccharide,Urea enzyme,vacuolating,immune-related protein and other ingredients may be as the immunogen, resulting in the immune response.The body's immune system was activated, result in the increasing lever of interleukin-8(IL-8),interleukin-12(IL-12),Monocyte Chemoattract -ant Protein-1 (MCP-1),granulocyte-stimulating factor (GM-CSF),Tumor necrosis factor-α(TNF-α) and other proinflammatory cytokines which produced by epithelial cells .the Activating immune and (or) inflammatory cells in turn secrete interleukin-6 (IL-6),Interferon-r (IFN-γ),interleukin-1 (IL-1),interleukin-8(IL-8)…etc,and make the expression of epithelial cells and mononuclear cells increasing in secreting the Class II major histocompatibility antigen (MHC class II antigen) and CD5 (Fine intercellular adhesion molecule-1). So as to transmit the effective component form Helicobacter pylori antigens to T cells and B cells and found the cell-mediated and humoral immunity against H. pylori-specific. When the chronic liver disease patients infected by H pylori, especially the hepatic cirrhosis patients infected by H pylori,the defence capability degrade,Gastric mucosa defense mechanisms subside, gastric mucosa congestion and swollen, ischemia, hypoxia, microcirculation disturbance. It's easy lead to Helicobacter pylori infection and gastric mucosa anabrosis and bleeding,so as to be not conducive to Helicobacter pylori eradication; Helicobacter pylori can produce urease, which can catabohlize urea ammonia to carbon dioxide and ammonia,make the lever of blood ammonia higher.Ammonia not only add to the protective role of Helicobacter pylori, but also is the direct or indirect damage caused gastric mucosal barrier.Then indirectly by stimulating cytokine expression, plus the presence of Helicobacter pylori is likely toxicity in the liver cells. and to increase the participation of chronic hepatitis, cirrhosis of the liver damage in the development process. H. pylori can promote of inflammatory cells to release cytokines such as IL-12, IL-18 through inducing inflammatory mediators,then interfere with the immune response network in chronic liver disease thus affecting the development of chronic liver disease and prognosis.The results are as following. The levels of IL-12 and IL-18 in sera of chronic liver disease are obviously higher than those of control group (P<0.05).,and the levels of IL-12 and IL-18 in sera of CH-Ⅱand CH-Ⅲare obviously higher than those of CH-Ⅰ(P<0.05).it indicates that IL-12,IL- 18 involved in the incidence of liver cirrhosis and chronic hepatitis B chronic developmental active process. They regulate the balance of Th1/Th2 through a variety of biological activity .so they are not only involved in the inflammatory liver injury but also closely related to the extent of damage of liver inflammation. The results also show that the detection of IL-12,IL-18 levels in Serum of Anti-HP-CagA(+) patients with chronic liver disease are obviously higher than those of Anti-HP-CagA(-)patients(P<0.05).It shows that H pylori infection in patients with chronic liver disease can indirectly participate the process of the development of chronic hepatitis and cirrhosis by stimulating cytokine expression. With the levels of TBIL being higher, the levels of IL-12 and IL-18 go up . There is a positive correlation between the levels of IL-12, IL-18 and TBIL. And the serum bilirubin level will be able to objectively reflect liver function, or the degree about liver cell necrosis.so to the patients of pachronic liver disease, with the levels of TBIL in the serum being higher, the levels of IL-12 and IL-18 go up too.all above elucidate that there is a positive correlation between the levels of IL-12, IL-18 and the degree of injury of liver parenchyma.It further indicates that IL-12,IL- 18 involved in the incidence of liver cirrhosis and chronichepatitis B chronic developmental active process.The results of this study confirmed the cytokines IL-12 and IL-18 in chronic liver cell damage; Therefore, the Clinical detection of H. pylori and IL-12, IL-18 activity levels have some practical value In monitoring the progress of the disease and treatment, prognosis and so on.