胰岛素抵抗影响慢性乙型肝炎干扰素治疗病毒

XinWang团队在AsianPacificAssociationfortheStudyoftheLiver主办的APASLSingleTopicConference进行大会论文交流，首次提出胰岛素抵抗下调了慢性乙型肝炎患者干扰素治疗早期TLR9信号通路表达与功能；并且指出慢性乙型肝炎干扰素治疗早期，机体TLR9信号通路的上调有利于未来获得更满意的病毒学应答。这是继XinWang团队在全球首次提出胰岛素抵抗影响慢性乙型肝炎干扰素治疗病毒学应答结局之后，对其机制的深入分析与揭示，有利于指导临床针对不同慢性乙型肝炎患者进行个体化治疗，以提高干扰素治疗方案的病毒学应答。

为了更好地理解这项研究，将在未来进行连续的详细介绍，本期将对XinWang团队首次提出的胰岛素抵抗影响慢性乙型肝炎干扰素治疗病毒学应答结局研究进行详细介绍。

Goals:Toelucidateimpactofinsulinresistance(IR)ontheresponsetointerferon-α(IFN-α)therapyinchronichepatitisB(CHB)patients.

Background:MetabolicfactorsinfluencingthevirologicalresponseofCHBpatientsonIFN-αtreatmentarestillunexplored.

Study:EightyCHBpatientsweretreatedwithIFN-αfor48weeks.TheIRwasevaluatedbyhomeostasismodelassessmentofIR(HOMA-IR)beforetreatment.Viralloadandbiochemicalparametersweremeasuredat12,24,and48weeksafterstartingtreatment,andthen24weeksaftertheendoftreatment.IFN-γandtumornecrosisfactor-αweretestedatbaselineand12weeksoftreatment.

Results:PretreatmentHOMA-IRprovedtobetheonlyindependentpredictorofprimarynon-response,aswellasthepretreatmentHOMA-IR,viralloadandprimarynon-responsewereindependentlyassociatedwithvirologicalresponseat24,48weeksoftreatmentandatthefollow-upendpoint.ThesignificanthighervirologicalrelapserateinpatientswithIRwasobservedinpatientswithvirologicalresponseat48weeksoftreatment.ThemeanHOMA-IRwassignificantlylowerinvirologicalrespondersthaninvirologicalnon-responders.ThesecretionofIFN-γandtumornecrosisfactor-αwasnotinducedinpatientswithIRat12weeksafterIFN-α?treatment.

Conclusions:OurdatasuggestthatIRisstronglyassociatedwithvirologicalresponse,thusreflectingtheimportantroleplayedbymetabolicfactorsintheviralkineticsduringIFN-αtreatment.ThesefindingssuggestedclinicalapplicationofpretreatmentHOMA-IRcouldenabletreatmentout







































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