【摘要】 目的研究HBV前C/BCP区基因变异对慢性乙型肝炎(CHB)患者特异性细胞毒性T淋巴细胞(CTL)免疫应答的影响。方法采用HBV核心抗原表位肽core18-27,流式细胞术胞内细胞因子(CFC)分析法检测CHB患者外周血单个核细胞(PBMC)中的特异性CTL,对扩增产物进行测序分析。结果54例CHB患者中G1896A突变毒株21例,占38.9%;1762/1764位核苷酸联合突变26例。占48.1%;3位点同时突变毒株13例,占24.1%。3种变异株体外HBV核心抗原表位肽core18-27刺激后,特异性CTL水平[(0.41±0.09)%、(0.36±0.08)%、(0.48±0.08)%]显著高于野毒株[(0.11±0.06)%,P<0.05]。结论G1896A变异及1762/1764位核苷酸联合突变能显著增强特异性CTL水平,在CHB患者病情活动过程中起重要作用。更多还原

【Abstract】 Objective To investigate the influences of mutation at precore and basic core promoter(BCP) region in hepatitis B virus(HBV) on the immune response of specific cytotoxic T lymphocytes(CTL) in patients with chronic hepatitis B(CHB).Methods The number of specific CTL in peripheral blood mononuclear(PBMC) of CHB patients were tested by cytokine flow cytome- try(CFC) and HBV core18-27 peptide.HBV precore and BCP fragments were directly sequenced. Results Twenty-one(38.9%) samples were HBV precore G1896A mutation.Twenty-six(48.1%) samples were BCP region 1762/1764 combined mutation.Thirteen(24.1%) stains were three sites mutated simultaneously.Stimulated with HBV core 18-27 in vitro,the specific CTL level was signifi- cantly higher in the patients with G1896A mutation and BCP region mutation [(0.41±0.09)%, (0.36±0.08)%,(0.48±0.08)%,respectively]than those without mutation[(0.11±0.06)%, P<0.05].Conclusion Specific CTL level is significantly increased due to G1896A mutation and BCP region mutation,which can play an important role in the pathogenesis of CHB.更多还原