CYTOKINE PROFILE OF VIRAL AND AUTOIMMUNE CHRONIC ACTIVE HEPATITIS

Background. Patients with,hepatitis have multiple immunologic abnormal ities, which may be related to cytokine production. Methods: We examin ed the in vitro production of interleukins (IL-2, IL-4, IL-6), tumor n ecrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) in purified peripheral blood mononuclear cells (PBMCs) of patients with h epatitis B virus positive (HBV), acute viral hepatitis (A-HBV), HBV+ c hronic active hepatitis (HBV-CAH), and autoimmune-type chronic active hepatitis (AI-ACH). Results. IFN-gamma and TNF-alpha production were c haracteristically higher in patients with A-HBV than in healthy contro l subjects (p < 0.001). However, patients with AI-CAH produced highly elevated levels of IL-4 and IL-6 compared with patients with A-HBV and HBV-CAH and healthy control subjects. The cytokine profile (PBMC-indu ced IL-2, IL-4, IL-6, IFN-gamma, and TNF-alpha production) is differen t in A-HBV, HBV-CAH, and AI-CAH disease. The increased cytokine secret ion (IFN-gamma and TNF-alpha in A-HBV and IL-4 and IL-6 in AI-CAH) cou ld reflect altered relative frequencies of different cell phenotypes i n these diseases. Conclusion: Specific cytokine production may be impo rtant in the pathophysiology associated with diverse inflammatory stat es in patients with hepatitis.