不同干扰素应答慢性乙型肝炎患者的基因组DNA甲基化谱差异分析

α干扰素,包括长效干扰素——聚乙醇化α干扰素(PEG-IFNα),是临床用以治疗慢性乙型肝炎的首选药物。但干扰素治疗通常只能在有限的患者中获得完全应答。目前干扰素治疗应答相关指标预测的灵敏度与特异度远未令人满意,因此继续寻找潜在的与干扰素疗效预测相关的分子标记仍是一个十分有意义的工作。为探讨慢性乙型肝炎患者基因组DNA甲基化状态与干扰素治疗疗效的关系,本研究采用RocheNimbleGen人甲基化DNA免疫共沉淀-芯片(MeDIP-chip)技术,分析20例不同干扰素疗效慢性乙型肝炎患者的血浆基因组启动子甲基化谱差异,并利用MeDIP-定量聚合酶链反应(MeDIP-qPCR)检验部分基因启动子区域DNA甲基化的水平。结果显示,与快速应答组相比,无应答组中有588个基因启动子区甲基化水平存在显著差异(P0.05)。这些基因主要涉及多个信号通路,即钙离子信号通路、细胞周期调节通路、肝脏代谢相关通路等。MeDIP-qPCR验证与芯片结果的一致性超过80%。本研究为探讨差异甲基化基因在干扰素应答中的作用及发现潜在的预测干扰素疗效的血液分子标记奠定了基础。     

A phase-II study of pegylated interferon alfa-2b for patients with metastatic renal cell carcinoma and removal of the primary tumor

Twenty-two patients with metastatic renal cell carcinoma and removal of the primary tumor were treated with subcutaneous pegylated interferon alfa-2b (PEG-Intron) to evaluate toxicity and efficacy. Start dose was 3.0 g/kg/week, escalated to 6.0 g/kg/week. After 2 months, therapy was extended in case of response or stable disease (SD) until progressive disease (PD) or relapse for a maximum of 2 years. National Cancer Institute common toxicity criteria (NCI-CTC) were monitored every 2–4 weeks. After 2 months, nine patients did not continue (8 PD, 1 SD with grade 4 CTC) and 13 extended treatment [three partial response (PR), 10 SD], of these, 11 progressed. One patient with PR developed a durable complete response later. Overall response rate was 13.6% (3/22). Median overall survival is 13 months (range 3–35 months). Dosage was escalated to 6 g/kg/week in three patients . NCI-CTC grade 2 and 3 required dose attenuation in 12 patients during escalation, and reduction in 10 during the trial. Three patients discontinued because of grade 4 CTC (two fatigue, one hyperglycemia). Fatigue was the major dose-limiting toxicity. These results suggest an efficacy and toxicity of PEG-Intron comparable to standard interferon alfa-2b in patients with mRCC and removal of the primary tumor.Author disclosure declaration: None of the authors has a relationship with pharmaceutical companies, biomedical device manufacturers or other corporations whose products or services are related to the subject matter of the submission, nor do the authors have financial interests such as investments, licensing, or other commercial interest in any drugs, goods, or services in connection with the matter under consideration.     

Suppressor of cytokine signaling (SOCS) 1 inhibits type I interferon (IFN) signaling via the interferon alpha receptor (IFNAR1)-associated tyrosine kinase Tyk2

Type I IFNs are critical players in host innate and adaptive immunity. IFN signaling is tightly controlled to ensure appropriate immune responses as imbalance could result in uncontrolled inflammation or inadequate responses to infection. It is therefore important to understand how type I IFN signaling is regulated. Here we have investigated the mechanism by which suppressor of cytokine signaling 1 (SOCS1) inhibits type I IFN signaling. We have found that SOCS1 inhibits type I IFN signaling not via a direct interaction with the IFN α receptor 1 (IFNAR1) receptor component but through an interaction with the IFNAR1-associated kinase Tyk2. We have characterized the residues/regions involved in the interaction between SOCS1 and Tyk2 and found that SOCS1 associates via its SH2 domain with conserved phosphotyrosines 1054 and 1055 of Tyk2. The kinase inhibitory region of SOCS1 is also essential for its interaction with Tyk2 and inhibition of IFN signaling. We also found that Tyk2 is preferentially Lys-63 polyubiquitinated and that this activation reaction is inhibited by SOCS1. The consequent effect of SOCS1 inhibition of Tyk2 not only results in a reduced IFN response because of inhibition of Tyk2 kinase-mediated STAT signaling but also negatively impacts IFNAR1 surface expression, which is stabilized by Tyk2.     

Immunity-related GTPase M (IRGM) proteins influence the localization of guanylate-binding protein 2 (GBP2) by modulating macroautophagy

The immunity-related GTPases (IRGs) are a family of proteins induced by interferon-γ that play a crucial role in innate resistance to intracellular pathogens. The M subfamily of IRG proteins (IRGM) plays a profound role in this context, in part because of the ability of its members to regulate the localization and expression of other IRG proteins. We present here evidence that IRGM proteins affect the localization of the guanylate-binding proteins (GBPs), a second family of interferon-induced GTP-binding proteins that also function in innate immunity. Absence of Irgm1 or Irgm3 led to accumulation of Gbp2 in intracellular compartments that were positive for both the macroautophagy (hereafter referred to as autophagy) marker LC3 and the autophagic adapter molecule p62/Sqstm1. Gbp2 was similarly relocalized in cells in which autophagy was impaired because of the absence of Atg5. Both in Atg5- and IRGM-deficient cells, the IRG protein Irga6 relocalized to the same compartments as Gbp2, raising the possibility of a common regulatory mechanism. However, other data indicated that Irga6, but not Gbp2, was ubiquitinated in IRGM-deficient cells. Similarly, coimmunoprecipitation studies indicated that although Irgm3 did interact directly with Irgb6, it did not interact with Gbp2. Collectively, these data suggest that IRGM proteins indirectly modulate the localization of GBPs through a distinct mechanism from that through which they regulate IRG protein localization. Further, these results suggest that a core function of IRGM proteins is to regulate autophagic flux, which influences the localization of GBPs and possibly other factors that instruct cell-autonomous immune resistance.     

胸腺五肽联合干扰素治疗慢性湿疹的疗效观察

目的：探讨胸腺五肽联合干扰素治疗慢性湿疹的临床效果及安全性。方法：随机将2009-2012年我科收治的60例慢性湿疹患者分为两组,治疗组30例在给予相应的抗组胺药、非特异性抗过敏治疗的基础上加用胸腺五肽针10mg与干扰素α-2b200万u交替肌注,对照组30例只给予抗组胺药、非特异性抗过敏治疗,两组均在3周后观察其治疗效果及不良反应的发生情况。结果：治疗三周后,治疗组总有效率为70％,对照组总有效率为33．33％,两组总有效率比较差异有统计学意义（P〈0．05）。两组不良反应的发生率比较并无统计学差异（P〉0．05）。结论：胸腺五肽联合干扰素治疗慢性湿疹的临床疗效显著,副作用较小,安全性较高,值得临床推广应用。     

病毒唑及其与干扰素联合对慢性乙型肝炎抗病毒效应观察

本文报道了病毒唑及其与干扰素联合对23例慢乙肝近、远期抗病毒效应观察结果,并与12例未经抗病毒治疗的慢乙肝作对照(Ⅲ组),其中病毒唑与干扰素联合组(I组)12例,病毒唑组(Ⅱ组)11例。近期HBeAg、DNAP及HBV·DNA阴转率,I组分别为(41.6％、55.5％及28.s％,Ⅱ组45.4％、100％及33.3％,Ⅲ组8.3％、16.6％及8.3％。远期HBeAg及DNAP阴转率在I组分别为70％、83.7％。Ⅱ组60％、100％,Ⅲ组8.3％,50％。综合抗病毒效应,近期有效率在I、Ⅱ、Ⅲ组分别为50％、72.7％及16.6％。远期则分别为70％、55.5％及8.3％。无一例出现毒副反应。均完成疗程。上述结果提示病毒唑及其与干扰素联合对慢乙肝均有一定抗病毒效应,联合应用并不优于单一用药,但毒副反应也未见加重,而且病毒唑药源较方便,使用较安全,值得进一步研究。