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Extract of Periplaneta Americana upregulating the Th1 response in chronic viral hepatitis B (CHB) patients
From AASLD 2011 (strange report and strange acceptance of this report in AASLD poster session):

Extract of Periplaneta Americana upregulating the Th1 response in chronic viral hepatitis B (CHB) patients
J. Wei1
1. Infectious disease and liver disease , The 1st affiliated hospital of Kunming Medical College and The 2nd people's hospital of Yunnan province, Kunming, Yunnan province, China.


Backgroud and Aim: Although have several nucleos(t)ide and interferon-alpha shown certain efficacy in anti chronic HBV infection, the ratio of sustain viral responses and HBeAg seroconvension have not arrived ideal treatment objective yet. Extract of Periplaneta Americana (EPA) as a traditional Chinese medicine to treat CHB approved by State of Food and Drug Administration of China (SFDA) in 2005. Owing to the mechanism of EPA to treat CHB still remain unknown; this study is to investigate the immunoregulation role of EPA in CHB patients.

Methods: 24 HBeAg-positive CHB patients were received 24 weeks oral administration EPA 200mg twice a day. All patients peripheral blood mononuclear cells (PBMCs) CD4+ T helper lymphocytes were detected intracellular IFN-gamma(Th1), IL-4(Th2) respectively in 0, 4, 8, and 24 weeks by flow cytometry.

Results: The serum HBV DNA levels of all patient are 7.44±2.53 log10 copies/mL. 24 weeks post-treatment HBV DNA levels suppression to 6.61±3.25 log10 copies/mL. 6 patients HBeAg disappear, of 5 patients anti-HBe seroconversion, all of 6 patients HBV DNA suppression<3 log10 copies/mL. The ratio of Th1 cells are significant increasing post-treatment 4 weeks compare with pre-treatment(18.87±9.59 vs. 14.07±10.47, p <0.05).24weeks treatment all patients have good tolerance and no sever adverse events happened. Conclusions: Th1 and Th2 lymphocytes imbalance have been proved play a crucial role in persistent of Hepatitis B virus. Th1 Cells which produce IFN-gamma are benefit to anti-viral immunoresponse. In this study the EPA shown play a significant role in upregulating Th1 differentiation thus lead HBV DNA suppression and HBeAg disappear or anti-HBe seroconversion. EPA provides a novel choice to treat CHB.
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