耶氏肺孢子菌合成抗原在不同人群抗体筛查中的应用  

Application of recombinant antigens of Pneumocystis jirovecii in detection of Pneumocystis jirovecii infection in different populations

作　　者：宋营改[1] 卜定方[2] 任翊[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京热带医学研究所,北京100050 [2]北京大学第一医院中心实验室,北京100034

出　　处：《中国热带医学》2014年第2期240-242,245,共4页China Tropical Medicine

基　　金：热带病防治研究北京市重点实验项目(No.2013RDBF03)

摘　　要：耶氏肺孢子菌(Pneumocystis jirovecii,Pj)是引起肺孢子菌肺炎(Pneumocystis pneumonia,PCP)的真菌类病原体,是免疫功能缺陷者重要的条件致病菌。Pj通过主要表面糖蛋白(Major surface glycoprotein,Msg)的抗原转换,逃避宿主免疫清除。MsgA,MsgB,MsgC1以及MsgC1的3个变种MsgC3,MsgC8和MsgC9是三组跨越Msg基因全长的原核表达重组肽段。对健康人群调查发现,84%的个体抗MsgA、MsgB或MsgC1 IgG抗体阳性。与健康对照相比,HIV感染者抗MsgC1 IgG抗体水平明显增高,而抗MsgA、MsgB IgG抗体水平没有变化。与非暴露组相比,职业暴露组医务人员的抗MsgC1 IgG抗体水平也明显增高,而抗MsgA、MsgB IgG抗体水平没有变化。因此,MsgC1抗体水平增高可以作为近期暴露过Pj的指标,对免疫缺陷者具有辅助诊断PCP的临床意义。Pj血清学研究的发展将会带来更大的PCP临床诊断和流行病学调查价值。Pneumocystis jirovecii（Pj）,a fungal opportunistic pathogen in humans,is the causative agent of pneumocystis pneumonia（PCP）, it is also a leading cause of serious illness in immunocompromised patients. Pj can evade host immune defenses through the antigenic variation of major surface glycoprotein（Msg）. MsgA, MsgB and MsgC1 consisting of the variants of MsgC3, MsgC8, and MsgC9 are three overlapping recombinant Msg fragments.The results of survey of healthy population revealed that anti- MsgA, anti-MsgB or anti-MsgC1 antibodies could be detected from 84% of the individuals surveyed. Compared with the healthy controls the anti-MsgC, IgG antibody level was apparently increased in HIV positives, while antiMsgA and anti-MsgB IgG antibody levels were remained.In comparison with the non-exposure group the anti-MsgC1 IgG antibody level in occupationally exposed medical workers was also obviously increased, but the anti-MsGA and anti-MsgB IgG antibody levels were stable. Therefore the rise of anit-MsgC1 antibody level can be used as an indicator for diagnosis of recent Pj infection and it is of auxiliary value for clinical diagnosis of PCP in immunocompromised persons.Thus with the development of serological diagnosis of Pj it would be used in clinical diagnosis and epidemiological survey of PCP.

关 键 词：肺孢子菌肺炎 耶氏肺孢子菌 主要表面糖蛋白 重组抗原 抗体 

分 类 号：R563.2[医药卫生—呼吸系统]