만성 B형간염에서 간 조직내 TGF-p1과 a-SMA 단백질의 발현정도와 인터페론 치료효과와의 상관관계

Backg round/Aims : The aim of this study was to evaluate the effect of α- interferon (IFN) on liver histology as well as on activation of hepatic stellate cell ( HSC) and trans for ming growth fact or β- 1 (TGF β- 1) expression. We had also investigated the clinical usefulness of TGFβ- 1 and α- smooth muscle actin (α- SMA) expression in liver tissue for predicting a response toα- IFN therapy in chronic hepat it is B. Methods : We studied the expression of TGFβ-1 and α- SMA in liver biopsys pecimens from 51 chronic hepatitis B pat ients . Using immunohistochemical staining and a semiquant it ative scoring met hod, we also evaluated TGF- β1 and α- SMA expression in liver stellate cells before and after α- IFN therapy in liver tissue from rebiopsys pecimen of the 12 chronic hepatitis B pat ients . Recombinant IFN α- 2b (Intron A) in doses of 6 MU/ d was given to patients intramus cularly three times per week for 6 months ( total doses , 432 MU). The patients were divided into two groups according to serum alanine aminotransferase levels as well as HBV- DNA and HBeAg s eroconversion stat e. Histological grading and staging scores were according to modified Histological Activity Index (HAI) gradingsys tems of Ishak ( 1995). Results : The index of portal inflammation and total scores of HAI grading significantly decreased in biopsies afterα - IFN t reat ment, but the scores of fibrosis staging showed no significant change in biopsies after IFN t reat ment. A significant decrease in α- SMA expression, especially in periportal area, was found, but the change of TGFβ- 1 expression was not significant. The immunoreactivity of α- S MA was significantly lower in responders than in non-res ponders , whereas the diffference of immun or eactivity of TGFβ - 1 between these two groups was not found. Conclusions : These findings suggest that α- IFN therapy may reduce the necroinflammatory activity in liver tissues of chronic B viral hepatitis and that the degree of - S MA ex pression before treatment may be employed as a pottent predicting indicat or for the therapeutic efficacy of IFN- alfa.(Korean J Hepatol 1998;4:317 329)