病毒性肝炎及肝細胞癌循環面免疫複合體之研究

• Main Authors: CAI, RONG-FA, 蔡榮發
• Other Authors: CAI, RUI-XIONG
• Format: Others
• Language: zh-TW
• Published: 1990
• Online Access: http://ndltd.ncl.edu.tw/handle/53538005155989274390

博士 === 高雄醫學院 === 醫學研究所 === 79 === In order to evaluate the role of circulating immune complexed (CIC) in the pathogenesis of acute viral hepatitis and hepatitis B surface antigen (HBsAg)-positive chronic liver diseases, immunoglobulin and HBsAg-specific immune complex assays have been developed in this study. IgM-CIC is the predominant CIC in acute viral hepatitis and chronic hepatitis B with hepatitis delta virus (HDV) superinfection, whereas IgG-CIC is the predominant CIC in HBsAg-positive chronic liver diseases. CIC may be related to hepatocellular damage in acute hepatitis B and hepatitis non-A, non-B, chronic hepatitis B, and chonic hepatitis B with HDV superinfction. In addition, HBsAg-CIc may be related to replicative state of hepatitis B virus. Hepatocellular carcinoma (HCC) may synthesize complements irrespective of impaired liver function. There was association between complement levels and alpha-fetoprotein (AFP) levels. There was shifting of CIC from complement-fixing to noncomplement-fixing as AFP level increased. 3% Polyethylene glycol (PEG)-CIC and 4% PEG-CIC were associated, in a dose related fashion, with an increased risk for developing HCC. In addition, they can be used as complementary markers to AFP for detection of HCC in patients with liver cirrhosis. 3% PEG-CIC can be used as a marker to monitor therapy with 為探討循環免病複合體（Circulating Immune Complexes ; CIC）在急性病毒性肝炎 及Ｂ型肝炎表面抗原（Hepatitis B surface antigen ; HBsAg ）陽性慢性肝細胞疾 病病因上擔當的角色，本研究發展出免疫球蛋白特異性及HBsAg特異性CIC測定法，做 為研究的主要工具． IgM-CIC是急性病毒性肝炎及慢性Ｂ型肝炎併Ｄ型肝炎次加感染時主要的CIC．IgG-CI C是HBsAg陽性慢性肝細胞痴病的主要CIC． 在急性Ｂ型肝炎，急性非Ａ非Ｂ型肝炎，慢性Ｂ型肝炎，及慢性Ｂ型肝炎併Ｄ型肝炎 次加感染時，CIC與肝細胞壞死的機轉有關．而HBsAg-CIC則與Ｂ型肝炎的複製狀態有 關． 儘管肝細胞癌常伴有肝機能異常，它可合成補體．補體的濃度與甲型胎兒蛋白（ alpha-fetoprotein ; AFP）濃度有關．當AFP濃度增加時，肝細胞癌病人CIC 由補體 結合性轉變成非補體結合性． 肝細胞癌病人IgG-CIC濃度增加．發生肝細胞癌的相對危險性，3%PEG (Polyethylene glycol-CIC及4% PEG-CIC可做為AFP的互補性腫瘤標記．此外，3%PEG-CIC可做為肝細 胞癌病人接受經導管動脈栓塞治療時追蹤治療效果的指標.