1.Effect of moxibustion at "Mingmen" (GV 4) and "Guanyuan" (CV 4) on immune function in healthy rats based on intestinal flora.
Jun-Hua ZHANG ; Si SHAN ; Mu-Chen WANG ; Ze-Han ZOU ; Hong-Ning LIU
Chinese Acupuncture & Moxibustion 2023;43(10):1157-1164
		                        		
		                        			OBJECTIVE:
		                        			To observe the effects of moxibustion at "Mingmen" (GV 4) and "Guanyuan" (CV 4) on immune function and intestinal flora in healthy rats, thereby investigating the underlying mechanism of moxibustion on immune function.
		                        		
		                        			METHODS:
		                        			Twenty 8-week-old SD rats were randomly divided into a young blank group and a young moxibustion group, with 10 rats in each group. Similarly, twenty 8-month-old SD rats were randomly divided into a middle-aged blank group and a middle-aged moxibustion group, with 10 rats in each group. The rats in the two moxibustion groups received moxibustion at "Mingmen" (GV 4) and "Guanyuan" (CV 4), 15 min per session, once daily, five times a week, for a total of four months. The rats in the two blank groups were fed under normal conditions. After the intervention, thymus and spleen indexes were calculated; the morphology of thymus and spleen tissues was observed using HE staining; the flow cytometry was used to detect the expression of CD and CD T lymphocytes and the CD/CD ratio was calculated; ELISA was used to measure the serum levels of tumor necrosis factor-alpha (TNF-α), interferon-gamma (IFN-γ), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-17 (IL-17); 16S rRNA high-throughput sequencing was used to analyze the intestinal flora. Additionally, the correlation between the relative abundance of intestinal flora and serum levels of TNF-α, IFN-γ, IL-6, IL-10 and IL-17 was analyzed.
		                        		
		                        			RESULTS:
		                        			Compared with the young blank group, the young moxibustion group exhibited an increase in the cortical area of thymus tissue with tighter lymphocyte arrangement; compared with the middle-aged blank group, the middle-aged moxibustion group showed an increase in thymus index (P<0.05) and an increase in the cortical area of thymus tissue. There were no significant differences in spleen index between the 2 moxibustion groups and the 2 blank groups (P>0.05). There were no significant differences in the expression of CD, CD, and CD/CD ratio between the 2 moxibustion groups and the corresponding blank groups (P>0.05). Compared with the young blank group, the young moxibustion group had elevated IL-6 level (P<0.05); compared with the middle-aged blank group, the middle-aged moxibustion group had decreased IL-10 and IL-17 levels (P<0.05). Compared with the young blank group, the young moxibustion group exhibited increased Sobs index, Ace index, and Chao index (P<0.01, P<0.05), as well as increased relative abundance of Spirochaetota, Treponema, Turicibacter, Rikenellaceae_RC9_gut_group (P<0.05), and decreased relative abundance of Dubosiella (P<0.05). Compared with the middle-aged blank group, the middle-aged moxibustion group had increased relative abundance of Spirochaetota, Treponema, norank_f_Peptococcaceae (P<0.05), and decreased relative abundance of Proteobacteria, Allobaculum, and Faecalibaculum (P<0.05). Correlation analysis revealed that relative abundance of Eubacterium_xylanophilum_group and unclassified _f_Lachnospiraceae was negatively correlated with serum TNF-α level (r=-0.39, P=0.03; r=-0.24, P=0.04), while relative abundance of norank_f_norank_o_Clostridia_UCG-014 and Lactobacillus was positively correlated with serum TNF-α level (r=0.37, P=0.04; r=0.43, P=0.02). The relative abundance of Roseburia and Monoglobus was negatively correlated with serum IFN-γ level (r=-0.40, P=0.02; r=-0.44, P=0.01), while relative abundance of Lactobacillus was positively correlated with serum IL-10 level (r=0.43, P=0.02).
		                        		
		                        			CONCLUSION
		                        			Moxibustion could improve immune function in healthy rats, and its mechanism may be related to the regulation of relative abundance of intestinal flora.
		                        		
		                        		
		                        		
		                        			Rats
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Moxibustion
		                        			;
		                        		
		                        			Rats, Sprague-Dawley
		                        			;
		                        		
		                        			Interleukin-10/genetics*
		                        			;
		                        		
		                        			Interleukin-17
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha/metabolism*
		                        			;
		                        		
		                        			Interleukin-6/genetics*
		                        			;
		                        		
		                        			Gastrointestinal Microbiome
		                        			;
		                        		
		                        			RNA, Ribosomal, 16S
		                        			;
		                        		
		                        			Interferon-gamma
		                        			;
		                        		
		                        			Immunity
		                        			
		                        		
		                        	
2.Expression and clinical significance of runt-related transcription factor 3 in children with bronchiolitis.
Shuai MEN ; Yan-Yan YU ; Yu-Hong ZHANG ; Yi-Fen WANG ; Qian QIAN ; Wei LI ; Chuang YIN
Chinese Journal of Contemporary Pediatrics 2019;21(10):1005-1011
		                        		
		                        			OBJECTIVE:
		                        			To study the mRNA level of runt-related transcription factor 3 (RUNX3) in children with bronchiolitis and its clinical significance in bronchiolitis.
		                        		
		                        			METHODS:
		                        			A total of 54 young children with bronchiolitis were enrolled as the bronchiolitis group, among whom 28 with atopic constitution were enrolled in the atopic bronchiolitis group and 26 with non-atopic constitution were enrolled in the non-atopic bronchiolitis group. A total of 48 healthy young children were enrolled as the healthy control group, among whom 24 with atopic constitution were enrolled in the atopic healthy control group and 24 with non-atopic constitution were enrolled in the non-atopic healthy control group. Quantitative real-time PCR was used to measure the mRNA level of RUNX3 in peripheral blood mononuclear cells. ELISA was used to measure the serum levels of interleukin-4 (IL-4) and interferon gamma (IFN-γ).
		                        		
		                        			RESULTS:
		                        			The bronchiolitis group had a significantly lower mRNA level of RUNX3 than the healthy control group, and the atopic bronchiolitis group had a significantly lower mRNA level of RUNX3 than the non-atopic bronchiolitis, atopic healthy control, and non-atopic healthy control groups (P<0.05). The bronchiolitis group had a significantly higher serum level of IL-4 than the healthy control group, and the atopic bronchiolitis group had a significantly higher serum level of IL-4 than the non-atopic healthy control group (P<0.05). The bronchiolitis group had a significantly lower serum level of IFN-γ than the healthy control group, and the atopic bronchiolitis group had a significantly lower serum level of IFN-γ than the non-atopic bronchiolitis, atopic healthy control, and non-atopic healthy control groups (P<0.05). The correlation analysis showed that the mRNA level of RUNX3 was negatively correlated with the serum level of IL-4 and was positively correlated with the serum level of IFN-γ (P<0.05).
		                        		
		                        			CONCLUSIONS
		                        			Measurement of RUNX3 gene expression in peripheral blood mononuclear cells has a certain value in identifying children with atopic constitution at high risk of asthma among children with bronchiolitis.
		                        		
		                        		
		                        		
		                        			Asthma
		                        			;
		                        		
		                        			Bronchiolitis
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Core Binding Factor Alpha 3 Subunit
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interferon-gamma
		                        			;
		                        		
		                        			Leukocytes, Mononuclear
		                        			
		                        		
		                        	
3.Correlation between Constitution of Yin Deficiency Syndrome and Polymorphism of HLA-DQA1/Treatment Response of Peg-IFNalpha Therapy in HBeAg Positive Chronic Hepatitis B Patients.
Jian-chun GUO ; Xiao-mei DENG ; Jing WU ; Yun-hao XUN ; Xiao-xiao HUANG ; Wei-wei WANG ; Wei-zhen SHI
Chinese Journal of Integrated Traditional and Western Medicine 2016;36(5):539-543
OBJECTIVETo observe the correlation between constitution of yin deficiency syndrome (YDS) and polymorphism of HLA-DQA1/treatment response of Peg-lFNalpha therapy in HBeAg positive chronic hepatitis B (CHB) patients, and to explore constitution of Chinese medicine (CM) in response of interferon therapy.
METHODSTotally 120 HBeAg positive CHB patients who were treated with Peg-IFNalpha were enrolled, and assigned to YDS group (59 cases) and non-YDS group (61 cases) according to classification of CM constitutions. All patients were subcutaneously injected with Peg-IFNalpha-2b (1.0 microg/kg body weight) or Peg-IFNalpha-2a (180 microg), once per week. Effective efficacy was primarily judged when complete response (CR) or partial response (PR) was obtained at month 6. Those with CR or PR completed 1 year therapeutic course. HLA-DQA1 gene types were detected by polymerase chain reaction sequence specific primers (PCR-SSP). The distribution difference of CM constitutions in patients with CR or PR and their inter-group HLA-DQA1 allele frequency were compared.
RESULTSDifferent treatment responses of Peg-IFNalpha were observed in CHB patients of two different CM constitutions. The ratio of CR + PR was 61.0% (36/59) in YDS group, obviously lower than that in NYDS group [78.7% (48/61), P < 0. 05]. Patients with CR had a lower allele frequency of HLA-DQA1 * 0501 than those with no-response [14.8% (8/54) vs. 30.6% (22/72)] with statistical difference (P < 0.05). Patients with CR had a higher allele frequency of HLA-DQA1 * 0601 than those with no-response [18.5% (10/54) vs. 5.6% (4/72)] with statistical difference (P < 0.05). The allele frequency of HLA-DQA1 * 0301 was lower in YDS group than in non-YDS group [2. 5% (3/118) vs. 9.8% (12/122)] with statistical difference (P < 0.05). The allele frequency of HLA-DQA1 * 0501 was higher in YDS group than in non-YDS group [33.9% (40/118) vs. 18.9% (23/122)] with statistical difference (P < 0.05). Yet statistical significance was lost after adjustment (Pc > 0.05 for both).
CONCLUSIONSBoth constitutions of CM and HLA-DQA1 gene polymorphism af- fect HBeAg positive CHB patients' response to Peg-INFalpha. Constitutions of YDS and HLA-DQA1 * 0501 was not favorable to response, their association needed to be further studied.
Antiviral Agents ; therapeutic use ; Gene Frequency ; HLA-DQ alpha-Chains ; genetics ; Hepatitis B e Antigens ; blood ; Hepatitis B, Chronic ; drug therapy ; genetics ; Humans ; Interferon-alpha ; therapeutic use ; Medicine, Chinese Traditional ; Polyethylene Glycols ; therapeutic use ; Polymorphism, Genetic ; Recombinant Proteins ; therapeutic use ; Remission Induction ; Yin Deficiency ; genetics
4.Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? - Treatment of Chronic Hepatitis C Genotype 2 and 3.
The Korean Journal of Gastroenterology 2016;67(3):132-136
		                        		
		                        			
		                        			Ever since direct-acting antiviral agents (DAA) have been approved and released into the world, numerous studies on the efficacy, adverse effects and drug-drug interactions of interferon-free DAA combination therapy have been studied and published. With all oral DAA therapy showing sustained virological response rate of 80-90% with minimal adverse events, HCV eradication has now become a realistic goal. DAA combination treatments were approved and adapted to practice in Korea in 2015, and Korean Association for the Study of the Liver (KASL) has revised the guideline based on the systematic approach that reflects evidence-based medicine and expert opinions. In this article, new recommendations for treatment of chronic HCV genotype 2 and 3 infected patients will be introduced base on KASL practice guidelines for management of hepatitis C that has been updated in 2015.
		                        		
		                        		
		                        		
		                        			Antiviral Agents/*therapeutic use
		                        			;
		                        		
		                        			Drug Therapy, Combination
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Hepacivirus/*genetics/isolation & purification
		                        			;
		                        		
		                        			Hepatitis C/*drug therapy/virology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interferon-alpha/therapeutic use
		                        			;
		                        		
		                        			Practice Guidelines as Topic
		                        			;
		                        		
		                        			Republic of Korea
		                        			;
		                        		
		                        			Ribavirin/therapeutic use
		                        			;
		                        		
		                        			Sofosbuvir/therapeutic use
		                        			
		                        		
		                        	
5.Renewed 2015 Clinical Practice Guidelines for Management of Hepatitis C by Korean Association for the Study of the Liver; What Has Been Changed? - Treatment of Chronic Hepatitis C Genotype 1.
The Korean Journal of Gastroenterology 2016;67(3):127-131
		                        		
		                        			
		                        			The introduction of direct-acting antiviral agents (DAAs) has markedly improved the sustained virological response (SVR) rates in patients with chronic hepatitis C. Currently, four classes of DAAs targeting three HCV proteins (NS3, NS5A, and NS5B) have been approved for treatment in many countries. Since drugs show advantages and disadvantages, use of a combination of two or more DAAs with different targets or addition of ribavirin in a difficult-to-treat patient shows an SVR rate of ~90% after 12 weeks of treatment or expanded treatment for 24 weeks. Various types of DAA are awaiting approval which will improve the treatment of chronic hepatitis C virus genotype 1 infection. However, high costs, drug resistance and interactions between various drugs remain to be overcome. With further advances in the development of antiviral agents, it could be expected that in the near future, there will be DAAs that are affordable and cost effective, require shorter treatment duration, effective in a broad range of patients, and have less side effects and drug-drug interactions.
		                        		
		                        		
		                        		
		                        			Antiviral Agents/*therapeutic use
		                        			;
		                        		
		                        			Drug Therapy, Combination
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Hepacivirus/*genetics/isolation & purification
		                        			;
		                        		
		                        			Hepatitis C/*drug therapy/virology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interferon-alpha/therapeutic use
		                        			;
		                        		
		                        			Practice Guidelines as Topic
		                        			;
		                        		
		                        			Quinoxalines/therapeutic use
		                        			;
		                        		
		                        			Republic of Korea
		                        			;
		                        		
		                        			Sofosbuvir/therapeutic use
		                        			
		                        		
		                        	
6.Identification and characterization of a novel neuropeptide (neuropeptide Y-HS) from leech salivary gland of Haemadipsa sylvestris.
Wei-Hui LIU ; Yan CHEN ; Xue-Wei BAI ; Hui-Min YAO ; Xu-Guang ZHANG ; Xiu-Wen YAN ; Ren LAI
Chinese Journal of Natural Medicines (English Ed.) 2016;14(9):677-682
		                        		
		                        			
		                        			The present study was designed to identify immunomodulatory components from the leech salivary gland of Haemadipsa sylvestris. The Sephadex G-50, Resource(TM) S column chromatography and reverse-phase high performance liquid chromatography (RP-HPLC) were used to isolate and purify the salivary gland extracts (SGE). Structural analysis of isolated compounds was based on Edman degradation and matrix assisted laser desorption ionization time-of-flight mass spectrometer (MALDI-TOF-MS). The cDNA encoding the precursor of the compound was cloned from the cDNA library of the salivary gland of H. sylvestris. The levels of inflammatory mediators, including tumor necrosis factor-α (TNF-α), interferon γ (IFN-γ), interleukin-6 (IL-6), and monocyte chemotactic protein-1 (MCP-1) were assayed using an enzyme-linked immunosorbent assay (ELISA). The effects on cell proliferation and cell viability were observed using MTT assay. A novel neuropeptide Y (Neuropeptide Y-HS) from the leech salivary gland of H. sylvestris was purified and characterized. It was composed of 36 amino acid residues and the amino acid sequence was determined to be FLEPPERPAVFTSVEQMKSYIKALNDYYLLLGRPRF-NH2, containing an amidated C-terminus. It showed significant inhibitory effects on the production of inflammatory cytokines including TNF-α, IFN-γ, IL-6, and MCP-1. Neuropeptide Y was identified from leeches for the first time. The presence of neuropeptide Y-HS in leech salivary gland may help get blood meal from hosts and inhibit inflammation.
		                        		
		                        		
		                        		
		                        			Amino Acid Sequence
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Immunologic Factors
		                        			;
		                        		
		                        			administration & dosage
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			Inflammation
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Interferon-gamma
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Interleukin-6
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Leeches
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Mass Spectrometry
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Molecular Sequence Data
		                        			;
		                        		
		                        			Neuropeptide Y
		                        			;
		                        		
		                        			administration & dosage
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			Peptide Mapping
		                        			;
		                        		
		                        			Salivary Glands
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha
		                        			;
		                        		
		                        			immunology
		                        			
		                        		
		                        	
7.Secreted Phosphoprotein 1 Promoter Genetic Variants Are Associated with the Response to Pegylated Interferon alpha Plus Ribavirin Combination Therapy in Egyptian Patients with Chronic Hepatitis C Virus Infection.
Fahmy T ALI ; Mohamed A M ALI ; Mayada M A ELGIZAWY ; Ahmed M ELSAWY
Gut and Liver 2015;9(4):516-524
		                        		
		                        			
		                        			BACKGROUND/AIMS: The T-helper 1 (TH1) immune reaction is essential for the eradication of hepatitis C virus (HCV) during pegylated interferon alpha (PEG-IFN-alpha)- and ribavirin (RBV)-based therapy in chronic HCV patients. Secreted phosphoprotein 1 (SPP1) was shown to be a crucial cytokine for the initiation of a TH1 immune response. We aimed to investigate whether SPP1 single nucleotide polymorphisms (SNPs) may influence sustained virological response (SVR) rates. METHODS: Two SNPs in the promoter region of SPP1 at the -443 C>T and -1748 G>A loci were genotyped in 100 patients with chronic HCV genotype 4 infection using a TaqMan SNP genotyping assay. RESULTS: Sixty-seven patients achieved a SVR, and 33 patients showed no SVR. Patients carrying the T/T genotype at the -443 locus showed a significantly higher SVR rate than those carrying the C/T or C/C genotype (83.67% vs 50.98%, p<0.001). At the -1748 locus, the SVR rate was significantly higher in patients with the G/G genotype than in those with the A/A genotype (88.89% vs 52.63%, p=0.028) and in patients with the G/A genotype than in those with the A/A genotype (85.29% vs 52.63%, p=0.001). CONCLUSIONS: SPP1 SNPs at -443 C>T and -1748 G>A loci may be useful markers for predicting the response to PEG-IFN-alpha-2b plus RBV therapy in Egyptian patients with chronic HCV genotype 4 infection.
		                        		
		                        		
		                        		
		                        			Adult
		                        			;
		                        		
		                        			Antiviral Agents/*therapeutic use
		                        			;
		                        		
		                        			Biomarkers/blood
		                        			;
		                        		
		                        			Drug Therapy, Combination
		                        			;
		                        		
		                        			Egypt
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Genotype
		                        			;
		                        		
		                        			Hepacivirus/drug effects/genetics
		                        			;
		                        		
		                        			Hepatitis C, Chronic/*drug therapy/virology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interferon-alpha/*therapeutic use
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Middle Aged
		                        			;
		                        		
		                        			Osteopontin/*genetics
		                        			;
		                        		
		                        			Polyethylene Glycols/*therapeutic use
		                        			;
		                        		
		                        			Polymorphism, Single Nucleotide/genetics
		                        			;
		                        		
		                        			Predictive Value of Tests
		                        			;
		                        		
		                        			*Promoter Regions, Genetic
		                        			;
		                        		
		                        			Recombinant Proteins/therapeutic use
		                        			;
		                        		
		                        			Ribavirin/*therapeutic use
		                        			;
		                        		
		                        			Treatment Outcome
		                        			
		                        		
		                        	
8.Effect of Tanreqing injection on immune activity of peripheral blood lymphocytes of patients with lung cancer.
Ming MA ; Xing-xiao YANG ; Jie ZHANG ; Lian-mei ZHAO ; Li-hua LIU ; Bao-en SHAN
China Journal of Chinese Materia Medica 2015;40(6):1207-1211
		                        		
		                        			
		                        			To investigate the effect of Tanreqing injection on immune activity of peripheral blood lymphocytes of patients with lung cancer. The peripheral blood lymphocytes of patients with lung cancer and healthy persons were separated by the density gradient centrifugation method for subsequent experiments, with those from healthy persons as the positive control. The effect of Tanreqing injection on stimulating the proliferation of lymphocytes with phytohemagglutinin (PHA) was determined by MTT method. The effect of Tanreqing injection on the lymphocyte secretions of IFN-γ and TNF-α and the subset ratio of lymphocytes cultured separately or with Tanreqing injection of different concentrations were examined by ELISA and flow cytometry (FCM) respectively. In addition, the LDH release assay was used to detect the cytotoxicity of cytotoxic T cells (CTL) and natural killer cells (NK). According to the findings, all of immunological indexes of lymphocytes from patients with lung cancer were weaker than that of healthy persons, but with the obvious increases in proliferation activity and IFN-γ and TNF-α secretions of lymphocytes co-cultured with Tanreqing Injection (P < 0.05). Among lymphocyte subsets co-cultured with Tanreqing Injection, CD3+, CD3+ CD4+ and CD3- CD16 + 56+ cell ratios notably increased, whereas CD4+ CD25+ Treg cell ratio obviously decreased (P < 0.05). In the meantime, Tanreqing injection can markedly promote the cytotoxicities of CTL and NK (P < 0.05). In conclusion, Tanreqing injection shows a significant effect in promoting the immune activity of lymphocytes from patients with lung cancer and their anti-tumor immunity.
		                        		
		                        		
		                        		
		                        			Cell Proliferation
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			Cells, Cultured
		                        			;
		                        		
		                        			Drugs, Chinese Herbal
		                        			;
		                        		
		                        			administration & dosage
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Interferon-gamma
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Killer Cells, Natural
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Lung Neoplasms
		                        			;
		                        		
		                        			drug therapy
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			physiopathology
		                        			;
		                        		
		                        			T-Lymphocytes, Cytotoxic
		                        			;
		                        		
		                        			drug effects
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Tumor Necrosis Factor-alpha
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			immunology
		                        			
		                        		
		                        	
9.Antiviral treatment and long-term clinical outcome of decompensated cirrhotic patients with hepatitis C virus infection.
Fanpu JI ; Shuangsuo DANG ; Zhifang CAI ; Hongan XUE ; Na HUANG ; Layang LIU ; Shu ZHANG ; Yonghong GUO ; Xiaoli JIA ; Yuan WANG ; Zongfang LI ; Hong DENG
Chinese Journal of Hepatology 2015;23(9):647-652
OBJECTIVETo investigate the efficacy and safety of antiviral treatment in patients with hepatitis C virus (HCV) infection and decompensated cirrhosis and determine the effects of virological response on long-term prognosis.
METHODSSixty-six consecutive,interferon (IFN)-na(i)ve patients with HCV infection and decompensated cirrhosis were enrolled in this prospective study. All patients were given a 48-to 72-week course of IFN plus ribavirin (RBV) combined therapy,with a low accelerating dosage regimen using either:pegylated (PEG)-IFNa-2b at 1.0-1.5 mug/kg/week,PEG-IFNa-2a at 90-180 mug,or standard IFN-a-2b at 3MU,every other day.RBV was given at 800 to 1000 mg/day. All patients were routinely monitored for adverse drug reactions and virological response.Effects of treatments on patient survival were assessed by Kaplan-Meier analysis.
RESULTSAt the end of treatment,74.2% of patients were HCV RNA-negative,with 45.5% having achieved sustained virological response and 28.8% having relapsed;the remaining 25.7% of patients showed non-virological response (NVR). Among the patients with HCV genotype 1, 65.9% achieved end-of-treatment virological response (ETVR) and 34.1% achieved SVR;among the patients with HCV genotype 2,90.9% achieved ETVR and 68.2% achieved SVR. The positive and negative predictive values of early virological response (EVR) for ETVR were 95.7% and 75.0% respectively, and for SVR were 65.2% and 100% respectively. Compared with baseline,patients who achieved ETVR had better liver function,as evidenced by changes in levels of total bilirubin,alanine aminotransferase and albumin,as well as prothrombin activity and Child-Pugh score (t =4.564,11.486,2.303,2.699,3.694 respectively, all P less than 0.05).Compared with the NVR patients, the ETVR patients had lower risk of hepatic decompensation and hepatocellular carcinoma, and had improved survival (x2=18.756,6.992,7.580, respectively, all P less than 0.05).Twelve (18.2%) patients experienced serious adverse events,with 10 requiring premature treatment withdrawal and 2 dying.
CONCLUSIONAntiviral treatment for patients with HCV infection and decompensated cirrhosis using interferon in a low accelerating dosage regimen in combination with ribavirin is feasible.Patients who achieved ETVR had significantly improved long-term prognosis.
Alanine Transaminase ; Antiviral Agents ; therapeutic use ; Carcinoma, Hepatocellular ; Drug Therapy, Combination ; Genotype ; Hepacivirus ; genetics ; Hepatitis C ; diagnosis ; drug therapy ; Humans ; Interferon-alpha ; therapeutic use ; Kaplan-Meier Estimate ; Liver Cirrhosis ; drug therapy ; virology ; Liver Neoplasms ; Polyethylene Glycols ; therapeutic use ; Prospective Studies ; Recombinant Proteins ; therapeutic use ; Ribavirin ; therapeutic use ; Treatment Outcome
10.Infection-stimulated anemia results primarily from interferon gamma-dependent, signal transducer and activator of transcription 1-independent red cell loss.
Zheng WANG ; Dong-Xia ZHANG ; Qi ZHAO
Chinese Medical Journal 2015;128(7):948-955
BACKGROUNDAlthough the onset of anemia during infectious disease is commonly correlated with production of inflammatory cytokines, the mechanisms by which cytokines induce anemia are poorly defined. This study focused on the mechanism research.
METHODSDifferent types of mice were infected perorally with Toxoplasma gondii strain ME49. At the indicated times, samples from each mouse were harvested, processed, and analyzed individually. Blood samples were analyzed using a Coulter Counter and red blood cell (RBC) survival was measured by biotinylation. Levels of tumor necrosis factor-α (TNF-α), inducible nitric oxide synthase (iNOS), and inducible protein 10 (IP-10) mRNA in liver tissue were measured by real-time polymerase chain reaction.
RESULTST. gondii-infected mice exhibited anemia due to a decrease in both erythropoiesis and survival time of RBC in the circulation (P < 0.02). In addition, infection-stimulated anemia was associated with fecal occult, supporting previous literature that hemorrhage is a consequence of T. gondii infection in mice. Infection-induced anemia was abolished in interferon gamma (IFNγ) and IFNγ receptor deficient mice (P < 0.05) but was still evident in mice lacking TNF-α, iNOS, phagocyte NADPH oxidase or IP-10 (P < 0.02). Neither signal transducer and activator of transcription 1 (STAT1) deficient mice nor 129S6 controls exhibited decreased erythropoiesis, but rather suffered from an anemia resulting solely from increased loss of circulating RBC.
CONCLUSIONSInfection-stimulated decrease in erythropoiesis and losses of RBC have distinct mechanistic bases. These results show that during T. gondii infection, IFNγ is responsible for an anemia that results from both a decrease in erythropoiesis and a STAT1 independent loss of circulating RBC.
Anemia ; genetics ; metabolism ; Animals ; Erythrocytes ; pathology ; Interferon-gamma ; metabolism ; Male ; Mice ; Mice, Knockout ; Nitric Oxide Synthase Type II ; genetics ; metabolism ; Receptors, Interferon ; genetics ; metabolism ; STAT1 Transcription Factor ; genetics ; metabolism ; Toxoplasma ; pathogenicity ; Tumor Necrosis Factor-alpha ; genetics ; metabolism
            
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