Serum interferon gamma in primary biliary cirrhosis: effect of ursodeoxycholic acid and prednisone therapy alone and in combination

Background Interferon-gamma may have immunopathogenic importance in primary biliary cirrhosis, stimulating aberrant expression on biliary epithelium o f class II major histocompatibility molecules and inter-cellular adhesion m olecule-1. Liver transcripts for interferon-gamma are found in primary bili ary cirrhosis. Its serum level is increased in pretransplantation stages an d decreases after transplantation. Objectives (1)To verify whether serum interferon-gamma levels are increased in non-cirrhotic stages of primary biliary cirrhosis. (2) To evaluate the effect of ursodeoxycholic acid and prednisone alone and in combination on s erum levels of interferon-gamma and soluble inter-cellular adhesion molecul e-1. Methods Nine non-cirrhotic, anicteric patients with primary biliary cirrhos is (patient test group), 14 healthy, negative controls and 14 positive cont rols, with chronic hepatitis related to hepatitis C virus were studied in b asal condition. Primary biliary cirrhosis patients were treated with ursode oxycholic acid, prednisone and the association of the two drugs for three 4 -week periods, each period separated by a 4-week wash-out, Interferon-gamma and soluble inter-cellular adhesion molecule-1 were measured in serum by c ommercially available immuno-enzymatic kits. Results Median interferon-gamma levels were increased in patients with prim ary biliary cirrhosis compared with healthy controls (44 vs 19 pg/ml; P < 0 .01) but similar to those in chronic hepatitis patients (47 pg/ml). Serum s oluble inter-cellular adhesion molecule-1 was significantly reduced by urso deoxycholic acid, and an even greater reduction was obtained on addition of prednisone. No treatment affected interferon-gamma levels. Conclusion Serum interferon-gamma is increased in noncirrhotic patients wit h primary biliary cirrhosis, but this is not disease-specific. Neither urso deoxycholic acid, nor prednisone, nor the combination of the two drugs infl uenced this immunological pathway of primary biliary cirrhosis, Lippincott Williams & Wilkins.