HBV感染免疫状态与HBV基因型关系研究思路

HBV感染免疫状态不同,临床意义不同;HBV基因型不同,导致病毒致病性、变异、抗病毒等临床疗效及预后不同.HBV感染临床意义的不同,是宿主与病毒共同作用的结果.将HBV感染免疫状态与HBV基因型结合在一起研究,探索广西桂北地区不同免疫状态下基因型的分布情况及HBV感染免疫状态与基因型的关系,并希期望能针对宿主免疫状态、病毒特性,为每一位HBV感染患者制订最好的治疗方案.     

趋化因子在HBV感染发病中的作用

乙型肝炎是一种以局部炎性为主的感染性疾病,乙型肝炎病毒（HBV）感染宿主细胞后可诱导宿主细胞中趋化因子分泌及其受体表达,趋化因子／受体的相互作用进一步介导中性粒细胞、淋巴细胞等向炎症部位聚集,参与组织损伤;同时诱导T、B细胞分化成熟,对乙型肝炎的发展与转归、肝组织的损伤与修复有重要影响。HBV引发的慢性乙型肝炎（CHB）以Th1细胞性炎性反应为主,研究表明乙型肝炎中某些趋化因子在肝脏高表达,其受体CXCR3和CCR5在Th1细胞高表达。趋化因子尤其是CXC和CC亚家族趋化因子在趋化Th1细胞中发挥重要的作用：     

抗HBV与HCV免疫乳的实验免疫研究

确定重组HBV表面抗原和HCV核心抗原对奶牛的最适免疫剂量、免疫次数及间隔时间,观察牛奶中抗HBV与抗HCV的效价与消长规律。表达HBV表面抗原和HCV核心抗原的重组菌经IPTG诱导后,目的蛋白以包涵体形式存在。放大发酵工艺,菌体发酵密度达40g／L,目的蛋白表达量为26％～30％。将包涵体变性、复性后,测定蛋白含量,并用SDS-PAGE鉴定。采用不同的剂量和不同的抗原处理方法免疫奶山羊和奶牛,检测HBV抗体、HCV抗体、干扰素与白介素等细胞因子。免疫奶山羊羊奶中的HBV抗体效价最高为1：80,HCV抗体效价最高为1：20;6个月后,HBV抗体效价无明显下降,HCV抗体效价下降明显。对奶牛5个批次的免疫结果显示,免疫次数应多于3次,免疫剂量以每头牛300μg为宜,间隔时间以1个月为宜。免疫牛奶中HBV抗体的阳性率约为66．0％,抗体效价最高为1：160;HCV抗体阳性率约为17．0％,维持时间较短;孕牛比旺奶牛产生抗体的效价高。免疫牛奶中检测到了干扰素和白介素等细胞免疫活性因子。     

广西桂北地区HBV感染者不同免疫状态HBV基因型分布研究

为了了解广西桂北地区乙型肝炎病毒(Hepatitis B Virus,HBV)感染者基因型分布情况及探讨HBV感染不同免疫状态与基因型的关系。将HBV感染者按免疫耐受、免疫清除(应答)和免疫不全(病毒残留)三种免疫状态分类,各选150例,共450例,运用实时荧光定量PCR法检测HBV感染三种不同免疫状态者的HBV基因型。450例中B型为323例、C型为94例、B+C混合型为23例和非B非C型为10例;HBV感染三种免疫状态均B型占多数,分别为70.0%、78.0%和67.33%,不同免疫状态基因型构成比差异无统计学意义;免疫状态与基因型相关性无统计学意义;B型HBV-DNA载量高于C型,各组中年龄≥30岁者C型显著多于30岁者,差异有统计学意义;各基因型间丙氨酸氨基转移酶(ALT)、天门冬氨酸氨基转移酶(AST)、总胆红素(TBil)阳性率差别无统计学意义;男女基因型分布差异无统计学意义。结果表明,广西桂北地区HBV基因型以B型为主,C型占部分比例,少量B+C混合型,偶有未能分型;HBV感染免疫耐受、免疫清除(应答)和免疫不全(病毒残留)三种免疫状态均B型占多数,慢性HBV感染免疫状态与HBV基因型相关性无统计学意义。     

乙型肝炎免疫指标全阴的原发性肝细胞癌患者体内HBV—DNA的检测…

本文以聚合酶链式反应（ＰＣＲ）对３５例乙型肝炎免疫指标（ＨＢＶｍ）全阴性的原发性肝细胞癌（ＰＨＣ）患者血清,外周血单核细胞（ＰＢＭＣ）肝活检标本进行乙型肝炎病毒ＨＢＶ－ＤＮＡ检测,其检出率分别为３４．２９％,６０．００％,６８．５７％,说明一部分血清ＨＢＶｍ全阴性的ＰＨＣ患者血清并非无传染性,ＥＬＳＩＡ法具有一定局限性。ＰＢＭＣ内有相当的ＨＢＶ－ＤＮＡ存在,这对于研究ＰＨＣ患者体内ＨＢＶ的存在情况     

HCV/HBV复合抗原基因的克隆、表达及免疫应答研究

为探讨ＨＣＶ／ＨＢＶ 复合疫苗的可行性,将合成的丙型肝炎病毒（ＨＣＶ）复合多表位抗原基因ＰＣＸ与ＨＢｓＡｇ 基因连接成ＰＣＸＳ基因,与β－半乳糖苷酶（ＧＺ）基因融合后在大肠杆菌及减毒鼠伤寒沙门氏菌中获得表达．目的蛋白ＧＺ－ＰＣＸＳ可被抗－ＨＢｓ 及抗－ＨＣＶ 抗体所特异识别．ＧＺ－ＰＣＸＳ抗原皮下注射免疫ＩＣＲ小鼠后,诱发了较高水平的抗－ＧＺ－ＰＣＸＳＩｇＧ反应．构建的重组减毒鼠伤寒沙门氏菌ＳＬ３２６１（ｐＷＲ／ＰＣＸＳ）口服免疫小鼠后,诱发了高水平的ＣＤ８＋ Ｔ细胞增殖反应及抗ＧＺ－ＰＣＸＳＩｇＧ反应．所有免疫小鼠均未见明显的毒副作用．该研究揭示,ＨＣＶ／ＨＢＶ 复合抗原可诱发特异性体液免疫及细胞免疫应答,而活菌苗口服可能是理想的免疫途径,为ＨＣＶ／ＨＢＶ 双价疫苗研究提供了一定的理论及实验依据．     

乙型肝炎病毒变异与宿主免疫应答的研究进展

分子生物学与免疫学的新进展使乙型肝炎病毒（ＨＢＶ）的研究发生了革命的变化。由突变ＨＢＶ所致不同类型的感染是由宿主免疫系统,干扰素（ＩＦＮ）的反应和病毒基因型之间的复杂相互作用所致。本文从病毒变异与宿主免疫应答两方面综述了近年来ＨＢＶ分子生物学研究中的新进展。     

蛋白激酶底物p36在肝硬变、肝细胞肝癌中的表达及与HBV、HCV感染的关系

本文应用鼠抗蛋白激酶底物ｐ３６单克隆抗体,采用免疫组织化学法对ｐ３６在５４例肝硬变,７９例肝细胞肝癌中的表达分布进行了研究,同时结合ＨＢＶ、ＨＣＶ感染情况分析其相互关系,结果显示：ｐ３６在肝硬变及肝细胞肝癌中定位于肝细胞或癌细胞胞浆内,在胞浆内弥漫分布,阳性细胞呈灶状或弥漫分布,部分病例癌周肝细胞信号较癌组织为强,ｐ３６在肝硬变、肝细胞癌中的阳性率分别为８８．８％（４８／５４）及８２．３（６５／７９）,ＨＢｘＡｇ在两种组织的阳性率分别为７０．４％及７６％,ＨＣＶ核心抗原在两种组织的阳性率分别为８０％及７８．５％;三者同时阳性分别为５５．５％及５８．２％;ｐ３６、ＨＢｘＡｇ同时阳性分别为６８．５％及６４．５％;ｐ３６、核心抗原同时阳性分别为７４．１％及７０．８％,我们的结果提示,肝硬变、肝细胞肝癌组织中ｐ３６存在高表达,其高表达可能与ＨＢＶ、ＨＣＶ感染密切相关     

乙肝疫苗免疫后抗体的持久性

<正> 据报导,医护人员连续接种三针疫苗后,93％～98％的接种者抗体上升。几年后抗体下降,其比率与每一接种者获得最大抗体应答的具体情况有关,尚无文献记载免疫后抗体的持续时间,五年的随访调查证实,接种疫苗的同性恋者,早期具有抗体应答的,五年后抗体仍是阳性者占58％。     

Inhibition of the replication of hepatitis B virus in vitro by a novel 2,6-diaminopurine analog, beta-LPA

Antiviral therapy of chronic hepatitis B remains a major clinical problem worldwide. Like lamivudine, nucleoside analogs have become the focus of investigation of anti-hepatitis B virus (anti-HBV) drugs. Here, β-LPA is a novel 2,6-diaminopurine analog found to possess potent anti-HBV activity. In HepG2.2.15 cell line, β-LPA had a 50% effective concentration (EC₅₀) of 0.01 μM against HBV, as determined by analysis of secreted and intracellular episomal HBV DNA. Levels of HBV surface antigen (HBsAg) and e antigen (HBeAg) in drug-treated cultures revealed that β-LPA had no significant inhibitory effects on HBsAg and HBeAg. β-LPA didn’t show any cytotoxicity up to 0.4 μM with a 50% cytotoxic concentration (CC₅₀) of 50 μM. Furthermore, treatment with β-LPA resulted in no apparent inhibitory effects on mitochondrial DNA content. Considering the potent inhibition of HBV DNA synthesis and no obvious toxicity of β-LPA, this compound should be further explored for development as an anti-HBV drug.     

血清乙肝病毒大蛋白与乙肝前S1抗原联合检测在HBeAg阴性乙肝患者诊断中的意义

目的 探讨乙型肝炎e抗原阴性[HBeAg（－）]乙肝患者血清乙肝病毒大蛋白（HBV-LP）和乙肝前S1抗原（PreS1-Ag）联合检测的临床意义。方法 采用酶联免疫吸附（ELISA）法测定300例慢性乙肝患者的血清HBV-LP和PreS1-Ag浓度;实时荧光定量PCR（qRT-PCR）法检测血清HBV-DNA表达量;比较不同HBV-M模式下HBV-LP、PreS1-Ag与HBV-DNA的阳性检出率;分析以HBV-DNA表达量作为HBV感染及复制的金标准时,血清HBV-LP和PreS1-Ag单独检测及联合检测对HBeAg阴性乙肝患者的阳性预测值和阴性预测值。结果 （1）115例HBeAg（+）血清中,HBV-LP和PreS1-Ag的阳性率均与HBV-DNA阳性率差异无统计学意义（Ps＞0.05）;120例HBeAg（－）HBeAb（+）血清中,HBV-LP阳性率（64.2%）明显高于HBV-DNA阳性率（P＜0.05）,而PreS1-Ag阳性率与HBV-DNA阳性率差异无统计学意义（P＞0.05）;65例HBeAg（－）HBeAb（－）血清中,HBV-LP阳性率（72.3%）和PreS1-Ag阳性率（67.7%）均明显高于HBV-DNA阳性率（Ps＜0.05）;（2）以185例HBeAg（－）乙肝患者的HBV-DNA表达量为参考标准,HBV-LP、PreS1-Ag的阳性预测值分别为72.6%、71.6%,阴性预测值分别为93.4%、84.1%;HBV-LP和PreS1-Ag联合检测,HBV-LP/PreS1-Ag双阳性中的HBV-DNA阳性率（66.0%）显著高于HBV-LP/PreS1-Ag双阴性（P＜0.05）。结论 血清HBV-LP和PreS1-Ag水平与HBV-DNA表达量有关,二者联合检测可灵敏地反映HBeAg（－）乙肝患者HBV的复制状态,预测HBV-DNA水平。     

A viral mechanism in acute exacerbations of chronic type B hepatitis: Hepatitis B virus reinfection and subsequent reactivation of two viral strains

Chronic hepatitis B virus (HBV) infections are frequently associated with exacerbations of hepatitis of which the majority are due to reactivation of viral activity. Variation in a viral genome during persistent infection has been shown to be a possible cause for reactivation. In this study, we have found another possible mechanism. HBV in a patient with repeated exacerbations was isolated at six different times during follow-up and was characterized by polymerase chain reaction and DNA sequencing. The first episode of exacerbation was accompanied with increased replication of an HBV strain. The second episode, however, was associated with the sudden appearance of an HBV strain that displayed enough sequence variations to warrant the designation as a separate strain. The results suggested a reinfection event by another independent HBV. Subsequent exacerbations were then related to coactivation of both viral stains. These observations provide significant information toward understanding the acute exacerbations of chronic type B hepatitis.     

Modeling the mechanisms of acute hepatitis B virus infection

Mathematical models have been used to understand the factors that govern infectious disease progression in viral infections. Here we focus on hepatitis B virus (HBV) dynamics during the acute stages of the infection and analyze the immune mechanisms responsible for viral clearance. We start by presenting the basic model used to interpret HBV therapy studies conducted in chronically infected patients. We then introduce additional models to study acute infection where immune responses presumably play an important role in determining whether the infection will be cleared or become chronic. We add complexity incrementally and explain each step of the modeling process. Finally, we validate the model against experimental data to determine how well it represents the biological system and, consequently, how useful are its predictions. In particular, we find that a cell-mediated immune response plays an important role in controlling the virus after the peak in viral load.     

Vaccine- and hepatitis B immune globulin-induced escape mutations of hepatitis B virus surface antigen

Hepatitis B virus surface antigen (HBsAg) vaccination has been shown to be effective in preventing hepatitis B virus (HBV) infection. The protection is based on the induction of anti-HBs antibodies against a major cluster of antigenic epitopes of HBsAg, defined as the 'a' determinant region of small HBsAg. Prophylaxis of recurrent HBV infection in patients who have undergone liver transplantation for hepatitis B-related end-stage liver disease is achieved by the administration of hepatitis B immune globulins (HBIg) derived from HBsAg-vaccinated subjects. The anti-HBs-mediated immune pressure on HBV, however, seems to go along with the emergence and/or selection of immune escape HBV mutants that enable viral persistence in spite of adequate antibody titers. These HBsAg escape mutants harbor single or double point mutations that may significantly alter the immunological characteristics of HBsAg. Most escape mutations that influence HBsAg recognition by anti-HBs antibodies are located in the second 'a' determinant loop. Notably, HBsAg with an arginine replacement for glycine at amino acid 145 is considered the quintessential immune escape mutant because it has been isolated consistently in clinical samples of HBIg-treated individuals and vaccinated infants of chronically infected mothers. Direct binding studies with monoclonal antibodies demonstrated a more dramatic impact of this mutation on anti-HBs antibody recognition, compared with other point mutations in this antigenic domain. The clinical and epidemiological significance of these emerging HBsAg mutants will be a matter of research for years to come, especially as data available so far document that these mutants are viable and infectious strains. Strategies for vaccination programs and posttransplantation prophylaxis of recurrent hepatitis need to be developed that may prevent immune escape mutant HBV from spreading and to prevent these strains from becoming dominant during the next decennia.     

两种抽提乙型肝炎病毒共价闭合环状DNA方法的效果比较

乙型肝炎病毒(hepatitis B virus,HBV)作为一种嗜肝DNA病毒,在感染肝细胞后会在细胞核中形成病毒转录复制的模板和基因储存库--共价闭合环状DNA(covalently closed circular DNA, cccDNA),其持续存在是乙型肝炎慢性化和难以治愈的核心,也是此研究领域内的重点。从细胞样品中稳定抽提获取cccDNA对于保证cccDNA检测的准确性至关重要。Hirt法是一种抽提真核细胞染色体外DNA的方法,被用于HBV cccDNA的抽提,但存在操作复杂和耗时长等问题。为简化操作,有研究对Hirt法进行改良,结合硅胶膜离心柱来抽提染色体外DNA,但尚不清楚该法用于HBV cccDNA抽提与传统Hirt法的效果差异。本研究基于HBV cccDNA细胞转染系统、HBV复制细胞系及感染系统,以DNA印迹(Southern blot)和定量聚合酶链式反应(quantitative polymerase chain reaction, qPCR)作为检测评价手段,平行比较了传统Hirt-酚/氯仿法与改良Hirt-过柱法抽提HBV cccDNA的效果。结果表明,两种方法具有相当的抽提效率和抽提特异性,而改良Hirt-过柱法耗时更短,提示在进行细胞HBV cccDNA抽提时可选择改良Hirt-过柱法以提高实验效率。     

乙型肝炎病毒DNA疫苗的研究进展

预防与控制乙型肝炎发病的乙型肝炎病毒(HBV)疫苗,是有重大的社会和经济意义。HBV的持续感染可引起慢性肝脏疾患,并逐步发展为肝硬化和肝细胞癌(HCC)。目前的乙肝重组亚单位疫苗可以使90％的接种产生保护性抗体;但是对慢性HBV携带,由于其机体对HBsAg蛋白产生耐受,不能产生体液和细胞免疫,因此它只能作为一种预防性的疫苗。DNA疫苗(基因疫苗)是一种新的疫苗技术,通过向体内递送编码抗原的细菌质粒,刺激产生特异的体液和细胞免疫反应。在小鼠和其他的肝炎病毒感染动物模型中,HBV DNA疫苗可以特异性地引起体液和细胞免疫,清除HBV转基因动物血循环中的HBsAg颗粒和HBV DNA。如果加入各种免疫调节细胞因子的基因,可以进一步提高HBV DNA疫苗的免疫效果,因此它不仅可作为预防性疫苗,也可作为治疗型疫苗。     

Small rodent models of hepatitis B and C virus replication and pathogenesis

The narrow host range of infection supporting the long-term propagation of hepatitis B and C viruses is a major limitation that has prevented a more thorough understanding of persistent infection and t...