Role of IL-4 expression in HBsAg positive pregnant women in intrauterine transmission of HBV

Abstract

Objective To investigate the expression of IL- 4 in peripheral blood of HBsAg positive parturients in intrauterine transmission of hepatitis B virus (BIT).

Methods Epidemiological investigation was carried out on 306 HBsAg positive parturients delivered in Northwest Women and Children's Hospital of Shaanxi Province and 74 health parturientsas control group. Enzyme-linked immunosorbent assay (ELISA) was used to detect five makers of hepatitis B, real time PCR was used to detect HBV-DNA, and flow liquid chip method was used to detect IL-4 in peripheral blood of pregnant women and newborns.

Results The incidence of dominant HBV infection(DBI), occult HBV infection(OBI) and BIT were 11.44%(35/ 306), 36.60% (112/306) and 48.04% (147/306), respectively. The levels of IL- 4 in peripheral blood of HBsAg- negative parturients were significantly lower than those of HBsAg-positive parturients, NBIT group, DBI group, and OBI group ( P< 0.01).The level of IL-4 in HBeAg negative group of DBI group was significantly higher than that in OBI group ( P<0.05) and HBIT group ( P<0.05). With the increase of HBV DNA load in maternal blood, the level of IL-4 in DBI group descended ( P< 0.05). When HBV DNA load was smaller than 10 ³ IU/mL, the level of IL-4 in DBI group was significantly higher than OBI group ( P<0.05) and NBIT group ( P<0.01), and descended with the increase of BIT. The level of maternal IL-4 had positive relation to the maternal HBeAg status and HBV DNA load in maternal blood. The level of maternal IL-4 had negative relation to the maternal HBeAb status in maternal blood.

Conclusions There is imbalance of Th1/Th2 cells in pregnant women, which causes the activity of IL-4 increases. Monitoring the level of IL-4 in HBsAg-positive pregnant women can predict the probability of HBV intrauterinetransmission.

Abstract

摘要： 目的 探讨HBsAg阳性孕妇外周血IL-4水平在乙型肝炎病毒 (HBV) 宫内传播中的表达变化。 方法 以陕 西省西北妇女儿童医院住院分娩的306例HBsAg阳性孕妇为病例组, 74例健康孕妇为对照组进行流行病学调查, 采用 ELISA法检测孕妇和新生儿外周血乙型肝炎5项指标, 采用实时荧光定量PCR检测HBV DNA水平, 采用流式液相芯片 法检测细胞因子IL-4水平。 结果 HBsAg阳性孕妇发生HBV宫内显性感染 (DBI) 、HBV宫内隐匿性感染 (OBI) 和HBV 宫内传播(BIT)率为11.44% (35/306) 、36.60% (112/306) 、48.04% (147/306) 。对照孕妇IL-4水平低于HBsAg阳性孕妇 组、HBV宫内未传播组(NBIT)、显性感染组 (DBI) 和隐匿性感染组 (OBI), 差异均有统计学意义 (均有 P<0.01) ; HBeAg 阴性组中DBI组的IL-4水平高于OBI组和HBIT组, 差异有统计学意义 ( P<0.05) ; 随着母血中HBV DNA载量的增高, DBI组IL-4水平呈下降趋势 ( P<0.05), 在HBV DNA载量小于10 ³ IU/mL时, DBI组IL-4水平高于OBI组 ( P<0.05) 和 NBIT组 ( P<0.01), 并且随着BIT程度的加重, 母血中IL-4水平呈增高趋势 ( P<0.05) ; 多因素分析显示：孕妇HBeAg和 HBV DNA 载量与其IL-4水平呈正相关; 孕妇HBeAb与其IL-4水平呈负相关。 结论 HBsAg阳性孕妇细胞免疫功能 紊乱导致IL-4水平升高, 开展HBsAg阳性孕妇外周血IL-4监测对其新生儿是否发生HBV宫内传播可能具有一定预测 作用。