Correlation between interleukin-6 and ammonia in patients with overt hepatic encephalopathy due to cirrhosis.

OBJECTIVE: Previous studies have shown that elevated serum levels of interleukin-6 (IL-6) correlate with the severity of overt hepatic encephalopathy (OHE) in cirrhotic patients. However, the correlation between serum IL-6 levels and plasma ammonia levels in these patients remains unclear. Therefore, the present study investigated this correlation between both variables in cirrhotic patients with OHE. METHODS: Fifty-five cirrhotic patients with various grades of OHE, 29 cirrhotic patients without OHE, and 30 healthy controls were recruited. Concentrations of plasma ammonia and serum IL-6 were simultaneously measured. RESULTS: In cirrhotic patients with OHE, the severity of OHE, represented by the West Haven criteria, correlated with serum IL-6 levels (r=0.43, P<0.05) and plasma ammonia levels (r=0.59, P<0.05). IL-6 and ammonia were found to be significant independent predictors of OHE severity (P<0.05 for both variables). Furthermore, the severity of liver cirrhosis, determined by Child-Pugh scores, correlated with serum IL-6 levels (r=0.45, P<0.05) and plasma ammonia levels (r=0.68, P<0.05) in these patients. Moreover, there was a significant positive correlation between serum IL-6 levels and plasma ammonia levels (r=0.58, P<0.05) in cirrhotic patients with OHE, but not in patients without OHE (r=0.42, P>0.05) or healthy controls (r=0.27, P>0.05). The correlation between IL-6 and ammonia was independent of infectious precipitating factors. CONCLUSIONS: The results of the present study suggest that IL-6 might be involved in the mechanism by which ammonia contributes to the pathogenesis of OHE. There is also evidence of a potential synergistic interaction between proinflammatory cytokines and ammonia in the pathogenesis of OHE.

[Induction of anti-hepatocellular carcinoma immunity by Hyper-IL-6 gene in vivo].

AIM: To prepare the mouse hepatocellular carcinoma (HCC) cells with the stable expression of Hyper-IL-6 and explore the possibility of inducing active anti-HCC immune response by Hyper-IL-6 gene. METHODS: Hyper-IL-6 gene was transfected into mouse HCC cells MM45T.Li using Lipofectamine(TM);2000. G418-resistant clones named MM45T-HIL-6 were selected and detected for the expression of Hyper-IL-6 gene by RT-PCR and ELISA. Mouse HCC cells transfected with pEGFP-C1, named MM45T-mock, were prepared as controls. Tumor models were established by injecting subcutaneously 5×10(5); cells of MM45T.Li, MM45T- mock and MM45T-HIL-6 on the right anterior limb of BALB/c mouse, respectively. In vivo experiments were performed to observe the tumorigenicity of MM45T.Li, MM45T-mock and MM45T-HIL-6. The levels of CD4(+); and CD8(+); T cells in mouse peripheral blood were detected by flow cytometry (FCM). RESULTS: RT-PCR and ELISA showed that Hyper-IL-6 gene was expressed in the MM45T-HIL-6 cells, but not in the control cells. We observed that the tumorigenicity of MM45T-HIL-6 decreased compared with control cells after they were inoculated subcutaneously into mice. FCM results indicated that the levels of CD4(+); and CD8(+); T cells in the peripheral blood significantly increased in the mice inoculated with MM45T-HIL-6 compared with the ones inoculated with MM45T.Li and MM45T-mock cells (P<0.05). CONCLUSION: The mouse HCC cells with the stable expression of Hyper-IL-6 can induce active anti-HCC immune response after inoculated subcutaneously into mice.

[The correlation of HBeAg expression and HBV-DNA in serum or peripheral blood mononuclear cells in patients with chronic hepatitis B].

OBJECTIVE: To study the relationship between HBeAg expression and HBV-DNA in serum and peripheral blood mononuclear cells (PBMCs). METHODS: 208 patients with chronic hepatitis B were included in this present study. HBV-DNA in the PBMCs were performed by polymerase chain reaction (PCR), with the serum HBV-DNA level being determined by the way of fluoresces quantities PCR (FQ-PCR). Meanwhile, HBV-GM was also detected via enzyme-linked immunosorbent assay (ELISA). RESULTS: There were 106 patients for positivity in the HBV-DNA level of PBMCs with 102 for negativity, in which the HBV-DNA high levels (HBV DNA load > or = 1.0E5) in serum were 91.5%, 45.1% (chi2=52.12, P>0.01) respectively, with 76.4% and 50.9% (chi2=21.55, P>0.01) for the positive percentage of HBeAg expression. CONCLUSION: A significantly positive correlation was found between HBV-DNA in PBMCs and serum HBV-DNA along with the positive percentage of HBeAg, indicating that obvious PBMCs' increase infected by HBV in patients with positivity of HBeAg and high level of serum HBV-DNA.

[The relationship between HBV genotypes and the efficacy of antiviral therapies in hepatitis B e antigen- positive patients].

OBJECTIVES: To study the relationship between HBV genotypes and the efficacy of antiviral therapies. METHODS: HBV genotypes of 90 hepatitis B e antigen positive patients with chronic hepatitis B (CHB) were determined by PCR sandwich hybridization-ELISA technique. Forty-one patients with CHB were treated with lamivudine (100 mg/day) for 48 weeks and 49 patients with CHB were given alpha-interferon (3 MU/QOD) therapy for 48 weeks. The serological, biochemical and virological symbols were measured before, during and after treatment for all the patients. RESULTS: Of the 90 patients, genotype B HBV was found in 16 and C in 74. There was no difference in the rate of response to lamivudine treatment between patients with genotype B or C HBV (33.3% vs. 20.0%) after 48 weeks treatment with lamivudine in the 41 patients. Of the 49 HBeAg positive CHB patients treated with alpha-interferon for 48 weeks, in HBV genotype B and C patients the rates of normalization of ALT were 60.0% and 20.5%; the rate of HBeAg turning to negativity was 50.0% and 17.9%; and the rate of HBV DNA undetectability was 50.0% and 17.9%. The rate of response to the interferon treatment was significantly higher in patients with HBV genotype B compared to those with genotype C. CONCLUSIONS: Our study shows that there is no influence on the lamivudine treatment effects for the HBV genotype B and C CHB patients, but the alpha-interferon treatment for HBV genotype B CHB patients is more effective than that for the genotype C ones.

[Relationship between the HBV core gene mutation and the cellular immunity in host].

OBJECTIVES: To study the relationship between the mutation of Leu60Val in HBV core region and the cellular immunity in patients with chronic hepatitis B (CHB). METHODS: HBV DNA C gene mutation was confirmed by polymerase chain reaction (PCR) and sequencing the products directly. The cytokines (IFN-gamma, TNF-alpha and IL-2) levels in serum were measured by enzyme linked immunosorbent assay (ELISA). The distribution of T-lymphocyte subpopulations in peripheral blood was detected by flow cytometry (FCM). RESULTS: The mutation of Leu60Val was found in 19 out of the 91 CHB patients. With the CHB severity, the mutation rate was getting higher, especially in the severe hepatitis group. The IFN-gamma and TNF-alpha levels were much higher in mutant strain group than those in wild strain group (t=2.584, 4.766, P<0.01), so was the ratio of CD4+/CD8+ (t=2.275, P<0.05). CONCLUSION: The mutant strain of 60Val may increase affinity to HLA-I molecule, or up-regulate the expression of HLA-I molecule, resulting in the activation of CTL to release the cytokines and cause immune response in liver.