Cytokine profile of viral and autoimmune chronic active hepatitis

Background: Patients with hepatitis have multiple immunologic abnormalities, which may be related to cytokine production. Methods: We examined the in vitro production of interleukins (IL-2, IL-4, IL-6), tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in purified peripheral blood mononuclear cells (PBMCs) of patients with hepatitis B virus positive (HBV), acute viral hepatitis (A-HBV), HBV + chronic active hepatitis (HBV-CAH), and autoimmune-type chronic active hepatitis (AI-ACH). Results: IFN-γ and TNF-α production were characteristically higher in patients with A-HBV than in healthy control subjects ( p < 0.001). However, patients with AI-CAH produced highly elevated levels of IL-4 and IL-6 compared with patients with A-HBV and HBV-CAH and healthy control subjects. The cytokine profile (PBMC-induced IL-2, IL-4, IL-6, IFN-γ, and TNF-α production) is different in A-HBV, HBV-CAH, and AI-CAH disease. The increased cytokine secretion (IFN-γ and TNF-α in A-HBV and IL-4 and IL-6 in AI-CAH) could reflect altered relative frequencies of different cell phenotypes in these diseases. Conclusion: Specific eytokine production may be important in the pathophysiology associated with diverse inflammatory states in patients with hepatitis.