基因HLA-DR13表达及BCP突变与HBV感染后临床转归的相关性研究  

Relationship of HLA-DR13 gene expression and BCP mutation with clinical outcomes of hepatitis B virus infection

作　　者：杨小蓉[1] 刁蔚欣[1] 冯红梅[1] 卢景辉[1] 

机构地区：[1]广东药学院附属第一医院检验科,广州510080

出　　处：《免疫学杂志》2014年第10期892-896,共5页Immunological Journal

基　　金：广东省医学科研基金资助项目(2012314)

摘　　要：目的探讨宿主基因HLA-DR13、T细胞亚群及病毒基因BCP(基本核心启动子)A1762T/G1764A突变与乙型肝炎病毒感染后临床转归的关系。方法实时荧光定量PCR检测急性肝炎、慢性肝炎、携带者、肝硬化、肝癌及自动清除(对照)组血液中的HBV-DNA及白细胞HLA-DR13基因水平,流式细胞仪检测T淋巴细胞CD4+、CD8+表达,测序法检测样本BCP变异,ELISA方法检测乙肝病毒e抗原并分析各因素对临床结局的影响。结果 HLA-DR13定量结果以自动清除组值最高,与急性组和肝癌组比较有显著性差别(P=0.027,0.049,P<0.05);CD4+及CD4+/CD8+百分率:肝硬化和肝癌组与对照相比有显著性差别(P=0.003,0.000,0.025,0.006,P<0.05),慢性组和携带组无显著性差别(P>0.05);CD8+百分率:肝癌组与其它5组比较均有显著性差别(P=0.013,0.012,0.024,0.010,0.009,P<0.05);BCP百分率:急性组和携带者组与其它3组相比较有显著性差别(χ2=36.117,P<0.05);HBV-DNA定量结果以急性肝炎组最高,肝硬化组最低,各组之间相比较有显著性差别(F=16.909,P=0.000,P<0.05);HBeAg阳性率:急性肝炎组与其它4组相比较有显著性差别(χ2=94.590,P<0.05)。结论 HLA-DR13基因表达水平与HBV感染后急性发病和肝癌结局呈负相关,BCP与急性发病及携带者结局呈正相关,联合检测宿主自身免疫因素与病毒因素有利于HBV患者的临床诊治。This study designed to investigate the relationship of HLA-DR13 gene and BCP（basic core promoter,BCPA1762T/G1764A） with the clinical outcomes of patient with hepatitis B virus infection.Flow cytometry was applied to detect HBV-DNA,HLA-DR13 gene DNA,and lymphocytes indicators levels of acute hepatitis,chronic hepatitis,carrier,cirrhosis,hepatocellular carcinoma and resolved groups.Furthermore,BCP and antigen e were detected by sequencing and ELISA,and association between various indicators and clinical outcomes was analyzed.Results showed that compared with resolved group,HLA-DR13 gene level were significant lower in acute and hepatocellular carcinoma groups（P=0.027,0.049,P〈0.05）,CD4＋percentage and CD4＋/CD8＋ratio were significant lower in cirrhosis and hepatocellular carcinoma groups（P =0.003,0.000,0.025,0.006,P〈0.05）;while CD8＋percentage in hepatocellular carcinoma group was significant different as compared with others（P=0.013,0.012,0.024,0.010,0.009,P〈0.05）;BCP percentage was significant higher in acute and carrier groups than that in other groups（χ^2=36.117,P〈0.05）;HBV-DNA level was significant different in all groups（F=16.909,P=0.000,P〈0.05）;HBeAg positive rate was significant higher in acute group as compared with others（χ2=94.590,P〈0.05）.Our study suggested that HLA-DR13 gene is one of the host factors which may influences the immune response of HBV clearance,while BCP is one of HBV factors which may be associated with high HBV-DNA level.Thus detection of combined indictors of host and virus would be conducive to treating the patient with HBV infection.

关 键 词：乙型肝炎病毒感染 HLA-DR13基因 T淋巴细胞免疫 BCP 临床转归 

分 类 号：R512.62[医药卫生—内科学]