mNGS在耶氏肺孢子菌的药物靶位基因多态性中的应用  

Application of mNGS in Gene Polymorphisms ofDrug Targets in Pneumocystis Jiroveci

作　　者：张竞 段巧慧 李涛 ZHANG Jing;DUAN Qiaohui;LI Tao(The third people s hospital,Jiujiang,Jiangxi,332000,China)

机构地区：[1]九江市第三人民医院,江西九江332000

出　　处：《九江学院学报（自然科学版）》2024年第3期110-113,共4页Journal of Jiujiang University：Natural Science Edition

基　　金：江西省卫健委科技计划项目支持(编号202211729)的研究成果之一。

摘　　要：目的 探究宏基因组二代测序(mNGS)在耶氏肺孢子菌的药物靶位基因多态性中的应用。方法 选择2018年11月—2023年11月76例九江市第三人民医院收治的疑似PCP的艾滋病患者为研究对象。根据mNGS测序结果,分为PCP感染组(n=27)和非PCP感染组(n=49)。聚合酶链反应(pCR)检测药物靶位基因多态性。结果 mNGS结果显示,76例疑似PCP的患者中,27例(35.53%)为PCP。非PCP感染组CD4+明显高于PCP感染组(p<0.05)。DHpS基因中2株(7.41%)为耐药突变株。DHFR基因中1株(3.70%)的碱基188位点出现非同义突变,11株(40.74%)的碱基312位点出现同义突变,未检测出耐药突变株。CYB基因,共发现CYB1、CYB2、CYB、CYB和CYB10等5个基因型,未见药物相关靶位位点的突变。结论 通过结合pCR扩增和mNGS,可以在检测耶氏肺孢子菌的同时检测出肺孢子菌的药物靶位基因,从而针对性选择治疗方案。Objective To explore the application of metagenomic next-generation sequencing(mNGS)in gene polymorphisms of drug targets in pneumocystis jiroveci.Method A total of 76 AIDS patients with suspected pneumocystis jiroveci pneumonia(PCP)in Jiujiang Third people's Hospital were enrolled as the research objects between November 2018 and November 2023.According to mNGS results,patients were divided into PCP infection group(n=27)and non-infection group(n=49).The gene polymorphisms of drug targets were detected by polymerase chain reaction(pCR).Result In the 76 patients with suspected PCP,mNGS results showed that there were 27 cases(35.53%)with PCP.CD4+in non-infection group was significantly higher than that in PCP infection group(p<0.05).In dihydropteroate synthetase(DHpS)gene,there were 2 strains(7.41%)with drug-resistant mutation.In dihydrofolate reductase(DHFR)gene,there was 1 strain(3.70%)with non-synonymous mutation at base 188 locus and 11 strains(40.74%)with synonymous mutation at base 312 locus,and there was no one strain with with drug-resistant mutation.In cytochrome b(CYB)gene,there were 5 genotypes(CYB1,CYB2,CYB,CYB,CYB10),and there was no mutations of drug-related targets.Conclusion pCR amplification combined with mNGS could detect drug target genes of pneumocystis while detecting pneumocystis jiroveci so as to select targeted therapeutic regimens.

关 键 词：宏基因组二代测序 耶氏肺孢子菌 肺孢子菌肺炎 基因多态性 

分 类 号：R563.1[医药卫生—呼吸系统]