[The characteristics of peripheral lymphocytic subsets and cytokines in primary biliary and their changes to drug treatment.].

OBJECTIVE

To investigate the characteristics of peripheral lymphocytic subsets and cytokines in patients with primary biliary cirrhosis (PBC) and their changes after therapy.

METHODS

Eighty two patients with untreated PBC were divided randomly into three groups. Group U (28 patients) were treated with ursodeoxycholic acid (UDCA), group UP (27 patients) were treated with UDCA and prednisonlone, while group UA (27 patients) were treated with UDCA and azatharaprine. Levels of peripheral lymphocytic subsets and cytokines were monitored at 0, 3, 6 months after therapy. Twenty healthy people were included as healthy control (HC).

RESULTS

Compared with HC, the percentage of CD(4)(+)T cell (P = 0.044) increased in PBC; the levels of IFNgamma (P = 0.001), IL-2 (P = 0.000), IL-4 (P = 0.010), IL-6 (P = 0.029), tumor necrosis factoralpha (TNFalpha) (P = 0.000), IL-1beta (P = 0.008) and transforming growth factorbeta (TGFbeta) (P = 0.069) increased in PBC. The level of TNFalpha in peripheral was correlated with those of ALT (P = 0.005), AST (P = 0.002), total bilirubin (TBil) (P = 0.001), direct bilirubin (DBil) (P = 0.002), and mayo risk score (MRS) (P = 0.020). The percentage of CD(4)(+)T cell decreased in group U. In group U, the levels of IFNgamma, IL-4, IL-6 all decreased after therapy at the third month, but rebounded thereafter. In group of UP and UA, the levels of IFNgamma, IL-4, IL-6 were suppressed below the levels of baseline after therapy. Levels of TNFalpha and IL-2 decreased in all three groups after therapy.

CONCLUSIONS

Levels of both Th1 and Th2 related cytokines are abnormal in the peripheral blood of patients with PBC. The abnormal levels of Th1 related cytokine indicated that PBC is a cell immunity based autoimmune disease. IFNgamma, TNFalpha are directly related to the disease. The three treatments have different effects on the adjustment of the immune system.