Detection And Clinical Significance Of Interleukin-33 And-35 In The Patients With Chronic Hepatitis B

objective: The study was designed to investigate the role of IL-33, IL-35 and related cytokines in the occurrence, development and disease outcome of chronic hepatitis B(CHB) and hepatitis B virus related liver cirrhosis(HBV-LC) by detecting IL-33,IL-35 and their associated cytokines in the peripheral blood of CHB patients.Methods: 1. The correlation between peripheral blood cytokines and clinical indicators study: select healthy control(HC) 18 cases, 39 cases of HBV infection group, and the latter can be divided into patients with CHB 19 cases and HBV- LC 20 cases. Compare IL-33 and IL-35 between HC, CHB and HBV-LC group. The cytokines concentration in peripheral plasma were measured by enzyme-linked immunosorbent assay(ELISA). Compare the index of the difference between three groups, and analysis the above indicators correlated with clinical status, such as gender, age, HBe Ag status, HBV DNA, biochemical indicators(ALT, AST, TBil) and the severity of liver cirrhosis. 2. Compare between IL-33, IL-35, other associated cytokines and biochemical indicators before and after the treatment: Analysis the differences of IL-33, IL-35 and their related cytokines and clinical indexes of ALT, AST, HBV DNA load in the peripheral blood of patients with CHB before and after antiviral therapy.Result:1. Compare with HC group, the concentration of IL-33 and IL-35 were significantly increased in HBV infected groups(P<0.05). Further analysis of the HBe Ag-positive CHB patients, we found the concentration of IL-33 and IL-35 is higher than in HBe Ag negative group(P<0.05). The lever of IL-33 and IL-35 were significantly increased in the peripheral boold of in the HC group, CHB group and HBV-LC group(P<0.05). Compare with CHBgroup, there were significantly increased in HBV-LC groups. The levels of TGF-β1, IL-31, IL-10 and IL-22 were significantly higher in the HBV-LC group than in the CHB group and HC group(P<0.05), and there were significantly difference in the CHB group and HC group(P<0.05). 2. IL- 33 and IL- 35 between were positively correlated. At the same time, IL-33 and TGF- beta 1, IL- 10, IL- 23 were positively correlated, and IL- 35 and IL-10, IL- 22 were positive correlation(P < 0.05), and both were not associated with clinical indexes of ALT, AST and HBV DNA load(P > 0.05). In the Group according to the severity of cirrhosis, IL- 33 and IL-35 both increase as the Child- Pugh score graded. In the MELD score correlation analysis, we found that IL- 33 and MELD were positively correlated(P < 0.05), while IL- 33 was not correlated to the MELD(P > 0.05). 3. After effective antiviral treatment, IL- 33, IL- 35, TGF- beta 1, IL- 31, IL-10, IL- 22 were significantly decreased in the patients with CHB(P < 0.05).Conclusion: IL-33 and IL-35 in the peripheral blood of patients with CHB were increased in CHB patients and more obviously in HBV related liver cirrhosis, and were positively correlated with the severity of the liver cirrhosis. After the effective antiviral treatment, the decrease of IL-33, IL-35 showed that they plays an important role in development and outcome in CHB. IL-33 and IL-35 may be an effective evaluation of its curative effect of one of the immune indexes in HBe Ag positive patients with CHB.