前C区基因变异对慢性重型乙型肝炎免疫应答的影响  

Influence of mutation in hepatitis B virus precore region on immune response of patients with chronic severe hepatitis B

作　　者：黄利华[1] 蒋跃明[1] 戴亚新[1] 

机构地区：[1]无锡市传染病医院,江苏省无锡市214005

出　　处：《世界华人消化杂志》2006年第19期1921-1923,共3页World Chinese Journal of Digestology

基　　金：江苏省科技计划项目;No.BS2003615;无锡市自然科学基金资助;No CK030013

摘　　要：目的：分析乙型肝炎病毒(HBV)前C区G1896A变异对慢性重型乙型肝炎(慢重肝)发病及免疫应答的影响．方法：流式细胞仪检测31例慢重肝患者外周血细胞胞内细胞因子IFN-γ,IL-4的百分率；测定Th1,Th2,Tc1,Tc2；固相夹心法酶联免疫吸附试验检测其血清IL-4,IFN-γ的水平；套式聚合酶链反应扩增HBV DNA前C/C基因并作序列分析．结果：在31例患者中8例(25．8%)发生G1896A变异,8例G1896A变异株中4例(50%)出现1913位联合变异,而23例野毒株仅1例(4．3%)出现C1913A变异；G1896A变异株Tcl水平显著高于野毒株(P=0．023,t=2．407)；G1896A变异株与野毒株相比IL-4,IFN-γ水平无显著性差异(P＞0．05)；变异株与野毒株2组死亡率无显著性差异(P＞0．05)．结论：G1896A变异能显著增强Tcl水平,后者在慢重肝发病中起重要作用．AIM： To investigate the role of mutation at site 1896 in hepatitis B virus （HBV） precore region in the pathogenesis of chronic severe hepatitis B and its influence on the immune response of patients. METHODS： The production of interferon-γ （IFN-γ） and interleukin-4 （IL-4） by Thl/Th2 and Tc1/Tc2 cells in the peripheral blood from 31 patients with chronic heavy hepatitis were assessed by flow cytometry. The serum concentration of IL-4 and IFN-γ were examined by solidphase sandwich enzyme-linked immunosorbent assay （ELISA）. HBV DNA was amplified by nested polymerase chain reaction and the precore/core fragment was directly sequenced. RESULTS： The mutation at site 1896 in HBV precore region appeared in 8 of 31 （25.8%） patients with chronic severe hepatitis. Of the 8 patients, 4 （50%） were confirmed with the mutationat site 1913. However, of the 23 patients without the mutation at site 1896, 1 case was detected with the mutation at site 1913. The level of Tcl was significantly higher in the patients with G1896A mutation than that in those without G1896A mutation （t=2.407, P=0.023）. The levels of serum IFN-γ and IL-4 were not markedly different between the patients with and without G1896A mutation （P〉0.05）. The mortality rate was also similar between the two groups. CONCLUSION： Tcl level is significantly enhanced due to G1896A mutation and plays an important role in the pathogenesis of chronic severe hepatitis B.

关 键 词：前C基因 变异 慢性重型乙型肝炎 免疫应答 

分 类 号：R512.62[医药卫生—内科学] R575.1[医药卫生—临床医学]