CYTOKINE PROFILE OF VIRAL AND AUTOIMMUNE CHRONIC ACTIVE HEPATITIS

Background. Patients with,hepatitis have multiple immunologic abnormalities, which may be related to cytokine production. Methods: We examined the in vitro production of interleukins (IL-2, IL-4, IL-6), tumor necrosis factor-alpha (TNF-alpha), and interferon-gamma (IFN-gamma) in purified peripheral blood mononuclear cells (PBMCs) of patients with hepatitis B virus positive (HBV), acute viral hepatitis (A-HBV), HBV+ chronic active hepatitis (HBV-CAH), and autoimmune-type chronic active hepatitis (AI-ACH). Results. IFN-gamma and TNF-alpha production were characteristically higher in patients with A-HBV than in healthy control 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-induced IL-2, IL-4, IL-6, IFN-gamma, and TNF-alpha production) is different in A-HBV, HBV-CAH, and AI-CAH disease. The increased cytokine secretion (IFN-gamma and TNF-alpha in A-HBV and IL-4 and IL-6 in AI-CAH) could reflect altered relative frequencies of different cell phenotypes in these diseases. Conclusion: Specific cytokine production may be important in the pathophysiology associated with diverse inflammatory states in patients with hepatitis.