肠道菌群失衡对乙型肝炎相关慢加急性肝衰竭患者 血浆降钙素原升高的影响

目的探讨肠道菌群失衡对乙型肝炎相关慢加急性肝衰竭(hepatitis B virus-related acute-on-chronic liver failure,HBV-ACLF)患者血浆降钙素原(procalcitonin,PCT)水平升高的影响。方法检测29例HBV-ACLF(肝衰组)、14例慢性乙型肝炎(乙肝组)患者入院时的血浆PCT、内毒素(endotoxin,LPS)水平,收集患者新鲜尾便并通过高通量测序检测肠道菌群状况,统计分析两组患者间肠道菌群、B/E值、PCT和LPS水平的差异,以及肝衰组患者PCT、LPS、B/E值三者间的相关性。结果与乙肝组患者比较,肝衰组厚壁菌门、放线菌门、双歧杆菌属、乳杆菌属等肠道细菌显著减少,而拟杆菌门、变形菌门、埃希菌属等肠道细菌过度生长,两组患者间各菌群比较差异均具有统计学意义(t=-4.84,Z=-2.84,Z=-2.57,Z=-4.39,t=3.59,t=2.64,t=2.19,P0.01、0.01、=0.01、0.01、0.01、=0.01、=0.04);肝衰组PCT[0.50(0.96)]ng/mL、LPS(0.46±0.10)EU/mL、B/E值(0.04±0.01),乙肝组PCT(0.08±0.02)ng/mL、LPS(0.05±0.02)EU/mL、B/E值(1.62±0.31),各指标两组间比较差异均具有统计学意义(Z=-3.17,t=5.88,t=16.18,P0.01、0.01、0.01);肝衰组B/E值与LPS水平呈负相关关系(r=-0.81,P0.01),B/E值与PCT水平呈负相关关系(r=-0.79,P0.01),且PCT水平与LPS呈正相关关系(r=0.76,P0.01)。结论 HBV-ACLF患者肠道菌群失衡导致肠源性LPS生成增多,而肠源性LPS促使PCT产生增多。     

甲型肝炎病毒的提取及免疫学性质分析

目的建立甲型肝炎病毒(hepatitis A virus, HAV)的提取方法,了解和掌握HAV的免疫学性质。方法利用人胚肺二倍体细胞培养并收获HAV,用层析纯化等方法提取HAV,然后通过抗原检测、免疫电镜检查以及小鼠免疫试验对HAV的免疫学性质进行检测和分析。结果利用层析纯化等方法提取HAV,抗原回收率达84%以上,蛋白去除率达97%以上,电镜及免疫电镜检查可以观测到典型的HAV以及HAV+IgM抗原抗体免疫复合物和HAV+IgG抗原抗体免疫复合物,免疫小鼠抗体阳转率为100%。结论利用层析纯化等方法可以对HAV进行有效提取,提取的HAV具有良好的免疫反应性和免疫原性。     

人类免疫缺陷病毒/丙型肝炎病毒混合感染者免疫细胞和肝生化指标的分析

目的 探讨人类免疫缺陷病毒/丙型肝炎病毒(HIV/HCV)混合感染者的免疫淋巴细胞亚群和肝脏生化指标的特征。方法 检测并分析研究组(40例混合感染HIV/HCV的血友病患者)和对照组(12例单独感染HIV的血友病患者)若干相关实验室指标。结果两组(研究与对照)结果 差异显著的指标分别为:自然杀伤(NK)细胞9.26%±5.98%对12.19%±5.80%,P<0.05;CD4/CD8细胞比值0.39±0.21对0.53±0.24,P<0.05;CD3细胞74.99%±10.33%对68.42%±8.82%,P<0.05;CD8细胞52.28%±12.59%对43.58%±10.99%,P<0.05;丙氨酸氨酶(ALT)(48.59±40.21)U/L对(26.87±27.23)U/L,P<0.01;天冬氨酸转氨酶(AST)(61.66±51.02)U/L对(34.17±30.24)U/L,P<0.001;谷氨酰转肽酶(GGT)(136.50±111.50)U/L对(43.88±36.17)U/L,P<0.001;甘胆酸(CG)(683.41±962.22)μg/L对(250.96±290.81)μg/L,P<0.001;透明质酸(HA)(180.94±196.69)ng/ml对(64.68±32.74)ng/ml,P<0.001;白/球蛋白(A/G)比值1.35±0.24对1.50±0.34,P<0.05。与单独HIV感染者比较,HIV/HCV混合感染者的NK细胞、CD4/CD8细胞比值和A/G比值显著降低,而ALT、AST、GGT、CG和HA的水平显著增加。结论 HIV/HCV混合感染可能加剧患者淋巴细胞亚群的不平衡,加重肝脏损伤和出现肝硬化趋势。     

MyD88抑制乙型肝炎病毒复制依赖活化NF-κB信号通路

目的 研究髓样细胞分化蛋白(MyD88)抗乙型肝炎病毒(HBV)效应的作用机制。方法 构建MyD88的截短突变体,获得核因子kappa B(NF-κB)超抑制剂IkBa-SR或者NF-κB信号通路激活剂IKKα/IKKβ的表达质粒,分别与HBV复制型质粒瞬时转染Huh7细胞,检测细胞上清液中HBeAg,HBsAg的表达以及胞质中HBV复制中间体DNA的含量,并以NF-κB依赖的荧光素酶报道系统检测它们活化NF-κB的程度。结果 MyD88全长蛋白和2个截短突变体M(1-151)、M(151-296)活化NF-κB的程度与其抑制HBV蛋白以及复制中间体DNA合成的能力相一致。与空载相比,表达NF-κB信号通路激活剂IKKα/IKKβ的质粒共同瞬转细胞后,转染MyD88和HBV表达质粒的细胞中NF-κB的通路明显活化,同时HBV core蛋白的合成显著降低;而NF-κB的超抑制剂IκBα-SR共同瞬转的细胞中core蛋白的表达量显著增加,检测细胞培养上清液中HBeAg和HBsAg及胞质中HBV复制中间体DNA的合成,得到相似结果。结论 NF-κB信号通路的活化在MyD88抑制HBV复制中发挥了关键作用     

母乳喂养与婴儿HCV感染关系的研究

目的：探讨母乳喂养与婴儿HCV感染的关系。方法：采用Meta分析方法对中国生物医学数据库、雏普数据库、方正数据库、PUBMED数据库和MEDLINE报道的文献进行分析。纳入标准依据Abdolmaleky HM方法。用RevMan4．2软件对纳入文献计算特异OR值。x^2test检验OR值异质性。联系的强度采用0R值进行评价。结果：共有120篇文献,37篇为综述,只有6篇文献符合纳入标准。Meta分析OR值为0．60（95％CI=0．22-1．60）,证实母乳喂养与婴儿HCV感染无关。结论：母乳喂养不是婴儿感染HCV的危险因素。     

氧化应激下角质形成细胞中YTHDC1升高促进IL-1β表达

摘要 目的：探讨氧化应激下角质形成细胞内m6A甲基化修饰酶YTHDC1异常对促炎因子的调控机制。方法：通过Western blot和qRT-PCR实验检测氧化应激下角质形成细胞中YTHDC1蛋白和mRNA表达水平。siRNA转染至角质形成细胞以干涉YTHDC1表达,随后继续给予300 μM过氧化氢处理,通过Western blot和qRT-PCR实验检测角质形成细胞中促炎因子IL-1β蛋白和mRNA表达,进一步通过ELISA检测细胞上清中IL-1β分泌,通过CCK8法检测细胞存活水平。结果：1）过氧化氢刺激后人角质形成细胞系HaCaT细胞中YTHDC1表达水平较未处理组明显升高;2）干涉YTHDC1可以显著降低HaCaT细胞中IL-1β表达和上清中分泌;3）干涉YTHDC1后IL-1β mRNA稳定性下降,并且细胞存活率下降。结论：氧化应激下角质形成细胞中m6A甲基化修饰酶YTHDC1表达水平升高,通过提高mRNA稳定性促进IL-1β表达,可能是外界环境应激引起各种免疫性皮肤病的重要机制。     

血清VEGF、miR-122、GDF15及TK1在乙肝相关性肝病表达水平及其临床意义

摘要 目的：分析不同类型乙肝相关性肝病患者血清血管内皮生长因子（VEGF）、microRNA-122（miR-122）、生长分化因子15（GDF-15）及胸苷激酶1（TK1）的表达差异变化及其临床意义。方法：随机选取2020年1月-2022年6月在我院消化内科收治的不同类型乙肝相关性肝病患者135例作为研究组。其中根据乙型肝炎诊断标准分为慢性乙型肝炎组（CHB）76例,乙型肝炎肝硬化组（LC）57例,乙型肝炎肝癌组（HCC）78例,选取同时期在本院进行体检的健康受检者96例作为健康组。比较各组的基本资料、检测研究对象血清VEGF、miR-122、GDF15、TK1、HBV DNA载量水平和AFP表达水平。采用Pearson相关性检验分析乙肝相关性肝病患者血清VEGF、miR-122、GDF15及TK1表达水平与HBV DNA载量水平的相关性,采用受试者工作特征曲线（ROC）诊断LC和HCC的价值。结果：CHB 组、LC 组 和HCC组VEGF、TK1表达水平显著高于健康组,差异具有统计学意义（P<0.01）,CHB 组、LC 组 和HCC组组间两两比较,差异具有统计学意义（P<0.01）。CHB 组、LC 组 和HCC组miR-122表达水平显著低于健康组,差异具有统计学意义（P<0.01）,CHB 组、LC 组 和HCC组组间两两比较,差异具有统计学意义（P<0.01）。LC 组 和HCC组GDF15表达水平显著高于 CHB 组和健康组,差异具有统计学意义（P<0.01）,CHB 组和健康组组间比较差异无统计学意义（P>0.05）。CHB 组、LC 组 和HCC组HBV DNA载量水平显著高于健康组,差异具有统计学意义（P<0.01）,LC 组 和HCC组组间比较,差异无统计学意义（P>0.05）。LC 组 和HCC组AFP表达水平显著高于 CHB 组和健康组,差异具有统计学意义（P<0.01）,LC 组 和HCC组、CHB 组和健康组组间比较差异无统计学意义（P>0.05）。CHB组、LC+HCC组血清VEGF、miR-122、GDF15及TK1水平与HBV DNA载量水平具有相关性（P<0.01或P<0.05）。血清VEGF、miR-122、GDF15及TK1单独检测诊断LC和HCC的曲线下面积（AUC）为0.695、0.783、0.743及0.7687,四项指标联合检测诊断LC和HCC的AUC为0.839,敏感度为84.21,特异度为83.25。结论：血清VEGF、miR-122、GDF15及TK1在各类型乙肝相关性肝病中表达水平存在差异,血清VEGF、miR-122、GDF15及TK1联合检测诊断LC和HCC具有临床价值。     

Hepatitis E Virus: An emerging enigmatic and underestimated pathogen

Hepatitis E virus (HEV) is an RNA virus causing hepatitis E disease. The virus is of one serotype but has diverse genotypes infecting both humans and animals. Based on evidence from seroprevalence studies, about 2 billion people are estimated to have been infected with HEV globally. HEV, therefore, poses a significant public health and economic challenge worldwide. HEV was discovered in the 1980s and was traced back to the 1955 – 1956 outbreak of hepatitis that occurred in India. Subsequently, several HEV epidemics involving thousands of individuals have occurred nearly annually in different countries in Asia and Africa. Initially, the virus was thought to be only enterically transmitted, and endemic in developing countries. Due to the environmental hygiene and sanitation challenges in those parts of the world. However, recent studies have suggested otherwise with the report of autochthonous cases in industrialised countries with no history of travel to the so-called endemic countries. Thus, suggesting that HEV has a global distribution with endemicity in both developing and industrialised nations. Studies have also revealed that HEV has multiple risk factors, and modes of transmission as well as zoonotic potentials. Additionally, recent findings have shown that HEV leads to severe disease, particularly among pregnant women. In contrast to the previous narration of a strictly mild and self-limiting infection. Studies have likewise demonstrated chronic HEV infection among immunocompromised persons. Consequent to these recent discoveries, this pathogen is considered a re – emerging virus, particularly in the developed nations. However, despite the growing public health challenges of this pathogen, the burden is still underestimated. The underestimation is often attributed to poor awareness among clinicians and a lack of routine checks for the disease in the hospitals. Thus, leading to misdiagnosis and underdiagnosis. Hence, this review provides a concise overview of epidemiology, diagnosis, and prevention of hepatitis E.     

乙型肝炎病毒体外感染和复制的细胞模型

慢性乙型肝炎病毒(Hepatitis B virus,HBV)感染是严重威胁人类生命健康的世界性公共卫生问题。基于现有抗HBV药物的治疗策略,仅能在极少部分患者中实现慢性乙肝的功能性治愈。发展更为有效的抗HBV药物,需要更加透彻全面地认识各个病毒组分和关键宿主因子在HBV感染和复制生命周期中发挥的功能和机制,并在此基础上发现鉴定新的治疗靶点。支持HBV体外感染和复制的细胞模型,是研究HBV生活史的重要工具,并在治疗新靶点的发现和候选药物功效评估等研究工作中发挥关键作用。本文对支持HBV感染和复制细胞模型的新近研究进展进行梳理分析,并对这些模型的应用特点和局限性、新近研究进展和未来发展方向进行系统阐述和讨论。     

Discovery of a novel series of hDHODH inhibitors with anti-pulmonary fibrotic activities

Human dihydroorotate dehydrogenase (hDHODH) is a flavin-dependent enzyme essential to pyrimidine de novo biosynthesis, which serves as an attractive therapeutic target for the treatment of autoimmune disorders. A novel series of hDHODH inhibitors was developed based on a lead which was obtained by a medicinal chemistry exploration. Most compounds showed moderate to significant potency against hDHODH, compounds 5d, 5e, and 6a effectively inhibited the activities of hDHODH with IC₅₀ values from 0.9 to 2.8 μM. Further studies showed that compound 5e also effectively suppressed proliferation of the activated PBMCs (IC₅₀ = 20.35 μM). Surprisingly, compound 5e also showed anti-pulmonary fibrotic activity similar to that of pirfenidone in vitro assay. Therefore, compound 5e might have potential to be developed as a novel hDHODH inhibitors for autoimmune diseases therapy.