HLA-DPβ1表达水平与乙型肝炎病毒母婴传播阻断效果的关系研究  

Study on the relationship between HLA-DPβ1 expression level and blocking effect of hepatitis B virus transmission from mother to child

作　　者：李丽[1] 胥文敏 赵睿[1] 马小雨 李红梅[1] LI Li;XU Wenmin;ZHAO Rui;MA Xiaoyu;LI Hongmei(Department of Obstetrics,Affiliated Hospital of Yan'an University,Yan'an 716000,China)

机构地区：[1]延安大学附属医院产科,陕西延安716000

出　　处：《延安大学学报（医学科学版）》2023年第4期54-58,67,共6页Journal of Yan'an University:Medical Science Edition

基　　金：陕西省教育厅专项科学研究计划项目(18JK0881)。

摘　　要：目的 研究人类白细胞抗原基因编码的跨膜糖蛋白(human leukocyte antigen class ii histocompatibility antigen, DPβ1 chain,HLA-DPβ1)在人胎盘组织及脐静脉血中的表达水平与乙肝母婴传播阻断效果的关系。方法 本研究采用巢式病例对照对延安大学附属医院产科2019年9月至2021年8月住院分娩的HBsAg阳性部分孕妇及其新生儿进行研究,新生儿均完成主被动联合免疫接种且进行乙肝五项指标及乙肝病毒DNA(Hepatitis B virus DNA,HBV DNA)血清学随访。收集产妇胎盘组织及脐静脉血,采用化学发光法检测乙肝五项指标定量水平,荧光定量PCR法检测HBV DNA定量水平;采用免疫组织化法(MaxVision?法)及酶联免疫吸附测定法(ELISA法)测定胎盘组织及脐静脉血中的HLA-DPβ1表达。结果 本研究中符合纳入标准并完成全程随访的病例组有76例婴儿,于7~12月龄进行乙肝五项指标及HBV DNA血清学随访,HBsAg及HBV DNA均阴性,主被动联合免疫阻断成功率为100%(76/76)。根据其血清HBsAb水平将免疫阻断效果进行分组,其中无应答及低应答组17例(22.37%),中应答组36例(47.37%),高应答组23例(30.26%)。76例HBsAg阳性孕妇胎盘组织HLA-DPβ1阳性率51.31%,与对照组比较,差异有统计学意义(P<0.05);胎盘组织中HLA-DPβ1阳性率在无应答及低应答组、中应答组、高应答组、对照组均中依次增加(分别为35.29%、44.44%、73.91%及93.33%),进行组间两两多重比较,无应答及低应答组、中应答组与对照组比较,差异均有统计学意义(P<0.05);HLA-DPβ1在各组脐静脉血标本中均有表达,但组间差异均无统计学意义(P>0.05)。结论 HLA-DPβ1的表达水平与乙肝母婴传播阻断效果有关,提示其高表达为主被动联合免疫应答的保护性因素。推断HLA-DPβ1可能为HBV感染的不易感基因。Objective To study the relationship between the expression of human leukocyte antigen class ii histocompatibility antigen,DPβ1 chain(HLA-DPβ1)in human placenta tissue and umbilical vein blood and the blocking effect of Hepatitis B transmission from mother to child.Methods In this study,nested case-control study was conducted on some HBsAg positive pregnant women and their newborns delivered in Affiliated Hospital of Yan'an University from September 2019 to August 2021.All newborns completed active and passive combined immunization and underwent serological follow-up of Hepatitis B five items and Hepatitis B virus DNA(HBV DNA).Human placental tissue and umbilical venous blood samples were collected,the quantitative level of Hepatitis B five items was detected by chemiluminescence method,and the quantitative level of HBV DNA was detected by fluorescence quantitative PCR;the expression of HLA-DPβ1 in placental tissue and umbilical venous serum were detected by immunohistochemical staining(MaxVision™method)and enzyme-linked immunosorbent assay(ELISA method).Results There were 76 infants who met the inclusion criteria and completed the whole follow-up period in this study.Serological follow-up of Hepatitis B five items and HBV DNA was conducted at the age of 7~12 months,and the results of HBsAg and HBV DNA were all negative.The success rate of active-passive combined immune blockade was 100%(76/76).The immune blocking effect was grouped according to serum HBsAb levels,17 cases(22.37%)were non-response and low response group,36 cases(47.37%)were medium response group and 23 cases(30.26%)were high response group.The positive rate of HLA-DPβ1 in placental tissue of 76 HBsAg positive pregnant women was 51.31%,and the difference was statistically significant compared with the control group(P<0.05).The positive rate of HLA-DP-β1 in placental tissue increased successively in the no-response and low-response group,medium response group,high response group and control group(35.29%,44.44%,73.91%and 93.33%,respectively).M

关 键 词：HLA-DPβ1 HBV DNA 母婴传播 免疫阻断效果 

分 类 号：R714.251[医药卫生—妇产科学]