C- Phycocyanin Effect on IFN-γ Production in Patients with Chronic

Transcription

Egyptian Journal of Medical Microbiology, April 2009
Vol. 18, No. 2
C- Phycocyanin Effect on IFN-γ Production in Patients with
Chronic Hepatitis C Infection: In vitro Study
Osama M. Basha,* Sahar G. Zaghloul,* Refat A. Sadeq,** Raghda A. Hafez,**
Mohammad A.A. El-Mohsen,* Yassin M. El-Ayoty ***
*
Department of Internal Medicine, ** Department of Microbiology, Faculty of
Medicine, Zagazig University, *** Department of Botany, Faculty of Science,
Zagazig University, Egypt
ABSTRACT
Hepatitis C virus (HCV) is a serious global health threat and current medical treatment options are
limited. Gama interferon (IFN-γ) is an important pro-inflammatory cytokine with antiviral activity
however, the mechanism of its action as anti-hepatitis C treatment remains unclear. Many studies suggest
that priming with IFN-γ prior to initiation of INF-γ treatment has a beneficial effect in some cases of
chronic hepatitis C infected patients through changing the balance of cytokines in favour of a Th-1 type
response in the host. C-phycocyanin is a water-soluble biliprotein from the filamentous Cyanobactrium
spirulina platenesis with a potent antioxidant, anti-inflammatory and anti cancerous properties. In this
study we investigated the effect of C-phycocyanin on the production of IFN-γ from the peripheral blood
mononuclear cells (PBMC) obtained from patients with chronic hepatitis C with different degrees of liver
disease severity. We obtained two groups of blood; the first was from healthy volunteers as a control
group and the second was from patients with hepatitis C virus infection. Both groups were subjected to
phycocyanin and phytoheamaglutinin as stimulators of the release of interferon gamma from the PBMC.
We found that in both groups the level of IFN-γ production without addition of phycocyanin or
phytoheamaglutinin was less than after addition of 5ul or 10 ul of phycocyanin. Also the results showed
that the mean level of IFN-γ production in the diseased group was higher than that of the control group.
Among the diseased group the production was much higher in class B subgroup (Child B)sss. The safety
of Spirulina and its content C-phycocyanin and its immune stimulatory effects encourage us to
recommend its use in vivo study specially in chronic hepatitis C patients who failed to respond to or unfit
for the classical interferon therapy.
Key wards: Hepatitis C-virus (HCV), C-phycocyanin (C-Pc), Gama interferon (IFN-γ)
and interleukin I secretion,(5) antioxidant
effects,(6) anticancer(7) and antiviral effects as it
affects the replications of several viruses
including Herpes simplex type I, human
cytomegalo virus, measles, mumps, influenza A
virus and HIV-I virus.(8)
Spirulina
contains
mainly
two
phycobiliproteins, namely C-phycocyanin (CPC) and allophycocyanin (A-PC) approximately
at a ratio of 10:1.(9) C-phycocyanin comprises a
protein and chromophore. The protein moiety
consists of α and β subunits of molecular weight
in the range of 18.000 and 20.000, respectively
and exist as a complex interacting mixture of
trimer, hexamer and decamer aggregates.(10)
Many reports proved that C-PC has many
pharmacological characteristics including antiinflammatory,
anti-oxidant,(11)
radical
scavenging
activities,(12)
inhibits
cyclooxygenase-2(13) and has anti-tumor activity.(14)
Hepatitis C virus infects an estimated 170
million person's world wide.(15) In most infected
INTRODUCTION
Natural compounds from blue green algae
have attracted a great deal of interest as
physiologically functional food supplements and
several bioactive metabolites have been
successfully developed into clinically useful
drugs.(1) More than 60 % of anti-cancer and 70
% of anti-infective antibiotics currently in
clinical use are natural product or natural
product-based.(2) Spirulina has long history of
use as food. Its name derives from the spiral or
helical nature of its filaments. There are reports
that it was used as food in Mexico during Aztec
civilization. It is still used as food in the lake
Chad area where it is sold as dried bread called
dihe.(3) Spirulina has a rich content of protein,
vitamins, essential amino acids, minerals and
essential fatty acids.(4) Many researches proved
that Spirulina and its extracts have many
pharmacological benefits as immunmo-dulatory
function with stimulatory effects on interferon
81
Vol. 18, No. 2
according to Child-Pugh classifications; class A,
B and C, each subgroup included 10 samples.
All were excluded to be free from renal, cardiac,
diabetes mellitus or autoimmune diseases
Methods
1. Liver function test:
• Serum
Alanin
amino
transferase,
Aspartate amino transferase, Alkaline
phosphatase using Bio merieux kit.
• Total direct and indirect bilirubin and
serum albumin using Diamond kits.
• Prothrombin time and INR using Diaplstin
kit.
2. Detection of viral markers in serum
• The presence of Anti-HCV antibodies
(IgG) in the serum was determined by
qualitative enzyme immunoassay.
• Viral nucleic acids extraction and
isolation. RNA in the serum was
extracted, reverse transcriped and
amplified using quantitative (PCR).The
results were interperated as copies /ml.
3. Detection of auto antibodies:
Antinuclear antibodies are assayed in all
cases of HCV group to exclude auto immune
hepatitis by indirect immuno-fluorescence.
4. Mononuclear cells (PBMC) isolation:
Under sterile safety hood, 5 ml of blood were
diluted with equal volume of phosphate
buffer solution (Biochrom AG); diluted blood
was added over Ficoll-Hypaque solution
1.077 (Biochrom AG) in a ratio of 3:1 for
each sample. The tubes were centrifuged at
2000 rpm at room temperature (22°C) for 30
minutes. The buffy coat containing the
mononuclear cells was obtained and washed
with phosphate buffer at 1:1 volume by
centrifugation at 1000 rpm for 10 minutes.
The last step was repeated for two extra times
but the last time was done with RPMI 1640
media (Furo-lone) ,(5)
5. Extraction and determination of C-PC:
C-PC was extracted from blue-green algae
according to Bousiba and Richmond(21) as
follow: 20 gm of experimental algae was
suspended in 200 ml of 0.1 sodium phosphate
buffer pH 7.2, containing 100ug/ml lysozome
and 10 ml EDTA. The enzymatic
disintegration of the cell wall occurred by
placing the algae in shaking water path at
30°C for 24 hours. The slurry centrifuged for
1 hour at 10.000 rpm to remove cell debris,
yielding a clear supernatant of C-PC. The
crude C-PC was centrifuged for 30 hours at
10.000 rpm at 40°C. C-PC was precipitated
using ammonium sulphate 75% at pH 7.2 for
individuals, this remarkable RNA virus evades
the immune system and establishes a chronic
infection that can lead to cirrhosis, end stage
liver disease and hepatocellular carcinoma.
While advances have been made in treating
HCV, the current therapy, a combination of
pegylated interferon IFN-α and ribavirin is
poorly tolerated and is effective in only 50% of
genotype I HCV- infected patients.(16) Thus, a
great need exist for more effective and better
tolerated therapies for HCV. Interferon-γ (INF–
γ) is a key player in immune response to virus
infection and its efficacy for treatment of
hepatitis C patients is under clinical trials. INF–
γ exerts multiple roles in the regulation of
inflammation and immune responses during
HCV infection and studies have suggested that it
plays a critical role in the control of HCV
infection and seems to be well tolerated.(17)
Further researches proved that in addition to
the reduction of claudin-1 expression, IFN-γ
treatment also led to significant changes in the
distribution of claudin-1, CD8, and scavenger
receptor class B type I. These receptors are
important for virus C to invade the hepatocyte or
other susceptible cells.(18,19) Other effects of
IFN-γ include enhancement of Th1 cells and
inhibition of Th2 cells, enhancement of immune
lysis of HCV infected cells, inhibition of hepatic
fibrosis by an effect on TGF-beta and has an
effect on HCV induced carcinogenesis.(20)
In this study, we tried to elucidate an
immunmodulatory role of natural safe
substances as phycocyanin in patients with
chronic viral C hepatitis through stimulation the
release of INF–γ from peripheral blood
mononuclear cell (PBMC)
SUBJECTS, MATERIALS &
METHODS
This study was performed in Internal
Medicine, Microbiology and Immunology
Departments, Faculty of Medicine, Zagazig
University and included 40 subjects. They were
divided into two main groups.
Group I: Control group, which included 10
healthy persons (6 males and 4 females their
ages ranged from 38 to 62 years) with no history
of liver diseases, negative HCV antibodies with
normal abdominal ultrasonography.
Group II: Included 30 hepatic patients (18
males and 12 females 38 to 62 years) having
chronic HCV infection previously diagnosed by
polymerase chain reaction (PCR). This group
was further subdivided into 3 subgroups
82
Vol. 18, No. 2
AST, ALT, INR, serum albumin, WBCs, PLT,
and total bilirubin. There was significant
positive correlation between the viral load, age,
AST, INR albumin and total bilirubin (Fig. 1, 2,
3, 4, 5).
6 hours. The precipitated C-PC was dissolved
in phosphate buffer and dialyzed over night
at 4°C against the name buffer.
6. Culture and stimulation of the peripheral
mononuclear cells(5):
200 ml of 1× 1000.000/ml PBMC were
recovered into RPMI 1640 media with 10%
(vol/vol) fetal bovine serum (FBs) and 1%
(wt/vol) L-glutamine, penicillin (1U/ml) and
Streptomycin (0.1 mg/ml) and incubated in
96 wells of tissue culture plate. 20 ul phytoheamaglutinin (PHA) was added to well. 5 ul
of phycocyanin, its concentration was 3.5
Mg/50ml were added to another well, and 10
ul of phycocyanin, its concentration was 3.5
Mg/50ml were added to another well. There
was another well without phycocyanin or
phyto-heamoaglutinin. The culture plates
were incubated in the incubator at 37°C, 5%
CO2 and optimum humidity. After 24 hours,
the supernatant was collected, centrifuged at
1000 rpm for 10 minutes and kept frozen at 20°C. The level of IFN-γ was measured in
the cell culture supernatant using ELISA.
7. Interferon gamma assay: (R , D . systemes)
This assay employs the quantitative
sandwhich enzyme immunoassay technique.
A polyclonal antibody specific for IFN-γ had
been per-coated into a microplate. Standards
and samples are pipetted into the wells and
any IFN-γ was bounded by the immobilized
antibody. After washing away any
unbounded substances, an enzyme-linked
polyclonal antibody specific to IFN-γ was
added. Following a wash to remove any
unbounded antibody enzyme reagent, a
substrate solution was added and colors
developed in proportion to the amount of
IFN-γ bound in the initial step. The color
development was stopped and the intensity of
the color was measured.
8. Calculation of results
Average the duplicate reading for each
standard, control, and sample and subtract the
average zero standard optical density. ELISA
reader [Stat Fox 303, made in Germany] was
adjusted at wave length 450 to read the
absorbance and four standards were used as
calibrator.
70
60
Age
50
40
30
20
10
0
0
500000
1000000
1500000
2000000
2500000
3000000
PCR
Figure (1) Correlation between viral load and
Age
160
140
120
AST
100
80
60
40
20
0
0
500000
1000000
1500000
2000000
2500000
3000000
PCR
AST
3.0
2.5
INR
2.0
1.5
1.0
0.5
0.0
0
500000
1000000
1500000
2000000
2500000
3000000
PCR
RESULTS
INR
Correlation between viral load and other
parameters
The relation of viral load and each of the
following parameters was determined; age, Hb,
83
Vol. 18, No. 2
6
350
5
300
250
PLT
Alb
4
3
2
200
150
100
1
50
0
0
0
500000
1000000
1500000
2000000
2500000
3000000
0
500
1000
Albumin
2000
2500
Figure (7) Correlation between interferon –γ
production level of and PLT
4.5
180
4.0
160
3.5
140
3.0
120
ALT
Bil
1500
Interferon γ
PCR
2.5
2.0
100
80
60
1.5
40
1.0
20
0.5
0
0.0
0
0
500000
1000000
1500000
2000000
2500000
500
3000000
1000
1500
2000
2500
Interferon γ
PCR
production level of and ALT
bilirubin
4.5
4.0
Correlation between IFN –γ and other
parameters
The relation of IFN –γ and each of the same
parameters was determined. There was
significant positive correlation between the level
of IFN–γ and Hb, PLT, ALT, total bilirubin
(Fig. 6,7,8,9).
3.5
Bil
3.0
2.5
2.0
1.5
1.0
0.5
0.0
0
1000
1500
2000
2500
production level of and bilirubin
16
14
12
HB
500
Interferon γ
18
10
Measurement of γ interferon without addition
of phycocyanin or phytohemagglutinin on
PBMNC of the two groups: in control group I;
it was 67.2 ±109.2. In group II: subgroup A; it
was 116.7 ± 128, subgroup B; it was 400.6 ±
304 and subgroup C; it was 175.2 ± 132.4.
There is statistically significant difference
among the groups K =14.9 and P =0.0018 (Fig.
10).
8
6
4
2
0
0
500
1000
1500
2000
2500
Interferon γ
production level of and Hb
84
450
A
B
C
Control
Vol. 18, No. 2
800
A
400
B
C
Control
700
350
600
300
250
500
200
400
150
300
100
200
50
100
0
A
B
C
Control
0
Figure (10) Measurement of gamma interferon
without addition of phycocyanin or phytohemagglutinin of the two groups
A
A
B
C
C
Control
after addition of 10 µl of phycocyanin on
PBMNC of the two groups
Measurement of gamma interferon after
addition of 5 µl of phycocyanin on PBMNC of
the two groups: in control group I; it was
99.87±83.3 In group II: subgroup A; it was
187.6± 148.3, subgroup B; it was 739.6 ± 730.7
and subgroup C; it was 363.7 ± 413.3. There
was statistically significant difference among
the groups (K =7.65 and P = 0.05) (Fig. 11).
800
B
Measurement of γ interferon after addition of
phyto-hemagglutinin on PBMNC of the two
groups: in control group I; it was 854.67±660
group II: subgroup A; it was 1446.5 ± 521.5,
subgroup B; it was 3336 ± 66.4 and subgroup C;
it was 2796.2 ± 744. There was statistically
significant difference among the groups (K =
31.2 and P = 0.001) (Fig. 13).
Control
3500
A
B
C
Control
700
3000
600
2500
500
2000
400
300
1500
200
1000
100
500
0
A
B
C
0
Control
A
B
C
Control
after addition of 5µl of phycocyanin on
after addition of phytohemagglutinin on
Measurement of γ interferon after addition of
10µl of phycocyanin on PBMNC of the two
groups: in control group I; it was 142.9±101.8.
In group II: subgroup A; it was 217.4 ± 172.3,
subgroup B; it was 765.1 ± 791.9 and subgroup
C; it was 447.8 ± 418.2. There was statistically
significant difference among the groups (K=16.6
and P = 0.001) (Fig. 12).
DISCUSSION
The overall majority of experimental
studies and clinical observations among patients
with HCV infection favour immune mediated
hepatocellular damage over direct viral
cytopathic effect.(22)
Recent investigations were done concerning
the benefits of gamma interferon in management
85
of chronic HCV patient especially who failed to
respond to classical interferon therapy.(25) IFN-γ
is a unique member of the IFN family. Its
receptor, signaling pathway, and cellular effects
differ from those of IFN- α and IFN-ß(26). IFN-γ
may contribute to HCV clearance in several
ways. First, it enhances NK cell activity and
induces the expression of inflammatory and
potentially antiviral cytokines such as tumor
necrosis factor alpha.(27) Second, it facilitates
induction and effector function of T cells via
upregulation of major histocompatibility
complex class I and II proteins and promotes
antigen processing via induction of immunoproteasomes.(28) Third, it facilitates T-cell
homing from lymph nodes and peripheral blood
to the site of infection via induction of T-cellrecruiting chemokines such as IFN-inducible
protein 10 (CXCL10), IFN-inducible T-cell
chemo-attractant (CXCL11) and monokine
induced by IFN- (CXCL9).(29) Further results
from confocal microscopy and Western blot
analysis showed that in addition to the reduction
of CLDN1 expression, IFN-γ treatment also led
to significant changes in the distribution of
CLDN1, CD81, and scavenger receptor class B
type I. The main receptors for viral activation.(30)
Many recent of researchers add an evidence for
the immuno-modulatory effects of phycobiliproteins.(31)
Phycobiliproteins are a small group of
highly conserved chromoproteins that constitute
the phycobilisome, a macromolecular protein
complex whose main function is to serve as a
light harvesting complex for the photosynthetic
apparatus of cyanobacteria and eukaryotic
groups.(33) The most common classes of
phycobiliproteins
are
allophycocyanin,
phycocyanin and phycoerythrin all of which are
formed of α and β protein subunits and carry
different isomeric linear tetrapyrrole prosthetic
groups.(34)
C-phycocyanin (C-PC) is one of the major
biliproteins of spirulina platensis, a blue grean
alga, with anti oxidant and radical scavenging
properties. It is also known to exhibit anti
inflammatory and anti cancer properties.
However the main mechanism of action of C-PC
is not clearly under stood.(35)
PC is composed of two dissimilar and
protein subunits of 17 000 and 19 500 Da,
respectively, with one bilin chromophore
attached to the αsubunit (α84) and two to the
subunit (β84, β155).(36)
The chemical structure of the bilin
chromophores in PC is very similar to bilirubin,
Vol. 18, No. 2
which is considered to be a physiologically
important
antioxidant
against
reactive
species.(37) It inhibits oxidative modification of
plasma proteins and aromatic amino acid
residues.(38)
In our work we found that the mean level of
INF –γ in the diseased sub groups (A, B and C)
was higher than control group in resting
condition. Also, the production of INF –γ by
PBMNCs was higher in hepatitis patients than
control group after addition of C-PC and
phytohemagglutinin .This was in agreement
with the results of Missale et al.(39) and Tsai et
al. (40) who reported higher concentration of INF
gamma in the serum of patients with chronic
viral C hepatitis. In contrast to this result Jirillo
et al. (41) reported that a significant decrease of
INF- γ was reported in patients with viral
hepatitis C. These conflicting results may be
due to changes in Th1 & Th2 responses among
patients with chronic viral hepatitis C. Also it
might be explained by the difference in study
size. Also, this work showed that INF-γ
production was higher in hepatic patient than in
control group after addition of 5 µl and 10 µl of
C-PC. This adds an evidence for the
immunmodulatory effects of phycocyanin and
supported by a group of researches from
University of California ‫ـ‬Davis(5) who reported
that Spirulina and its extracts stimulated the
secretion of interlukin-1, LL- 4 and interferon
IFN ‫ـ‬γ to nearly 2.0, 3.3, and 13.6 times basal
levels respectively. Also they reported that
induction of lFN–γ by Spirulina was found to be
comparable
to
that
seen
after
phytohemagglutinin (PHA) stimulation. In spite
it was different in our results where induction of
IFN ‫ـ‬γ by phytohemag-glutinin was higher than
that induced by phycocyanin. It may be
corrected by increasing the dose of phycocyanin
added to PBMNC. Also in paper presented at
the 30th annual meeting of the Japanese Society
for immunology. Saeki et al.(42) presented the
results of a human study using spirulina extract
and reported that lFN–γ secretion activity was
enhanced significantly after two weeks of
spirulina extract administration. Also he added
that, surprisingly, lFN–γ and NK cell activities
continued up to 6 months after administration of
extract was discontinued.
In the present work , the mean level of
IFN–γ production was increased in the diseased
group after addition of 5µl and 10µl of
phycocyanin but the increase was most obvious
in child B followed by C & lastly A.
Although many human studies showed low
level of IFN-γ in chronic HCV infection, our in-
86
vitro study showed that PBMNCs were still able
to produce IFN–γ, even in advanced stage of
liver disease, in resting state and after
stimulation by Phycocyanin with different
doses. This means that the body does not make
enough natural interferon to effectively fight
infection and the addition of exogenous help
(Phycocyanin that stimulation PBMNCs to
produce IFN-γ) may aid in fighting off the
infection. The safety of spirulina and the high
stimulatory effect of its constituent C-PC on
IFN–γ production, encourage for further in-vivo
study and on a large scale of people.
Vol. 18, No. 2
9.
10.
11.
REFERENCES
1.
2.
3.
4.
5.
6.
7.
8.
12.
Borowitzka M., A., (1995): microalgae as
sources of pharmaceuticals and other
biologically active compounds, J. Appl.
Phycol. 7,3-15.
Subhashi J., Mahipal S.V., Reddy M.C.,
et al. (2004): Molecular mechanisms in CPhycocyanin induced apoptosis in human
chronic myeloid leukemia cell line-K562,
Biochem. Pharmacol. 68 (3) 453-462.
Abdulqader G., Barsanti L. and Tredici
M. (2000): Harvest of Arthrospira platensis
from Lake Kossorom (Chad) and its
household usage among the Kanembu. J.
Appl Phycol. 12:493-498.
Belay A. and Houston M. (2002): IThe
Potential
Application
of
Spirulina
(Arthrospira) as a nutritional and therapeutic
supplement in health management. The
Journal of the American Nutraceutical
Association Vol. 5, No. 2,
Mao TK., Van de Water J. and Gershwin
ME. (2000): Effect of spirulina on the
secretion of cytokines from peripheral blood
mononuclear cells. J. Med Food; 3:135-140.
Bhat V.D. and Madhyastha K. M. (2001):
Scavenging of peroxynitrite by phycocyanin
and phycocyanobilin from Spirulina
platensis: protection against oxidative
damage to DNA. Biochem Biophys Res
Commun 285, 262-266.
Wang H., Liu Y., Gao X et al. (2007):
The recombinant B subunit of CPhycocyanin inhibits cell proliferation and
induces apoptosis Cancer letters 247, 150158.
Ayehunie S., Belay A., Baba TW. and
Ruprecht RM. (1998): Inhibition of HIV-1
replication by an aqueous extract of
Spirulina platensis (Arthrospira platensis). J
13.
14.
15.
16.
17.
18.
19.
20.
87
Acquired Immune Deficiency Syndromes
and Human Retrovirology. 18:7-12.
Bermejo R., Talavera E.M., Alvarez-pez
J.M.
and
Orte
J.C.
(1997):
Chromatographic purification of biliproteins
from spirulina platensis: High performance
liquid chromatographic separation of their
and sub units .J. Chrom. A. 778,441-450.
Glazer A.N. and Appl. J. (1994):
Phycobiliproteins – a family of valuable,
widely used fluorophores. J. Appl. Phycol.
6, 105-112.
Romay C., Armesto J., Remirez D., et al.
(1998): Antioxidant and anti-inflammatory
properties of C-phycocynin from blue-green
algae, Inflamm. Res. 47, 1:36-41.
Bhat V.B. and Madyastha K.M. (2000):
C-phycocyanin: a potent peroxyl radical
scavenger in vivo and in vitro, Biochem
Biophys, Res Commun. 275, 1:20-25.
Reddy M C., Subhashini J and Mahipal S
V. (2003): C-phycocyanin, a selective
cyclooxygenase -2 inhibitor. Biochem
Biophys Res. Commun. 304, 2:385 -92.
Roy KR., Arunasree KM., Reddy NP., et
al. (2007): Alteration of mitochondrial
membrane potential by Spirulina platensis
C-phycocyanin induces apoptosis in the
doxorubicinresistant human hepatocellularcarcinoma cell line. HepG2; 47, 3:159-67.
Major ME. and Feinstone SM. (1997):
The molecular virology of hepatitis C.
Hepatology. 25:1527-38.
Hadziyannis SJ., Sette H Jr., and
Morgan TR., et al. (2004): Peginterferon
alfa-2a and ribavirin combination therapy in
chronic hepatitis C: A randomized study of
treatment duration and ribavirin dose. Ann
Inter Med; 140:346-55.
Wei X., Jia Z., Lian J., et al. (2009):
Journal of Interferon & Cytokine Research.
29, 3:171-178.
Shin E., Protzer U., Untergasser A., et al.
(2005) : Liver-Directed Gamma Interferon
Gene Delivery in Chronic Hepatitis C.
Journal of Virology, p. 13412-13420 Vol.
79, No. 21.
Rüffer C. and Gerke V. (2004): The Cterminal cytoplasmic tail of claudins 1 and 5
but not its PDZ-binding motif is required for
apical localization at epithelial and
endothelial tight junctions. Eur J. Cell Biol.
83, 4:135-44.
Gattoni A., Parlato A., Vangieri B., et al.
(2006):
Interferon-gamma: biologic
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
Vol. 18, No. 2
31. Fairchild C.D. and Glazer A.N. (1994): J.
Biol. Chem. 269, 28988-28996.
32. Romay C., Gonzalez R., Ledon N., et al.
(2003): C-phycocyanin: a biliprotein with
antioxidant,
anti-inflammatory
and
neuroprotective effects, Curr Prot Pept Sci
4, 207-216.
33. Glazer A.N. (1988): in Methods Enzymol.
(Fleischer, S. and Parker, L. Eds.)Vol. 167,
304-312.
34. Wejestal R., Norkrans G. and Weilm O.
(1995): Lymphocyte subsets and beta 2
microglobulin expression in chronic
hepatitis C. Clin Exp Immunol 87, 3:340.
35. Reddy C.M., Bhat V.B., Kiranmai G., et
al. (2000) Biochem. Biophys. Res Commun
277, 599-603.
36. Turner L., Houghton J.D. and Brown
S.B. (1997): Planta 201, 78-83.
37. Stocker R., Yamamoto Y., McDonagh
A.F., Glazer A.N. and Ames B.N. (1987):
Science, 235, 1043-1046.
38. Neuzil J. and Stocker R. (1994): J. Biol.
Chem., 269, 16712-16719.
39. Missale G., Ferrari G. and Fiaccadori F.
(1995): Cytokine mediators in acute
inflammation and chronic course of viral
hepatitis. Ann Ital Med Int 10, I:14.
40. Tsai SL., Liaw YF., Chen MH., et al.
(1997): Detection of type 2 like Thelper
cells in hepatitis C virus infection:
Implications for hepatitis C virus chronicity.
Hepatology 25, 2:449.
41. Jirillo E., Greco B., Caradonna L. et al.
(1995): Evaluation of cellular immune
responses and soluble mediators in patients
with chronic hepatitis C virus (cHCV)
infection.
Immunopharmacol
Immunotoxicol; 2: 347–64.
42. Saeki Y., Matsumoto M., Hayashi A., et
al. (2000): The effect of Spirulina hot water
extract to the basic immune activation.
Summary of paper presented at the 30th
Annual Meeting of the Japanese Society for
Immunology. 14-16.
functions and HCV therapy (type I/II) (2 of
2 parts). 157, 5:457 - 68.
Boussiba S. and Richmond A.E. (1979):
Isolation
and
characterization
of
phycocyanin from the blue green algae
spirulina platensis. Arch. MicroBiol 120,
155-159.
Weber F., Kochs G. and Haller O.
(2004): Inverse interference: how viruses
fight the interferon system. Viral Immunol
17:498-515.
Fan XG., Yakoob J., Fan XJ., Keeling
PWN. (1995): Effect of IL-4 on peripheral
blood lymphocyte proliferation: implication
in immuno-pathogenesis of H. pylori
infection. Immunol Lett; 48:45–48.
Fan XG., Yakkob J., Fan XJ., et al.
(1996): Enhanced Th2 responses: immune
mechanism of H. pylori infection. Ir J. Med
Sci 165:37–39.
Thimme R., Bukh J., Spangenberg H. C.,
et al. (2002): Viral and immunological
determinants of hepatitis C virus clearance,
persistence, and disease. Proc. Natl. Acad.
Sci. USA 99:15661-15668.
Biron, C. A. (2001): Interferons and other
cytokines, p. 321-351. In D. Knipe and P.
Howley (ed.), Fields virology, vol. 1.
Lippincott
Williams
&
Wilkins,
Philadelphia, Pa.
Paludan S. R. (2000): Synergistic action of
pro-inflammatory agents: cellular and
molecular aspects. J. Leukoc. Biol. 67:1825.
Fruh K. and Yang Y. (1999): Antigen
presentation by MHC class I and its
regulation by interferon gamma. Curr. Opin.
Immunol 11:76-81.
Zeremski M., Petrovic L.M. and Tala
A.H. (2006): The role of chemokines as
inflammatory mediators in chronic hepatitis
C virus infection. Journal of viral hepatitis
14, 10:675-687.
Lalor P.F., Shields P., Grant A., and
Adams D.H. (2002): Recruitment of
lymphocytes to the human liver. Immunol.
Cell Biol. 80:52-64.
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‫‪Vol. 18, No. 2‬‬
‫‪Egyptian Journal of Medical Microbiology, April 2009‬‬
‫ﺗﺄﺛﻴﺮ اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﻋﻠﻰ اﻧﺘﺎج اﻻﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻓﻰ ﻣﺮﺿﻰ‬
‫اﻻﻟﺘﻬﺎب اﻟﻜﺒﺪى اﻟﻔﻴﺮوﺳﻰ اﻟﻤﺰﻣﻦ )س( ‪ :‬دراﺳﺔ ﺧﺎرج اﻟﺠﺴﻢ‬
‫اﺳﺎﻣﺔ ﻣﺤﻤﺪ ﺑﺎﺷﺎ * ‪ ،‬ﺳﺤﺮ ﺟﻮدة زﻏﻠﻮل* ‪ ،‬رﻓﻌﺖ ﻋﺒﺪ اﻟﺴﻤﻴﻊ ﺻﺎدق** ‪ ،‬راﻏﺪة ﻋﺒﺪ اﻟﻠﻄﻴﻒ ﺣﺎﻓﻆ**‪،‬‬
‫ﻣﺤﻤﺪﻋﺒﺪ اﻟﻮاﺣﺪ ﻋﺒﺪ اﻟﻤﺤﺴﻦ*‪ ،‬ﻳﺎﺳﻴﻦ اﻟﻌﻴﻮﻃﻰ ***‪.‬‬
‫*ﻗﺴﻢ اﻟﺒﺎﻃﻨﺔ اﻟﻌﺎﻣﺔ ‪ **،‬ﻗﺴﻢ اﻟﻤﻴﻜﺮو ﺑﻴﻮﻟﻮﺟﻰ واﻟﻤﻨﺎﻋﺔ آﻠﻴﺔ اﻟﻄﺐ‬
‫*** ﻗﺴﻢ اﻟﻨﺒﺎت آﻠﻴﺔ اﻟﻌﻠﻮم ‪.‬ﺟﺎﻣﻌﺔ اﻟﺰﻗﺎزﻳﻖ ‪.‬ﻣﺼﺮ‬
‫ﻳﻌﺘﺒﺮ اﻵن أآﺜﺮ ﻣﻦ ‪ %٦٠‬ﻣﻦ اﻷدوﻳ ﺔ اﻟﻤ ﻀﺎدة ﻟﻠ ﺴﺮﻃﺎن واﻟﻤ ﻀﺎدات اﻟﺤﻴﻮﻳ ﺔ ﻣﻨﺘﺠ ﺎت ﻃﺒﻴﻌﻴ ﺔ أو ﻣ ﺸﺘﻘﺔ ﻣ ﻦ ﻣ ﺼﺎدر‬
‫ﻃﺒﻴﻌﻴﺔ ‪.‬‬
‫اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ هﻮ ﻣﺮآﺐ ﻃﺒﻴﻌﻰ ﻳﺤﻀﺮ ﻣﻦ اﻟﻄﺤﺎﻟ ﺐ اﻟﺰرﻗ ﺎء وﻗ ﺪ اﺗ ﻀﺢ ﻟ ﻪ ﺗ ﺄﺛﻴﺮات ﻣﺨﺘﻠﻔ ﺔ آﻤ ﻀﺎد ﻟﻸﻟﺘﻬ ﺎب وﻣ ﻀﺎد‬
‫ﻟﻸآﺴﺪة ‪ .‬وﺣﺪﻳﺜًﺎ ﻗﺪ ﻇﻬﺮ ﻟﻠﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﻧﺸﺎط ﺿﺪ اﻷورام‪.‬‬
‫اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﻳﻌﺘﺒﺮ ﻣﻦ ﻣﻜﻮﻧﺎت ﺳﺒﻴﺮوﻟﻴﻨﺎ ﺑﻼﺗﻴﻨﺰﻳﺰ واﻟﺘﻰ ﺗﺴﻤﻰ اﻵن أورﺛﺮوﺳﺒﻴﺮا واﻟﺘﻰ ﻃﺎﻟﻤﺎ اﺳﺘﺨﺪﻣﺖ آﻐﺬاء ‪.‬‬
‫اﻟﻬﺪف ﻣﻦ اﻟﺪراﺳﺔ ‪-:‬‬
‫دراﺳﺔ ﺗﺄﺛﻴﺮ اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﻋﻠﻰ إﻧﺘﺎج اﻹﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻣﻦ ﺧﻼﻳﺎ أﺣﺎدﻳ ﺔ اﻟﻨ ﻮى ﻓ ﻰ ﻣﺮﺿ ﻰ اﻷﻟﺘﻬ ﺎب اﻟﻜﺒ ﺪى اﻟﻔﻴﺮوﺳ ﻰ‬
‫اﻟﻤﺰﻣﻦ )س( دراﺳﺔ ﺧﺎرج اﻟﺠﺴﻢ ‪.‬‬
‫اﻟﻤﺮﺿﻰ وﻃﺮﻳﻘﺔ اﻟﺒﺤﺚ ‪:‬‬
‫ﺷ ﻤﻠﺖ اﻟﺪراﺳ ﺔ ﻋﻠ ﻰ ‪ ٤٠‬ﺷﺨ ﺼﺎ ﻣ ﻦ ﻏﻴ ﺮ اﻟﻤ ﺼﺎﺑﻴﻦ ﺑ ﺄﻣﺮاض اﻟﻜﻠ ﻰ واﻟﻘﻠ ﺐ وداء اﻟ ﺴﻜﺮى وﻣ ﺮض ذاﺗ ﻰ اﻟﻤﻨﺎﻋ ﺔ أو‬
‫ﻳﺘﻨﺎوﻟﻮن أى دواء ﻳﺆﺛﺮ ﻋﻠﻰ ﻣﻨﺎﻋﺔ اﻟﺠﺴﻢ‪.‬‬
‫وﺗﻢ ﺗﻘﺴﻴﻤﻬﻢ إﻟﻰ ‪:‬‬
‫ﻣﺠﻤﻮﻋﺔ )أ( وﺷﻤﻠﺖ ﻋﻠﻰ ‪ ١٠ :‬أﺷﺨﺎص ﻣﻦ اﻷﺻﺤﺎء آﻤﺠﻤﻮﻋﺔ ﺿﺎﺑﻄﺔ ‪.‬‬
‫ﻣﺠﻤﻮﻋﺔ )ب( وﺷﻤﻠﺖ ﻋﻠﻰ ‪ ٣٠‬ﺷﺨﺺ ﻣﻤﻦ ﻳﻌﺎﻧﻮن ﻣﻦ اﻹﻟﺘﻬﺎب اﻟﻜﺒﺪى اﻟﻔﻴﺮوﺳﻰ اﻟﻤﺰﻣﻦ )س(‬
‫وﻗﺪ ﺗﻢ ﺗﻘﺴﻴﻢ هﺬﻩ اﻟﻤﺠﻤﻮﻋﺔ ﻋﻠﻰ ﺣﺴﺐ ﺗﻘﺴﻴﻢ ﺗﺸﺎﻳﻠﺪ ﺑﻮف‬
‫إﻟﻰ ﺛﻼث ﻣﺠﻤﻮﻋﺎت أﺧﺮى ‪:‬‬
‫ﻣﺠﻤﻮﻋﺔ ﻓﺮﻋﻴﺔ )‪ (١‬وﺗﺸﻤﻞ ﻋﺸﺮة ﻣﺮﺿﻰ ﻣﻦ ﺗﻘﺴﻴﻢ ﺗﺸﺎﻳﻠﺪ ﺑﻮف وهﻰ آﻼس ‪. A‬‬
‫ﻣﺠﻤﻮﻋﺔ ﻓﺮﻋﻴﺔ )‪ (٢‬وﺗﺸﻤﻞ ﻋﺸﺮة ﻣﺮﺿﻰ ﻣﻦ ﺗﻘﺴﻴﻢ ﺗﺸﺎﻳﻠﺪ ﺑﻮف وهﻰ آﻼس ‪. B‬‬
‫ﻣﺠﻤﻮﻋﺔ ﻓﺮﻋﻴﺔ )‪ (٣‬وﺗﺸﻤﻞ ﻋﺸﺮة ﻣﺮﺿﻰ ﻣﻦ ﺗﻘﺴﻴﻢ ﺗﺸﺎﻳﻠﺪ ﺑﻮف وهﻰ آﻼس ‪. C‬‬
‫آﻞ أﻓﺮاد هﺬا اﻟﺒﺤﺚ واﻟﺬﻳﻦ ﺗﻢ اﺧﺘﻴﺎرهﻢ ﻗﺪ ﺗﻢ ﻓﺤﺼﻬﻢ إآﻠﻴﻨﻴﻜﻴﺎ وﻋﻤﻞ اﻟﻔﺤﻮﺻﺎت اﻟﺮوﺗﻴﻨﻴﺔ ﻟﻬﻢ ﺷﺎﻣﻠﺔ آﻼ ﻣﻦ ‪:‬‬
‫‪ -١‬ﺻﻮرة دم آﺎﻣﻠﺔ ‪.‬‬
‫‪ -٢‬وﻇﺎﺋﻒ اﻟﻜﺒﺪ وﺗ ﺸﻤﻞ )أﻧﻨﺰﻳﻤ ﺎت اﻵﻻﻧ ﻴﻦ أﻣﻴﻨﻮﺗﺮاﻧ ﺴﻔﺮاز– واﻟﻔﻮﺳ ﻔﺎﺗﻴﺰ اﻟﻘﻠ ﻮى واﺳ ﺒﺮﺗﺎت اﻣﻴﻨﻮﺗﺮاﻧ ﺴﻔﺮاز– اﻟﺒﻠﻴ ﺮوﺑﻴﻦ‬
‫ﺑﺎﻟﺪم آﺎﻣﻞ– واﻷﻟﺒﻮﻣﻴﻦ– وزﻣﻦ اﻟﺒﺮوﺛﺮوﻣﺒﻴﻦ (‪.‬‬
‫‪ -٣‬اﻷﺷﻌﺔ اﻟﺘﻠﻴﻔﺰﻳﻮﻧﻴﺔ ﻋﻠﻰ اﻟﺒﻄﻦ ﺑﺎﻹﺿﺎﻓﺔ إﻟﻰ ﻗﻴﺎس ﻧﺴﺒﺔ اﻹﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻗﺒﻞ وﺑﻌﺪ إﺿﺎﻓﺔ اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ اﻟﻤﻔﺮز ﻣﻦ ﺧﻼﻳﺎ‬
‫أﺣﺎدﻳﺔ اﻟﻨﻮى ﺑﻌﺪ ﻋﺰﻟﻬﺎ ‪.‬‬
‫أوﺿﺤﺖ ﻧﺘﺎﺋﺞ اﻟﺪراﺳﺔ ﻣﺎ ﻳﻠﻰ ‪:‬‬
‫‪ -١‬ﻓﻰ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻀﺎﺑﻄﺔ وﻓﻰ آﻞ ﻣﻦ اﻟﻤﺠﻤﻮﻋ ﺎت اﻟﻔﺮﻋﻴ ﺔ ‪ :‬أن ﻣﺘﻮﺳ ﻂ إﻧﺘ ﺎج اﻻﻧﺘﺮﻓﻴ ﺮون ﺟﺎﻣ ﺎ ﻓ ﻰ ﻋ ﺪم إﺿ ﺎﻓﺔ أى ﻣ ﻦ‬
‫اﻟﻔﻴﻜﻮﺳ ﻴﺎﻧﻴﻦ واﻟﻔﻴﺘ ﻮهﻴﻢ أﺟﻠ ﻮﺗﻴﻨﻴﻦ أﻗ ﻞ ﻣ ﻦ ﻣﺘﻮﺳ ﻂ إﻧﺘ ﺎج اﻻﻧﺘﺮﻓﻴ ﺮون ﺟﺎﻣ ﺎ ﻋﻨ ﺪ إﺿ ﺎﻓﺔ ‪ ٥‬و‪ ١٠‬ﻣﻴﻜﺮوﻟﺘ ﺮ ﻣ ﻦ‬
‫اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ وأﻗﻞ ﻣﻦ ﻣﺘﻮﺳﻂ إﻧﺘﺎج اﻹﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻋﻨﺪ إﺿﺎﻓﺔ اﻟﻔﻴﺘﻮهﻴﻢ أﺟﻠﻮﺗﻴﻨﻴﻦ‪.‬‬
‫‪ -٢‬ﻣﺘﻮﺳ ﻂ إﻧﺘ ﺎج اﻹﻧﺘﺮﻓﻴ ﺮون ﺟﺎﻣ ﺎ ﻓ ﻰ اﻟﻤﺠﻤﻮﻋ ﺔ اﻟ ﻀﺎﺑﻄﺔ أﻗ ﻞ ﻣ ﻦ ﻣﺮﺿ ﻰ اﻹﻟﺘﻬ ﺎب اﻟﻜﺒ ﺪى اﻟﻔﻴﺮوﺳ ﻰ )س( ﻓ ﻰ‬
‫اﻟﻤﺠﻤﻮﻋﺎت اﻟﻔﺮﻋﻴﺔ اﻟﺜﻼث‪.‬‬
‫‪ -٣‬ﻣﺴﺘﻮى إﻧﺘﺎج اﻹﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻣﻦ ﺧﻼﻳﺎ أﺣﺎدﻳﺔ اﻟﻨﻮى آﺎن اﻋﻠﻰ ﻓﻰ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻔﺮﻋﻴﺔ ‪٢‬ﻣﻦ اﻟﻤﺠﻤﻮﻋﺎت اﻷﺧﺮى ‪.‬‬
‫ﻓﻰ ﺿﻮء اﻟﺪراﺳﺔ اﻟﺤﺎﻟﻴﺔ ﻧﺴﺘﺨﻠﺺ اﻵﺗﻰ‪:‬‬
‫‪ -١‬ﻓﻰ ﺣﺎﻟﺔ ﻋﺪم إﺿ ﺎﻓﺔ آ ﻼ ﻣ ﻦ اﻟﻔﻴﻜﻮﺳ ﻴﺎﻧﻴﻦ واﻟﻔﻴﺘ ﻮهﻴﻢ أﺟﻠ ﻮﺗﻴﻨﻴﻦ وأﻳ ﻀﺎ ﺑﻌ ﺪ إﺿ ﺎﻓﺔ ‪ ٥‬ﻣﻴﻜﺮوﻟﺘ ﺮ و‪ ١٠‬ﻣﻴﻜﺮوﻟﺘ ﺮ‬
‫واﻟﻔﻴﺘ ﻮهﻴﻢ أﺟﻠ ﻮﺗﻴﻨﻴﻦ وﺟ ﺪ أن إﻧﺘ ﺎج اﻻﻧﺘﺮﻓﻴ ﺮون ﺟﺎﻣ ﺎ ﻋ ﻦ ﻃﺮﻳ ﻖ ﺧﻼﻳ ﺎ أﺣﺎدﻳ ﺔ اﻟﻨ ﻮى آ ﺎن اﻋﻠ ﻰ ﻓ ﻰ ﻣﺠﻤﻮﻋ ﺔ‬
‫ﻣﺮﺿﻰ اﻟﻜﺒﺪ ﻋﻦ اﻟﻤﺠﻤﻮﻋﺔ اﻟﻀﺎﺑﻄﺔ‬
‫‪ -٢‬ﻣﺎزاﻟﺖ اﻟﺨﻼﻳﺎ أﺣﺎدﻳﺔ اﻟﻨﻮى ﻓﻰ ﻣﺮﺿﻰ اﻹﻟﺘﻬﺎب اﻟﻜﺒﺪى ﻗﺎدرة ﻋﻠﻰ اﻧﺘﺎج اﻻﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻓﻰ ﺣﺎﻟﺔ ﻋ ﺪم إﺿ ﺎﻓﺔ‬
‫آﻼ ﻣﻦ اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ واﻟﻔﻴﺘﻮهﻴﻢ أﺟﻠﻮﺗﻴﻨﻴﻦ وﻳﺰﻳﺪ ﺑﻌﺪ ﺣﺜﻬﺎ ﺑﺎﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﺑﺠﺮﻋﺎت ﻣﺨﺘﻠﻔﺔ واﻟﻔﻴﺘﻮهﻴﻢ أﺟﻠﻮﺗﻴﻨﻴﻦ ‪.‬‬
‫‪ - -٣‬إﻧﺘﺎج اﻹﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻓﻰ ﺣﺎﻟﺔ ﻋﺪم إﺿﺎﻓﺔ آﻼ ﻣ ﻦ اﻟﻔﻴﻜﻮﺳ ﻴﺎﻧﻴﻦ واﻟﻔﻴﺘ ﻮهﻴﻢ أﺟﻠ ﻮﺗﻴﻨﻴﻦ ﻣ ﻦ ﺧﻼﻳ ﺎ أﺣﺎدﻳ ﺔ اﻟﻨ ﻮى‬
‫وﺑﻌﺪ ﺣﺜﻬﺎ ﺑﺎﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ واﻟﻔﻴﺘﻮهﻴﻢ أﺟﻠﻮﺗﻴﻨﻴﻦ ﻳﻼﺣﻆ ﻓﻰ ﻣﺮﺿ ﻰ اﻟﻜﺒ ﺪ ﺑ ﺪرﺟﺎت اﻟﻤ ﺮض اﻟﻤﺨﺘﻠﻔ ﺔ ﻓ ﻰ اﻟﻤﺠﻤﻮﻋ ﺎت‬
‫اﻟﻔﺮﻋﻴﺔ اﻟﺜﻼث ‪.‬‬
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‫‪Vol. 18, No. 2‬‬
‫‪Egyptian Journal of Medical Microbiology, April 2009‬‬
‫ﻓﻰ ﺿﻮء اﻟﺪراﺳﺔ اﻟﺤﺎﻟﻴﺔ ﻧﺴﺘﺨﻠﺺ اﻟﺘﻮﺻﻴﺎت اﻵﺗﻴﺔ ‪-:‬‬
‫‪ -١‬اﻟﺨﻼﻳﺎ أﺣﺎدﻳﺔ اﻟﻨﻮى ﻟﻬﺎ اﻟﻘﺪرة ﻋﻠ ﻰ إﻧﺘ ﺎج اﻹﻧﺘﺮﻓﻴ ﺮون ﺟﺎﻣ ﺎ ﺧ ﺎرج اﻟﺠ ﺴﻢ وﻧﺤ ﻦ ﻧﻨ ﺼﺢ ﺑﺪراﺳ ﺎت ﻋﻠ ﻰ اﻹﻧ ﺴﺎن‬
‫ﺑﺎﻋﻄﺎء اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﺛﻢ ﻗﻴﺎس اﻹﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻓﻰ دم ﻣﺮﺿﻰ اﻹﻟﺘﻬﺎب اﻟﻜﺒﺪى اﻟﻔﻴﺮوﺳﻰ اﻟﻤﺰﻣﻦ ‪.‬‬
‫‪ -٢‬إﺟﺮاء ﻣﺤﺎوﻻت ﻹﻋﻄﺎء اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﻣﻊ اﻹﻧﺘﺮﻓﻴﺮون أﻟﻔﺎ ﻓ ﻰ ﻣﺮﺿ ﻰ اﻹﻟﺘﻬ ﺎب اﻟﻜﺒ ﺪى اﻟﻤ ﺰﻣﻦ أو ﻟﻠﻤﺮﺿ ﻰ اﻟﻐﻴ ﺮ‬
‫ﻣﻨﺎﺳﺒﻴﻦ ﻹﻋﻄﺎء اﻹﻧﺘﺮﻓﻴﺮون أﻟﻔﺎ ‪.‬‬
‫‪ -٣‬وﻷن اﻟﻔﻴﻜﻮﺳﻴﺎﻧﻴﻦ ﻟﺔ اﻟﻘﺪرة ﻋﻠﻰ إﻧﺘﺎج اﻹﻧﺘﺮﻓﻴﺮون ﺟﺎﻣﺎ ﻟﺬﻟﻚ ﻣﻤﻜﻦ اﺳﺘﺨﺪاﻣﺔ آﻐ ﺬاء ﻟﻠﻤﺮﺿ ﻰ واﻷﺻ ﺤﺎء وه ﻮ‬
‫ﻳﻌﺘﺒﺮ ﻣﻦ إﺣﺪى ﻣﻜﻮﻧﺎت ﺳﺒﻴﺮوﻟﻴﻨﺎ اﻟﺘﻰ ﺗﺘﻤﻴﺰ ﺑﺪرﺟﺔ ﻣﻦ اﻷﻣﺎن ‪.‬‬
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C- Phycocyanin Effect on IFN-γ Production in Patients with Chronic

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