血清IL-21与CHB患者核苷（酸）类药物抗病毒治疗相关研究进展

张婷; 吴剑华; 唐金模; 王敏

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微生物与感染 ›› 2024, Vol. 19 ›› Issue (4) : 237-243.

综述

血清IL-21与CHB患者核苷（酸）类药物抗病毒治疗相关研究进展

张婷¹,吴剑华¹,唐金模²,王敏²

作者信息 +

Research progress on the correlation between serum IL-21 and antiviral therapy with nucleoside (acid) drugs in CHB patients

Author information +

文章历史 +

摘要

摘要：慢性乙型肝炎是目前重要的传染性疾病，抗病毒治疗是延缓疾病进展、改善疾病预后的重要手段，机体的免疫反应在其整个过程中起到关键作用。本文探讨了免疫因子IL-21水平在慢性乙型肝炎治疗中的临床意义。血清IL-21在乙肝患者的病毒学应答、HBeAg血清学转换以及病毒复发等方面扮演着重要角色。血清IL-21水平的变化能够预测经核苷（酸）类似物治疗患者的病毒学应答情况，并且与停药后的复发有关，对血清IL-21水平的监测有助于临床制定更有效的个体化治疗策略。并且IL-21基于其免疫调节作用展现出良好的抗病毒潜能，为慢性乙型肝炎提供了新的治疗靶点与思路。

Abstract

Abstract:Antiviral treatment is a crucial tool for delaying the course of chronic hepatitis B and improving the prognosis of the illness. Chronic hepatitis B is today a significant infectious disease. Throughout the whole process, the body's immunological response is vital. The therapeutic relevance of immune factor IL-21 levels in the management of chronic hepatitis B is examined in this paper. The virologic response, HBeAg seroconversion, and viral recurrence in hepatitis B patients are all significantly influenced by serum IL-21. Variations in blood IL-21 levels are linked to recurrence after stopping nucleoside (acid) analogue treatment and can predict the virological response of individuals receiving these treatments. In clinical practice, serum IL-21 level monitoring can aid in the development of more successful individualized treatment plans. Additionally, IL-21 has demonstrated strong antiviral potential based on its immunomodulatory action, offering a novel treatment target and concept for chronic hepatitis B.

导出引用

张婷吴剑华唐金模王敏. 血清IL-21与CHB患者核苷（酸）类药物抗病毒治疗相关研究进展[J]. 微生物与感染. 2024, 19(4): 237-243

Research progress on the correlation between serum IL-21 and antiviral therapy with nucleoside (acid) drugs in CHB patients[J]. Journal of Microbes and Infections. 2024, 19(4): 237-243

中图分类号： R512.6+2

参考文献

[1].参考文献： [2]中华医学会肝病学分会, 中华医学会感染病学分会.慢性乙型肝炎防治指南年版[J].中华肝脏病杂志, 2022, 30(12):1309-1331 [3]赫捷, 陈万青, 沈洪兵, 等.中国人群肝癌筛查指南，北京[J].中国肿瘤, 2022, 31(08):587-631 [4]秦叔逵.中国原发性肝癌临床登记调查(CLCS)的中期报告[R/OL].(2020-09-30)[2022-10-24].https://mp.weixin.qq.com/s?_biz=MzA4ODQxMjgzNw==& mid=2653991033& idx=5& sn=9e4dd84a7f01003f09935ed0122943d2& chksm=8bee97b3bc991ea54dc39b8aeb99056e97085f0fc10bbe4ffea68f0a1958c23bc1cf2a79ab00& scene=27. [5]Murata K, Mizokami M.Possible biological mechanisms of entecavir versus tenofovir disoproxil fumarate on reducing the risk of hepatocellular carcinoma. J Gastroenterol Hepatol. 2023 May; 38(5):683-691. [6]Nguyen MH, Wong G, Gane E, et al.Hepatitis B Virus: Advances in Prevention, Diagnosis, and Therapy. Clin Microbiol Rev. 2020 Feb 26; 33(2):e00046-19. [7]Zhao J, Zhou L, Zhang Y, Cheng J, Zeng Y, Li X.TDF and TAF inhibit liver cancer cell migration, invasion via p7TP3. Sci Rep. 2024 Apr 8; 14(1):8161. [8]刘肄辉, 冯慧, 刘莉, 等.恩替卡韦对慢性乙型肝炎外周血细胞动态变化的影响研究[J].中国预防医学杂志, 2020, 21(02):163-167 [9]Isvoranu G, Chiritoiu-Butnaru M.Therapeutic potential of interleukin-21 in cancer. Front Immunol. 2024 Apr 4; 15:1369743. [10]李媛, 黄古叶.在感染中的作用[J].临床肝胆病杂志, 2017, 33(12):2421-2424 [11]Cai Y, Ji H, Zhou X, et al.Interleukin-21 modulates balance between regulatory T cells and T-helper 17 cells in chronic hepatitis B virus infection. BMC Infect Dis. 2023 Oct 24; 23(1):719. [12]许茵, 华忠, 俞萍等.阿德福韦酯治疗慢性乙肝后细胞免疫水平的临床研究[J].中国现代医学杂志, 2016, 26(21):94-96 [13]Wang L, Zeng X, Wang Z, Fang L, Liu J.Recent advances in understanding T cell activation and exhaustion during HBV infection. Virol Sin. 2023 Dec; 38(6):851-859. [14]王健, 吴东洋, 郑建兴, 等.恩替卡韦治疗阳性慢性乙型肝炎抗病毒效应评估[J].中华医院感染学杂志, 2023, 33(05):652-656 [15]邱天霁, 姚云清, 江萍等.与患者抗病毒治疗后免疫学相关细胞因子的变化及临床意义[J].四川大学学报医学版, 2020, 51(01):122-126 [16]Xiao L, Tang K, Fu T, et al.Cytokine profiles and virological markers highlight distinctive immune statuses, and effectivenesses and limitations of NAs across different courses of chronic HBV infection. Cytokine. 2024 Jan; 173:156442. [17]Jin Y, Sun Z, Geng J, Yang L, et al.IL-21 reinvigorates exhausted natural killer cells in patients with HBV-associated hepatocellular carcinoma in STAT1-depedent pathway. Int Immunopharmacol. 2019 May; 70:1-8. [18]高子翔, 沈忠良, 刘晶, 等.细胞因子在慢性乙型肝炎治疗中的研究进展[J].临床肝胆病杂志, 2022, 38(08):1710-1715 [19]Ji L, Wei J, Zhang R, Zhang X, Gao Y, Fang M, Yu Z, Cao L, Gao Y, Li M.Bushen Formula promotes the decrease of HBsAg levels in patients with CHB by regulating Tfh cells and B-cell subsets. J Ethnopharmacol. 2024 Jun 28; 328:118072. [20]胡璇, 叶俊钊, 廖献花等.和基因多态性与慢性乙型肝炎疗效血清学应答的关系[J].实用医学杂志, 2018, 34(18):2985-2989 [21]范清琪, 汪婷, 陈沛冬等.阳性慢性乙型病毒性肝炎患者外周血中分泌-的~+ 细胞频数的检测及临床意义[J].中国感染与化疗杂志, 2021, 21(06):659-663 [22]Ma SW, Huang X, Li YY, et al.High serum IL-21 levels after 12 weeks of antiviral therapy predict HBeAg seroconversion in chronic hepatitis B. J Hepatol. 2012 Apr; 56(4):775-81. [23]余希, 莫金英, 肖蒲军等.血清-水平与长期核苷类药物治疗患者停药后临床复发的相关性[J].热带医学杂志, 2021, 21(09):1167-1171 [24]邱源旺.白细胞介素-21与慢性乙型肝炎患者恩替卡韦停药后复发的相关性研究[D].苏州大学, 2017. [25]吴迪, 黄达, 宁琴.慢性乙型肝炎临床治愈新策略——病毒抑制联合免疫调节及其路线图[J].临床肝胆病杂志, 2018, 34(05):919-925 [26]Tang L, Chen C, Gao X, et al.Interleukin 21 Reinvigorates the Antiviral Activity of Hepatitis B Virus (HBV)-Specific CD8+ T Cells in Chronic HBV Infection. J Infect Dis. 2019 Feb 15; 219(5):750-759. [27]Tang L, Li Q, Chen L, et al.IL-21 collaborates with anti-TIGIT to restore NK cell function in chronic HBV infection. J Med Virol. 2023 Oct; 95(10):e29142. [28]Allweiss L, Testoni B, Yu M, et al.Quantification of the hepatitis B virus cccDNA: evidence-based guidelines for monitoring the key obstacle of HBV cure. Gut. 2023 May; 72(5):972-983. [29]Shen Z, Liu J, Wu J, et al.IL-21-based therapies induce clearance of hepatitis B virus persistence in mouse models. Theranostics. 2019 May 31; 9(13):3798-3811. [30]Shen Z, Zhang S, Jiang Q, et al Lipid nanoparticle-mediated delivery of IL-21-encoding mRNA induces viral clearance in mouse models of hepatitis B virus persistence.J Med Virol. 2023 Sep; 95(9):e29062. [31]Shen Z, Wu J, Gao Z, et al.Characterization of IL-21-expressing recombinant hepatitis B virus (HBV) as a therapeutic agent targeting persisting HBV infection. Theranostics. 2020 Apr 25; 10(12):5600-5612.