Clinic Significance Of Detecting IL-12and IL-21in Plasma Of Patients With Chronic Hepatic Disease Related To HBV Infection

Objective:To investigatet the plasma level of IL-12and IL-21of patients with chronic hepatitique diseases related to HBV infection, to analyse the association between IL-12and IL-21and HBV-DNA, HBV serologic markers, ALTand TB in patients with chronic hepatitique diseases related to HBV infection, to explore effect of IL-12and Il-21to response of antiviral treatment and prognosis, as the basic research for the IL-12and IL-21predicting HBeAg seroconversion in the nucleoside (acid) analogues'antiviral efficacy.Methods:HBV infection-related liver disease patients and healthy people as research subjects, according to the standards of the sixth edition textbook of infection disease including90cases of chronic hepatitis B,19cases hepatitis B cirrhosis,15cases of chronic HBV carriers and20persons as the healthy control group. IL-12and IL-21in plasma were detected with the ELISA technique.This transversal and retrospective research recruited66cases treated with nucleoside (acid) analogs antiviral therapy for not less than one year. Including25cases whose HBeAg remained positive and that of4leases has emergenced HBeAg seroconversion. Using quantitive ELISA with double antibody sandwich assay for the detection of interleukin-12and interleukin-21in peripheral plasma of patients.Negative HBV-DNA<1000copies/ml.Results:1. IL-12between the healthy controls, chronic hepatitis B, cirrhosis caused by hepatitis B and chronic HBV carriers group were not differente significantly, (P>0.05).Level of IL-21in plasma of healthy controls was significantly lower than other study groups, the difference was statistically significant (P<0.05).2. IL-21was positively correlated to that of IL-12(rs=0.214, p<0.05). Level of IL-21in HBeAg positive group was significantly lower than the healthy control group and HBeAg negative group (P<0.05). Levels of11-12in the different outcome of infection was not significantly differente (P>0.05). IL-12and IL-21between the HBV-DNA negative group and positive group was not significantly differente (P>0.05).3. IL-21of high HBV-DNA load group (≥1×106copy/mL) was lower than that of HBV-DNA negative group and the HBV-DNA low load group (1×103～1×104) copies/ml, the difference is significante(P<0.05). There is no significant difference between HBV-DNA negative group and the low load group(P>0.05). The level of IL-12between different HBV-DNA load groups was not significantly different (P>0.05). Spearman rank correlation analysis indicates that levels of IL-12and IL-21were not related to the replication of HBV-DNA(rs=0.108, P>0,05).4. IL-21in plasma in120<ALT<400group was significantly higher than other groups (P<0.05). The levels of IL-21was not related to ALT levels(rs=-0.026, p>0.05). IL-21in plasma increased with TB, but not statistically significant between all the groups(rs=0.118, p>0.05). IL-12in plasma increased with ALT levels, there was no significant difference between the different groups(P>0.05).Level of IL-12and ALT levels were positively related (rs=0.188, P<0.05). There was no differrence between the IL-12and serum TB levels(rs=0.13. P>0.05).5.IL-12and IL-21level are not significantly different in group received treatment,group not received treatment ang healthy control group(P>0.05).6.66cases of chronic hepatitis B who received the nucleos (t) analogues antiviral therapy for at least one year and HBeAg of them has converted to be negative, IL-21expression level in HBeAg negative group was significantly higher than that of HBeAg sustained positive group and the healthy control group (P<0.05). And the level in plasma of IL-12in HBeAg sustained group and HBeAg disapeared group has no obvious statistical difference (P>0.05). Conclusion:1. IL-21level of HBeAg positive group was lower within all the cases. HBeAg positive group after nucleos (t) analogues antiviral therapy expressed more IL-21than the group which occurred HbeAg HBV seroconversion, suggesting that IL-21may be used as predictor for the HBeAg seroconversion of antiviral therapy in chronic HBV patients.2. IL-21level in HBV-DNA high-load group of HBV infection-related patients was lower than other groups, suggesting that IL-21may be inhibited by the HBV during the immune tolerence, IL-21may contribute to be immune therapy for the chronic hepatitis B patients.3. IL-12level in all patients was not differente statistically, and the level was not related to HBeAg seroconversion. So whether IL-12levels as a routine test before the antiviral treatment of CHB patients needs to be further explored.