Analysis The Changes Of Peripheral Blood Th1/Th2 Type Cytokines Level Of Chronic Hepatitis B Patients In The Treatment Of ETV

Objectives: Peripheral blood Th1 cytokines TNF alpha,IFN gamma and Th2 cytokines IL-4,IL-6,IL-10 levels of 35 cases of chronic hepatitis b(CHB)patients in the entecavir(ETV)antiviral treatment by Luminex liquid chip technology were detected,to explore the changes of peripheral blood Th1/Th2 type cytokines expression level of CHB patients in the process of ETV antiviral treatment,analyze the correlation among of ALT,AST,HBV DNA and various cytokines,and the relationship between Th1/Th2 type cytokines.Methods: CHB patients in the infectious department from the affiliated hospital of North Sichuan Medical College were chosen from March 2015 to November 2016 for the study.Luminex liquid chip technology was applied to detect the peripheral blood Th1 cytokines TNF alpha,IFN gamma and Th2 cytokines IL-4,IL-6,IL-10 level before ETV antiviral treatment and after treatment of 4 weeks,12 weeks,24 weeks and 48 weeks.At the same time,blood routine,liver function and HBV DNA loads et al were monitored in each stage.The influences of ETV antiviral treatment on Th1/Th2 cytokines expression levels of CHB patients were compared with those of 23 healthy people in the control group.Results:1.Compared with those before the treatment,the ALT,AST level and HBV DNA load decreased significantly after 4 weeks of treatment(P=0.000).After 12 weeks of treatment the patient’s level of ALT and AST are below normal value(40U/L).After 24 weeks,the patients’ HBV DNA load is lowerthan normal values(500IU/mL).2.Before ETV antiviral treatment,peripheral blood Th1 cytokines IFN gamma expression level in patients with CHB increased significantly(P=0.010)compared with that of the control group while TNF alpha expression level having no statistically significant difference(P=0.095).After4,12 weeks of treatment,Th1 cytokines IFN gamma expression levels were reduced significantly(P=0.023,P=0.002),while TNF alpha expression levels having no statistically significant difference compared with before treatment(P=0.277,P=0.061).After 24 weeks of treatment,Th1 cytokines IFN gamma and TNF alpha expression levels were reduced significantly(P=0.000,P=0.018).After 48 weeks of treatment,Th1 cytokines IFN gamma and TNF alpha expression levels were reduced significantly(P=0.000,P=0.016).Before treatment,peripheral blood type Th2 cytokines IL-4,IL-6,IL-10 levels decreased obviously(P=0.039,P=0.014,P=0.026)compared with those in the control group.After 4,12 weeks of treatment,peripheral blood type Th2 cytokines IL-4,IL-6,IL-10 expression level having no statistically significant difference compared with before treatment(P>0.05).After 24 weeks of treatment,peripheral blood type Th2 cytokines IL-4 expression level increased significantly(P=0.024),IL-6,IL-10 expression level having no statistically significant difference(P=0.211,P=0.111)compared with that before treatment.After 48 weeks of treatment,peripheral blood type Th2 cytokines IL-4,IL-6 expression level increased significantly(P=0.004,P=0.029)compared with that before treatment while IL-10 expression level having no statistical significance(P=0.081).3.There is a negative correlation between CHB patients peripheral blood AST and IL-6 level before treatment(r=0.331,P=0.018).The other cytokineshave no correlation with AST expression level.AST expression level have no correlation with Th1/Th2 cytokines after 48 weeks of treatment.ALT expression level,HBV DNA load and Th1/Th2 cytokines expression had no correlation before and after the treatment.4.Before treatment,there is a positive correlation between the Th1 cytokine TNF alpha and Th2 cytokines IL-6 expression level(r=0.427,P=0.021).There is positive correlation between Th2 type cytokines IL-4 and IL-10(r=0.34,P=0.015).There is no correlation between other groups of cytokines.After 48 weeks of treatment,there is a positive correlation between Th1 cytokine TNF alpha,Th2 cytokines IL-6 and IL-10 expression level(r=0.496,P=0.000;r=0.468,P=0.001).There is a positive correlation between the Th2 type cytokines IL-6 and IL-4 expression level(r=0.332,P=0.017).There is no correlation between other groups of cytokines.Conclusions:1.Before antiviral treatment,the peripheral blood of CHB patients showed Th1 type cytokines high expression level,Th2 type cytokines low expression level,Th1/Th2 cytokines imbalance.2.After treatment with ETV,the peripheral blood of Th1 type cytokines expression level decreasing,Th2 type cytokines expression level increasing in patients with CHB.3.Before and after antiviral treatment,there was no correlation between ALT,AST,HBV DNA and the expression of Th1/Th2 type cytokines in patients with CHB.There was disorder and irregularity in the correlation between the levels of Th1/Th2 type cytokines.