High prevalence of anti-phospholipid antibodies and anti-thyroglobulin antibody in patients with hepatitis C virus infection treated with interferon-alpha.
High prevalence of anti-phospholipid antibodies and anti-thyroglobulin antibody in patients with hepatitis C virus infection treated with interferon-alpha.
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发表时间：
1995-07
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通讯作者：
J. Matsuda;N. Saitoh;M. Gotoh;K. Gohchi;M. Tsukamoto;S. Syoji;K. Miyake;M. Yamanaka
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作者：
J. Matsuda;N. Saitoh;M. Gotoh;K. Gohchi;M. Tsukamoto;S. Syoji;K. Miyake;M. Yamanaka
我们调查了β 2-糖蛋白I的患病率，（β 2-GPI）依赖性抗磷脂抗体（aPL）[抗心磷脂抗体（aCL）、抗磷脂酰丝氨酸抗体（aPS）和抗磷脂酸抗体（阿帕）]、抗核抗体（ANA）、抗脱氧核糖核酸抗体（aDNA）、抗甲状腺球蛋白抗体（aTG），对56例丙型肝炎病毒（HCV）感染患者进行抗甲状腺过氧化物酶抗体（aTPO）检测，并与干扰素（IFN）治疗相关。结果治疗前aCL、aPS和阿帕阳性分别为7/56（13%）、12/56（21%）和13/56（23%）。IFN治疗后aPS和阿帕分别出现6/44和9/43例，消失6/12和2/13例，差异有统计学意义。治疗后aPS和阿帕阳性的患者OD读数变化高于治疗后转为阴性的患者。患者组aTG和aTPO阳性率明显高于健康对照组，其中4例患者aTG升高，2例aTG消失。未观察到aTPO的明显变化;然而，在4名先前阳性的患者中，aTPO滴度增加。在长达1年的观察期内，任何抗体阳性的患者均未出现与这些抗体相关的异常。结论aPL、ATG/aTPO的产生机制及临床意义尚不清楚，但HCV感染和/或干扰素治疗等免疫紊乱可能是其产生的原因。需要进一步的研究来澄清用IFN治疗的HCV/aPL-和/或aTG/aTPO-阳性患者将来是否可能发展aPL相关的并发症和/或自身免疫性疾病，并确认IFN治疗是否证明在这种临床环境中的结果是合理的。
OBJECTIVES AND METHODS We investigated the prevalence rate of beta 2-glycoprotein I (beta 2-GPI)-dependent antiphospholipid antibodies (aPL)[anti-cardiolipin antibody (aCL), anti-phosphadidylserine antibody (aPS), and anti-phosphatidic acid antibody (aPA)], antinuclear antibody (ANA), anti-deoxyribonucleic acid antibody (aDNA), anti-thyroglobulin antibody (aTG), and anti-thyroid peroxidase antibody (aTPO) in 56 patients with hepatitis C virus (HCV) infection and correlated the results with inteferon-alpha (IFN) treatment. RESULTS aCL, aPS, and aPA were positive in, respectively, 7/56 (13%), 12/56 (21%), and 13/56 (23%) patients before treatment. aPS and aPA appeared in 6/44 and 9/43 and disappeared in 6/12 and 2/13 patients, respectively, after IFN treatment; the differences were statistically significant. The changes in OD readings were higher in the group of patients who became positive for aPS and aPA than in those who became negative after treatment. The positive rates of aTG and aTPO in the patient group were statistically higher than in the healthy controls, and aTG developed in four patients and disappeared in two. No obvious changes in aTPO were observed; however, the aTPO titer was increased in four previously positive patients. None of the patients positive for any antibodies developed an abnormality associated with these antibodies during an observation period of up to 1 yr. CONCLUSIONS The pathogenesis of production and clinical significance of aPL, ATG/aTPO in this clinical setting are unclear, but immunological disturbances, such as the effects of HCV infection and/or IFN treatment, were considered to be a possibility. Further investigation is needed to clarify whether HCV/aPL- and/or aTG/aTPO-positive patients treated with IFN might develop aPL-associated complications and/or autoimmune disease(es), in the future and to confirm whether IFN treatment justifies the outcome in this clinical setting.