Multiple cytokine profiling of the therapeutic responses to ribavirin and pegylated interferon-alpha2b using an "induction" approach with natural interferon-beta in difficult-to-treat chronic hepatitis C

J Interferon Cytokine Res. 2009 Jun;29(6):353-68. doi: 10.1089/jir.2008.0110.

Abstract

Cyclic and periodic IFN treatment (CPIT) consisting of induction treatment with nIFN-beta followed by maintenance treatment with IFN-alpha could prevent viral breakthrough and achieve rapid virological response (RVR) and early virological response (EVR) in chronic hepatitis C (CHC). The efficacy and immune response of RBV+PEG-IFN-alpha2b using induction approach with CPIT (novel combination treatment: NCT) in 7 CHC patients with genotype 1b and high viral load were evaluated. A biometric multiplex serum cytokine assay was utilized to characterize the immunomodulatory effect. RVR and EVR were 7/7 and 7/7, respectively. Viral titers dropped below detectable levels in five patients with sustained virological response (SVR) before the end of CPIT (early virological responder: EAVR), and two patients without SVR after the end of CPIT (late virological responder: LAVR). At baseline, in EAVR compared with the controls, IL-6 and IL-15, CXCL-8 and CXCL-10 levels were significantly higher (P < 0.05); IL-10 and IL-13 levels were significantly lower (P < 0.05); and the IL-12 level was lower. In LAVR, GM-CSF, CXCL-8 and CXCL-10, and CCL-4 levels were significantly higher (P < 0.05); and IL-10 and IL-12 were lower than the controls. In EAVR but not LAVR, the IL-12 increased and the CCXL-8 decreased significantly (P < 0.05). In conclusion, NCT-induced viral clearance leading to improvement in the innate immune response resulting in SVR in CHC with genotype 1b and high viral load.

MeSH terms

  • Adult
  • Cytokines / blood
  • Cytokines / genetics
  • Cytokines / immunology*
  • Drug Resistance, Viral
  • Drug Therapy, Combination
  • Female
  • Gene Expression Profiling
  • Hepacivirus / immunology*
  • Hepacivirus / pathogenicity
  • Hepatitis C Antibodies / blood
  • Hepatitis C Antibodies / genetics
  • Hepatitis C, Chronic / blood
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / immunology*
  • Hepatitis C, Chronic / therapy
  • Humans
  • Interferon alpha-2
  • Interferon-alpha / therapeutic use*
  • Interferon-beta / administration & dosage
  • Male
  • Middle Aged
  • Polyethylene Glycols / therapeutic use*
  • Recombinant Proteins
  • Ribavirin / therapeutic use*
  • Serologic Tests
  • Transcriptional Activation / drug effects
  • Transcriptional Activation / immunology
  • Treatment Outcome
  • Viral Load
  • Virulence / drug effects
  • Virulence / immunology

Substances

  • Cytokines
  • Hepatitis C Antibodies
  • Interferon alpha-2
  • Interferon-alpha
  • Recombinant Proteins
  • Polyethylene Glycols
  • Ribavirin
  • Interferon-beta
  • peginterferon alfa-2a