Published online Jun 6, 2020. doi: 10.12998/wjcc.v8.i11.2255
Peer-review started: March 3, 2020
First decision: April 1, 2020
Revised: April 18, 2020
Accepted: April 28, 2020
Article in press: April 28, 2020
Published online: June 6, 2020
Processing time: 96 Days and 16.6 Hours
Chronic hepatitis B virus infection remains a major global public health problem. Peginterferon-alpha-2a (PEG-IFN) has direct antiviral and immunoregulatory effects, and it has become one of the first choice drugs for the treatment of chronic hepatitis B (CHB). Cytokines play an important role in immunity, and they directly inhibit viral replication and indirectly determine the predominant pattern of the host immune response.
To determine the correlation between cytokine/chemokine expression levels and response to PEG-IFN treatment in patients with CHB.
Forty-six kinds of cytokines were analyzed before PEG-IFN therapy and at 24 wk during therapy in 26 CHB patients.
The monokine induced by INF-γ (CXCL9) and serum interferon-inducible protein 10 ( IP-10) levels at baseline were higher in virological responders than in non-virological responders (NRs) and decreased during treatment, whereas the NRs did not exhibit significant changes. The macrophage inflammatory protein 1d (MIP-1d) levels at baseline and during treatment were significantly higher in the virological responders than in the NRs, while thymus and activation-regulated chemokine (TARC) levels at baseline and during treatment were significantly lower in the virological responders than in the NRs. The CXCL9, IP-10, MIP-1d, and TARC baseline levels exhibited the expected effects for interferon treatment. The area under the receiver operating characteristic curve values of CXCL9, IP-10, MIP-1d, and TARC for predicting virological responses were 0.787, 0.799, 0.787, and 0.77 (P = 0.01, 0.013, 0.01, and 0.021), respectively.
We found that cytokine levels before and during treatment may represent potential biomarkers to select CHB patients who can respond to PEG-IFN. Therefore, cytokines can be used as an indicator of antiviral drug selection before CHB treatment.
Core tip: Analyses of the changes in cytokine expression patterns during treatment can help to understand the pathogenesis of chronic hepatitis B and predict treatment responses. We found that macrophage inflammatory protein 1d, CXCL9, CXCL6, interferon-inducible protein 10, and thymus and activation-regulated chemokine have predictive significance in interferon therapy. Therefore, further large and long-term follow-up studies are needed to determine the predictive value of cytokines in chronic hepatitis B patients receiving peginterferon-alpha-2a treatment. In addition, the differences in these factors between the response and non-response groups and their specific biological roles in hepatitis B virus infection require further investigation.