소화기 ; 유전자형 1형 만성 C형 간염 환자에서 혈청 인터페론감마유도단백질-10의 의미 = Gastroenterology ; The clinical significance of interferon inducible protein-10 in patients having chronic hepatitis C with genotype I

국문 초록 (Abstract)

목적: 최근 1형 만성 C형 간염 환자에서 CXC 케모카인중 하나인 IP-10의 치료 전 혈중 농도가 지속적 바이러스 반응을 예측할 수 있는 주요한 인자일 수 있다는 보고들이 있었다. 이에 본 연구에서는 국내의 1형 만성 C형 간염 환자에서 페그인터페론과 리바비린 병용 투여 시 T 림프구 특이성 케모카인인 IP-10의 혈중 농도 변화와 이들과 여러 바이러스 반응들 간의 연관성을 알아보고자 하였다. 방법: 유전자형 1형 만성 C형 간염으로 진단받고 초 치료로써 페그인터페론과 리바비린 병용 치료를 받은 환자 36명을 대상으로 진행하였다. 보관되어 있는 환자 혈청을 이용하여 치료 시작 1개월 전과 1개월 후의 IP-10 수치를 각각 측정하였으며, 치료 전 IP-10 수치와 여러 바이러스 반응과의 관계 및 치료 전과 치료 후의 IP-10 수치 변화와 여러 바이러스 반응과의 관계에 대하여 연구하였다. 결과: 환자의 나이는 평균 53.5±10세이고, 21명(58%)이 남자였으며, 치료 전 HCV RNA의 평균은 5.7±0.9 log10 IU/mL이었고, IP-10 정량 결과는 평균 432.2±343.7 pg/mL이었다. 치료 전 환자의 IP-10 정량 값과 HCV RNA 정량 값은 양의 상관관계를 나타내었으나, 통계적으로는 유의하지 않았다. 치료 전 환자의 IP-10의 평균값은 432.2±343.7 pg/mL이었고, 치료 1개월 후의 IP-10의 평균값은 306.5±246.1 pg/mL로 그 감소 정도는 유의하였다(p=0.033). 여러 바이러스 반응과 치료 전 IP-10치의 관계에 대한 분석에서 바이러스 반응 유무에 따른 치료 전 IP-10 값에는 유의한 차이를 발견할 수 없었다. 각각의 바이러스 반응을 보인 군과 그렇지 않은 군에서치료 전과 치료 후의 IP-10의 변화를 확인해 본 결과 바이러스 반응의 유무에 관계없이 전반적으로 치료 후 IP-10 값은 감소하는 모습이었으나 대체로 통계적으로 유의한 수준은 아니었다. 결론: 치료 전 IP-10 수치와 치료 한 달 전과 한 달 후의 IP-10 수치의 변화는 지속적 바이러스 반응의 예측인자는 아니었다. 하지만 더 큰 규모의 연구를 통하여 IP-10 수치와 바이러스 반응과의 관계를 규명하는 것이 필요하겠다.

다국어 초록 (Multilingual Abstract)

Background/Aims: Recent studies have shown that serum interferon γ-inducible protein-10 (IP-10) concentration decreased after pegylated interferon and ribavirin therapy, and was associated with a sustained virologic response (SVR). The aim of this study was to investigate the clinical significance of the pretreatment IP-10 level and change in serum IP-10 level between 1 month before and after treatment and its association with various virologic responses in patients having chronic hepatitis C (CHC) with genotype 1 undergoing pegylated interferon and ribavirin therapy. Methods: Thirty-six patients having CHC with genotype I undergoing pegylated interferon and ribavirin therapy who had available stored sera 1 month before and after treatment were enrolled retrospectively. Serum IP-10 levels were measured by ELISA. Serum HCV RNA was measured by RT-PCR (detection limit<50 IU/mL). Results: The mean age of patients (n=36; 21 men) was 53.5 years, and the mean of pretreatment HCV RNA levels was 5.7 log10 IU/mL. The serum IP-10 level at 1 month after treatment significantly decreased from 432.2 to 306.5 pg/mL (p=0.033). The rate of rapid virologic response (RVR), early virologic response (EVR), end-of-treatment response (ETR), and SVR were 58%, 83%, 74%, and 57%, respectively. No significant difference in pretreatment IP-10 levels was observed between the patients with (RVR, EVR, ETR, and SVR) and without various virologic responses (p>0.05). The change in serum IP-10 between 1 month before and after treatment had no clinical meaning based on various virologic responses (p>0.05). Conclusions: The level of pretreatment IP-10 and change in IP-10 level between 1 month before and after treatment were not predictive factors of a SVR. Additional large-scale studies to determine the SVR-predicting role of serum IP-10 levels in patients with CHC are needed. (Korean J Med 79:652-660, 2010)

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