肝癌患者体内乙型肝炎病毒基因组BCP/Pre C区基因突变多样性分析

为研究肝癌患者组织样本中HBV DNA核心启动子区(BCP区)和前C区(Pre C区)的基因突变多样性及其突变规律。收集第四军医大学附属西京医院2015年收治的192例HBV阳性的肝癌患者组织样本,PCR扩增HBV BCP/Pre C区DNA片段并进行测序分析,从测序失败的样本中随机抽取21例,采用构建单克隆文库后测序的方法进行分析。结果显示37.89%(72/190)的HBV阳性肝癌患者体内HBV病毒因呈现多种突变株混合感染的特点而导致PCR产物直接测序失败,经单克隆测序揭示,每一例失败样本的HBV DNA准种池中至少有2~11种突变株共同存在;突变株中缺失突变和插入突变的发生率高达80.95%;其它突变形式按照频率从高到低分别为A1762T/G1764A双突变90.48%,G1756C/T1803A/Δ(1 757~1 765)/Δ(1 824~1 832)四联突变80.95%,T1753C/A1762T/G1764A三联突变57.14%,A1762T/G1764A/G1896A三联突变42.86%,G1756C/Δ(1 757~1 765)双突变28.57%,T1753C/A1762T/G1764A/G1896A四联突变23.81%。由此可见,肝癌患者体内HBV病毒具有BCP/Pre C区DNA突变的多样性,这些缺失与插入突变是导致序列移码与PCR产物测序失败的直接原因。研究结果为HBV持续感染及基因突变检测、相关机制研究和个体化防治奠定了基础。     

肝癌患者体内乙型肝炎病毒基因组BCP/Pre C区基因突变多样性分析北大核心CSCD

为研究肝癌患者组织样本中HBV DNA核心启动子区(BCP区)和前C区(Pre C区)的基因突变多样性及其突变规律。收集第四军医大学附属西京医院2015年收治的192例HBV阳性的肝癌患者组织样本,PCR扩增HBV BCP/Pre C区DNA片段并进行测序分析,从测序失败的样本中随机抽取21例,采用构建单克隆文库后测序的方法进行分析。结果显示37.89%(72/190)的HBV阳性肝癌患者体内HBV病毒因呈现多种突变株混合感染的特点而导致PCR产物直接测序失败,经单克隆测序揭示,每一例失败样本的HBV DNA准种池中至少有2~11种突变株共同存在;突变株中缺失突变和插入突变的发生率高达80.95%;其它突变形式按照频率从高到低分别为A1762T/G1764A双突变90.48%,G1756C/T1803A/Δ(1 757~1 765)/Δ(1 824~1 832)四联突变80.95%,T1753C/A1762T/G1764A三联突变57.14%,A1762T/G1764A/G1896A三联突变42.86%,G1756C/Δ(1 757~1 765)双突变28.57%,T1753C/A1762T/G1764A/G1896A四联突变23.81%。由此可见,肝癌患者体内HBV病毒具有BCP/Pre C区DNA突变的多样性,这些缺失与插入突变是导致序列移码与PCR产物测序失败的直接原因。研究结果为HBV持续感染及基因突变检测、相关机制研究和个体化防治奠定了基础。     

建立一种反向斑点杂交法检测肺炎支原体23S rRNAV区A2063G基因突变的方法

目的建立检测肺炎支原体（Mycoplasma pneumoniae,MP）23S rRNA V区2063基因型的反向斑点杂交方法,并与PCR产物直接测序法的结果进行比较分析。方法19例自临床咽拭子标本分离培养的MP,用自行设计的反向斑点杂交法检测23S rRNA V区2063基因型,同时对相应序列测序分析。抽提标准菌株FH和127份经PCR测定MP阳性的临床标本基因组DNA,用MP阴性的基因组DNA抽提物5份作阴性对照,用反向斑点杂交法检测23S rRNA V区2063基因型。结果19例分离培养的MP,经反向斑点杂交法检测15株有23S rRNA V区基因A2063G位点突变;4株为2063A,与测序结果一致（Kappa一致性检验,P〉0.05）。经反向斑点杂交法检测,127份MP阳性的基因组DNA抽提物中有122份标本为A2063G位点突变,标准菌株FH和2份DNA抽提物的2063位点碱基为A,还有3份抽提物标本的2063位点碱基既有A又有G,5份阴性对照均无显色。结论反向斑点杂交方法能快速、准确检测临床MP 23S rRNA V区2063基因型。     

乙肝病毒BCP区突变（A1762T/G1764A）对乙肝病毒复制的影响研究

通过构建乙型肝炎病毒（Hepatitis B virus, HBV）单倍体分子，阐明HBV基本核心启动子突变（A1762T/+G1764A,BCP）对HBV复制的影响。本研究收集了HBeAg阴性的慢乙肝患者，将其中两例BCP突变的序列通过重叠PCR克隆到HBV1.3倍体的复制质粒；构建环状的HBV单倍体分子，转染Huh7.0细胞后，通过ELISA、实时荧光定量PCR等分析BCP突变对病毒复制的影响；通过荧光素酶实验分析BCP突变对HBV preC mRNA转录的影响。55例HBeAg阴性的慢乙肝患者中有30例带有A1762T/G1764A的突变；克隆带有BCP突变的临床序列到HBV 1.3倍体转染细胞后，上清中HBeAg为阴性，表面抗原降低10%(P>0.05)；构建的HBV单倍体环化后形成闭合环状的cccDNA分子，转染细胞后，结果表明BCP突变后，HBeAg下降55.48%(P<0.05)，表面抗原无显著性差异（P>0.05），细胞内病毒颗粒中DNA水平为野生型的3.18倍，上清中HBV DNA为野生型的1.36倍；BCP突变后preC mRNA水平降低81.05...     

野生型及突变型乙型肝炎病毒X基因在pGEX-6P-2系统中的克隆、表达、纯化及免疫鉴定

构建野生型和A1762T/G1764A双突变型乙型肝炎病毒(HBV)X基因原核表达系统,为深入研究HBV X基因及其双突变后对HBV慢性感染者病情发展和肿瘤发生的作用奠定基础。从慢性乙型肝炎患者血清中抽提HBV基因组DNA,经PCR扩增和基因测序,证实并获得野生型及A1762T∕G1764A双突变型HBV X基因。应用TA克隆及亚克隆技术将2基因分别插入pGEX-6P-2载体,构建pGEX-6P-2-hbvxw(野生型)及pGEX-6P-2-hb-vxm(A1762T∕G1764A突变型)重组表达载体;转化入宿主菌进行诱导表达;包涵体复性后,GSTrap FF蛋白纯化柱纯化带有GST标签的野生型和A1762T∕G1764A突变型HBV x抗原(HBxAg);应用SDS-PAGE、Westernblot和ELISA方法对表达的野生型和突变型HBxAg进行鉴定。结果SDS-PAGE证实本研究构建的2个表达系统均能高效表达目的蛋白;复性、纯化后野生型和突变型GST-HBxAg分别达到4.88mg/mL和5.07mg/mL;Western blot鉴定证实所纯化的野生型和突变型HBxAg均能被特异性的单克隆抗体所识别;ELISA方法检测显示2种抗原都能成功包被于微量滴定板上并与乙肝患者血清反应。证实本研究成功地构建了野生型和A1762T∕G1764A突变型HBxAg表达系统,为进一步研究A1762T∕G1764A基因突变对肿瘤发生学和慢性HBV感染者疾病进展的作用和分子机制奠定了基础。     

克隆化反向杂交探针的制备

反向斑点杂交是将寡核苷酸探针固定在膜上,用标记的靶序列与固定在膜上的探针进行杂交．与正向杂交相比,它通过一次杂交即可确定多种基因型,是一种快速筛查DNA点突变的诊断方法.我们选择β－地中海贫血基因-28 (A→ G), CD17 (A→T) and CD41～42 (-TTCT) 三种点突变为模型采用PCR扩增产生串联多拷贝序列探针并将其克隆化．将克隆化探针固定于尼龙膜上,与同位素标记的β－珠蛋白基因PCR片段进行杂交,检测β－地贫患者的基因型．     

福建省慢性HBV感染者HBV基因S区、基本核心启动子区和前C区基因变异特征分析

为研究福建省慢性HBV感染者HBV基因多样性及变异规律,了解该人群HBV-DNA的病毒学特征。收集慢性HBV感染者血清标本,通过巢式PCR法扩增其HBV基因序列,比对NCBI数据库中标准基因型序列,分析HBV基因S区,基本核心启动子区(BCP)及前C区的序列变异情况,并对这些变异可能造成的病毒抗原表达,疫苗逃逸,患者病症改变等情况进行探讨。最终成功扩增82例HBV全长基因序列,其中B基因型56例,C基因型26例。基因组特定功能区序列分析发现慢性HBV感染者HBV基因在S区(23.2%)、BCP区(61.0%)和前C区(29.3%)均出现了不同程度的变异。其中主蛋白(HBsAg)主要抗原决定簇a决定簇45.8%位点出现了变异,这些变异位点中包括与肝炎重症化及免疫逃逸密切相关的位点(aa126、aa129、aa145等)。位点G1896A(19.5%),G1764A(11.0%)和A1762T(9.8%)依然是BCP/前C区的主要突变位点。而位点A1752G(25.6%)高突变率的出现在BCP区应引起关注。此外位点G1764A(χ~2=5.742,P=0.030)、A1896G(χ~2=14.392,P=0.000)以及A1762T/G1764A(χ~2=7.289,P=0.012)的突变更容易发生在HBeAg阴性的样品中;而位点A1846T(χ~2=11.882,P=0.003)、A1762T(χ~2=6.561,P=0.038)和A1896G(χ~2=6.958,P=0.030)的突变与HBV-DNA的病毒载量存在一定相关性。总之,福建省慢性HBV感染者在HBV不同基因功能区域均存在不同程度的变异,一些与HBeAg表达情况、HBV-DNA载量、疫苗免疫逃避及肝细胞癌发生具有相关联的变异位点已经出现,BCP区A1752G位点的高频率出现应值得关注,对于这些变异位点的患者应加强监测。     

反向斑点杂交法快速检测HBV基因型反应条件的优化和建立*

利用反向斑点杂交技术,设计出特异性基因分型探针,并将探针固定在带正电荷的尼龙膜上,与PCR扩增带有地高辛标记的临床血清样本进行杂交。通过优化杂交反应条件,建立起简单、快速、特异地检测HBV基因型的方法。利用该方法对重庆地区临床样本进行分型检测,并与直接测序结果比较。结果表明新建的HBV基因分型方法可对拷贝数在103以上的血清样本准确分型,特异性达到96.67%。重庆地区感染HBV主要以B型为主。     

我国常见乙型肝炎病毒基因型与基本核心启动子及前C区突变关系的初步研究

收集81份HBV DNA阳性血清标本,经PCR扩增和序列测定确定其中有50份属于基因型C,31份属于基因型B;C基因型的基本核心启动子BCP T1762/A1764的突变率(38%)明显高于B基因型(12.9%,P<0.05);前C区A1896的突变在B、C两基因型间无显著性差异,B基因型为9.7%,C基因型为12%,P>0.05;HBeAg的表达与否与BCP双突变或前C区A1896突变均无明显相关性。经定量PCR检测证明,HBeAg阳性组中的HBV DNA含量明显高于抗-HBe阳性组,P<0.05。组内BCP双突变株和野生株及前C1896突变株和野生株的HBV DNA含量无显著性差异。     

应用4种方法检测结核分枝杆菌临床分离株对链霉素的耐受性

通过DNA测序、SSCP、RFLP和反向斑点杂交技术分析167株结核分枝杆菌临床分离株的耐药基因型,评价结核分枝杆菌rpsL或rrs基因突变与链霉素（SM）耐受性之间的关系,比较4种分子方法检测SM耐受性的临床价值。98株耐SM分离株中,78株（79．6％）rpsL 43位或88位密码子错义突变导致赖氨酸置换为精氨酸,6株（6．1％）rrs 513位碱基A突变为C或T或516位C突变为T,14株（14．3％）未发现突变;69株SM敏感的分离株未发现这两个基因突变。应用SSCP、RFLP和RDBH方法分析上述突变和野生序列的结果与DNA测序完全一致,RDBH方法可从98株耐SM分离株中正确鉴定出84株（85．7％）分离株的5种突变基因型。结果表明,应用分子技术分析rpsL和rrs基因突变可快速检测大多数结核分枝杆菌对SM的耐受性,反向斑点杂交方法是一个快速、简便和可靠地检测药物耐受性的分子方法。     

A1762T/G1764A mutations of hepatitis B virus, associated with the increased risk of hepatocellular carcinoma, reduce basal core promoter activities

Hepatitis B virus (HBV) infection is a major global health problem that causes over one million deaths annually. A1762T and G1764A mutations in the basal core promoter are often present in HBV patients but seldom in asymptomatic carriers, and are highly correlated with the increased risk of HBV-associated hepatocellular carcinoma (HCC). In this study, for the first time, we show that the basal core promoter activity of HBV strains isolated from asymptomatic carriers is decreased when 1762A is mutated to 1762T or 1764G is mutated to 1764A by site directed mutagenesis. By contrast, the promoter activity of HBV strains isolated from HCC patients is increased when 1762T and 1764A are reversely mutated into 1762A and 1764G, respectively. 1764G contributes more promoter activity than 1762T. We also show that T1762A and G1764A double mutations synergize the reduction of the promoter activity. A mechanism of HBV evasion from host immunoresponse that may facilitate disease development is also discussed.     

乙型肝炎病毒全基因序列的测定

测定７ 例慢性 Ｈ Ｂ Ｖ 携带者 Ｈ Ｂ Ｖ 基因组全序列,经同源性比较,确定基因型。２ 例基因型为 Ｂ 型,余均为 Ｃ 型;血清型ａｄｒ ４ 例,ａｄｗ ３ 例。各序列间 Ｘ 基因差异最大。未见 Ａ１８９６ 、 Ｔ１７６２ Ａ１７６４等重要位点的变异。结合已有的２ 株 Ｈ Ｂ Ｖ 中国流行株全基因序列,初步建立以中国流行株序列为基础的 Ｈ Ｂ Ｖ 标准序列,该标准序列与国外标准序列仅有２２ 个位点的差异     

Genome replication,virion secretion,and e antigen expression of naturally occurring hepatitis B virus core promoter mutants

The core promoter mutants of hepatitis B virus (HBV) emerge as the dominant viral population at the late HBeAg and the anti-HBe stages of HBV infection, with the A1762T/G1764A substitutions as the hotspot mutations. The double core promoter mutations were found by many investigators to moderately enhance viral genome replication and reduce hepatitis B e antigen (HBeAg) expression. A much higher replication capacity was reported for a naturally occurring core promoter mutant implicated in the outbreak of fulminant hepatitis, which was caused by the neighboring C1766T/T1768A mutations instead. To systemically study the biological properties of naturally occurring core promoter mutants, we amplified full-length HBV genomes by PCR from sera of HBeAg(+) individuals infected with genotype A. All 12 HBV genomes derived from highly viremic sera (5 x 10(9) to 5.7 x 10(9) copies of viral genome/ml) harbored wild-type core promoter sequence, whereas 37 of 43 clones from low-viremia samples (0.2 x 10(7) to 4.6 x 10(7) copies/ml) were core promoter mutants. Of the 11 wild-type genomes and 14 core promoter mutants analyzed by transfection experiments in human hepatoma cell lines, 6 core promoter mutants but none of the wild-type genomes replicated at high levels. All had 1762/1764 mutations and an additional substitution at position 1753 (T to C), at position 1766 (C to T), or both. Moreover, these HBV clones varied greatly in their ability to secrete enveloped viral particles irrespective of the presence of core promoter mutations. High-replication clones with 1762/1764/1766 or 1753/1762/1764/1766 mutations expressed very low levels of HBeAg, whereas high-replication clones with 1753/1762/1764 triple mutations expressed high levels of HBeAg. Experiments with site-directed mutants revealed that both 1762/1764/1766 and 1753/1762/1764/1766 mutations conferred significantly higher viral replication and lower HBeAg expression than 1762/1764 mutations alone, whereas the 1753/1762/1764 triple mutant displayed only mild reduction in HBeAg expression similar to the 1762/1764 mutant. Thus, core promoter mutations other than those at positions 1762 and 1764 can have major impact on viral DNA replication and HBeAg expression.     

乙型肝炎病毒变异与肝细胞癌发生关系

乙型肝炎病毒（hepatitisBvirus,HBV）基因组复制时,以病毒前基因组RNA作为模板合成子代病毒DNA,催化该过程的逆转录酶缺乏校对功能,所以HBV易出现变异。近年来,各国学者通过比较肝细胞癌（hepatocellular carcinoma,HCC）患者和非HCC患者的HBV基因序列,发现HBV基本核心启动子区的A1762T／G1764A变异或T1753V变异、增强子Ⅰ区的G1053A或G1229A变异、前S蛋白的F141L变异、前s2区基因缺失变异和x基因的截短变异,分别是HCC的易患因素,而前c区常见的G1896A变异,与HCC的发生无关。增强子Ⅱ区的C1653T变异在c基因HBV感染中可能与发生HCC有关,而在A基因型可能无关。     

Virological Characteristics of Acute Hepatitis B in Eastern India: Critical Differences with Chronic Infection

Hepatitis B Virus (HBV) manifests high genetic variability and is classifiable into ten genotypes (A-J). HBV infection can lead to variable clinical outcomes, ranging from self-limiting acute hepatitis to active chronic hepatitis, cirrhosis and hepatocellular carcinoma. The present study characterizes HBV strains circulating among patients with acute (AHB) and chronic HBV infection (CHB). Among a total of 653 HBsAg positive cases, 40 manifested acute infection. After sequencing the surface(S), basal core promoter/pre-core(BCP/PC) and the X gene regions, phylogenetic tree was constructed using MEGA4 by neighbor-joining method. Statistical robustness was established with bootstrap analysis. Nucleotide diversity was determined by Shannon entropy per site using the Entropy program of the Los Alamos National Laboratories. Analyses of acute patients revealed that HBV/D2 is the major circulating sub-genotype and commonly associated with sexual promiscuity and the age group between15-30 years. Comparison of AHB and CHB patients revealed that HBeAg positivity, ALT levels and genotype D were significantly high in AHB, whereas CHB patients were predominantly male, had a high viral load, and were commonly associated with genotype C. The frequencies of mutations in the S, BCP/PC, and X gene were low in AHB as compared to CHB. Drug resistant mutations were not detectable in the polymerase gene of AHB. Average nucleotide diversity in AHB was considerably low as compared to CHB. Further, the highest average ΔH (average difference in entropy between chronic and acute infection) was observed in the BCP/PC region implying that this region was most vulnerable to mutations upon HBV persistence, especially in case of genotype C. Additionally, among all substitutions, the A1762T and G1764A BCP mutations were the strongest indicators of chronicity. In conclusion, the study exhibits a general portrait of HBV strains circulating among acute hepatitis B patients in Eastern India and their intricate differences with chronic patients which should be useful from the clinical point of view.     

An improved reverse dot hybridization for simple and rapid detection of adefovir dipivoxil-resistant hepatitis B virus

Early detection of adefovir dipivoxil-resistant mutants during long-term treatment of chronic hepatitis B virus (HBV) infection with this drug is of great clinical importance. We developed an improved reverse dot hybridization test for simple and rapid detection of the rtA181V/T and rtN236T mutations associated with adefovir dipivoxil resistance in chronic hepatitis B patients. Probes were designed for genotypes B, C, and D of this resistance characteristic; a total of 70 clinical samples were analyzed with this improved reverse dot hybridization assay. Its usefulness was validated by comparing with sequencing data. Discordant results were confirmed by subclone sequencing. This reverse dot hybridization assay was sufficiently sensitive to detect 10(3) copies/mL; it also detected adefovir dipivoxil-resistant mutant strains when they comprised more than 5% of a mixed virus population. This reverse dot hybridization array correctly identified adefovir dipivoxil-resistant mutants; it had high concordance (98.5%) with direct sequencing data. There was no clear relationship between the HBV genotype and the development of adefovir dipivoxil-resistant mutants. This reverse dot hybridization assay proved to be simple and rapid for detection of rtA181V/T and rtN236T mutations associated with resistance to adefovir dipivoxil.     

乙型肝炎病毒全基因序列的测定

Seven cases of chronic hepatitis B virus carriers were included for sequencing of whole gene sequences of hepatitis B virus (HBV). The serotype of 4 strains of HBV were adr, and 3 strains were adw. Two strains were classified to genotype B, and the other 5 strains to genotype C. No significant mutations, such as A¹⁸⁹⁶, T¹⁷⁶²A¹⁷⁶⁴ were present. With other reported 2 complete sequences of HBV strains prevailing in mainland China, 7 strains of HBV whole sequences of genotype C from mainland China were analyzed to produce the consensus sequence of HBV of China. Comparing of the consensus sequence with that from Genbank, there were only 22 sites with different nucleotides.