ELEVATED SERUM IRON PREDICTS POOR RESPONSE TO INTERFERON TREATMENT IN PATIENTS WITH CHRONIC HCV INFECTION
ELEVATED SERUM IRON PREDICTS POOR RESPONSE TO INTERFERON TREATMENT IN PATIENTS WITH CHRONIC HCV INFECTION
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DOI：
10.1007/bf02063249
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发表时间：
1995-11-01
影响因子：
3.1
通讯作者：
GILAT, T
中科院分区：
文献类型：
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作者：
ARBER, N;MOSHKOWITZ, M;GILAT, T
到目前为止，还没有确切的临床、人口学、生化、血清学或组织学特征预测哪些慢性丙型肝炎患者更可能对干扰素- α治疗有反应。空腹时测定血清铁、总铁结合力、转铁蛋白饱和度和铁蛋白。肝活检标本中染色铁的数量也进行了组织化学评价。所有患者接受重组人ifn - α 2a皮下注射300万单位，每周3次自行给药。13名应答者中有11名（84%）血清铁水平低于正常水平，而26名无应答者中有1名（4%）血清铁水平低于正常水平（P < 0.001）。两组血清转铁蛋白相似，但反应者的铁饱和度（30 +/- 10%）明显低于无反应者（53 +/- 12%）（P < 0.001）。无应答者血清铁蛋白和肝铁含量较高。这表明血清铁和转铁蛋白饱和度的增加会减弱干扰素的作用，因为它们对免疫系统有相反的作用。因此，铁超载会导致对干扰素的不良反应。减少铁超载是否会改善对干扰素治疗的反应还有待观察。
To date, there are no firm clinical, demographic, biochemical, serologic, or histologic features predicting which patients with chronic hepatitis C are more likely to respond to therapy with interferon-alpha. Serum iron, total iron-binding capacity, transferrin saturation, and ferritin were measured in the fasting state. The amount of stainable iron in liver biopsy specimens was evaluated histochemically as well. All patients received subcutaneous recombinant human IFN-alpha 2a three million units thrice weekly by self-administration. Eleven of 13 (84%) responders had low to normal serum iron levels as compared to one of 26 (4%) nonresponders (P < 0.001). The serum transferrin was similar in both groups, but iron saturation was significantly lower in responders (30 +/- 10%) than in nonresponders (53 +/- 12%) (P < 0.001). Serum ferritin and hepatic iron content were higher in nonresponders (NS). It is suggested that increased serum iron and transferrin saturation blunt the action of interferon, as they have opposite effects on the immune system. Iron overload can thus lead to a poor response to interferon. It remains to be seen whether reducing iron overload will improve the response to interferon therapy.