应用转化细胞分泌的乙型肝炎病毒e抗原检测人血清中的乙型肝炎病毒e抗体

应用乙型肝炎病毒核心抗原基因转化的小鼠L细胞分泌的乙型肝炎病毒e抗原,采用ELISA法与Abbott公司抗-HBe EIA诊断盒平行比较,检测了31份抗-HBe阳性和19份抗-HBe阴性的人血清,结果完全相符。经多次重复试验,本法的OD490nm值的误差不超过8％。OD490nm值与血清稀释度之间呈直线关系。细胞培养液不经纯化即可应用,一般做1:4稀释。细胞分泌的抗原无感染性,价格低廉,不会因结合人血清蛋白而产生非特异性反应。因此比一般诊断盒中所用的人血清HBeAg有很大的优越性。     

基因工程表达的乙型肝炎病毒核心抗原转变为e抗原的研究

乙型肝炎病毒核心抗原及e抗原均为乙型肝炎病毒核衣壳的重要组成部分。自从发现病毒核心颗粒中存在着e抗原之后,它们之间的关系一直是人们研究的课题。有些报道认为,e抗原是核心抗原的组成成份。有人通过实验发现核心抗原和e抗原的氨基酸序列极其     

大肠杆菌表达的乙型肝炎病毒核心抗原的某些理化特性

1979年Pasek等用大肠杆菌表达乙型肝炎病毒核心抗原(HBcAg)成功以来,国内外也有类似的报道,但对其理化特性的报道不多。为了更有效地保存和应用此抗原,本文研究了从表达HBcAg的大肠杆菌菌液中纯化抗原的方法,以及抗原的某些特性。 HBcAg是由pHBV-1的C基因与pTL载体重组后在大肠杆菌BMH71-18内表达的,     

重组乙型肝炎病毒e抗原的研究进展

乙型肝炎e抗原（HBeAg）是由HBV DNA C基因区编码的一种非颗粒性的分泌型核壳蛋白,临床上将其作为判断HBV活动性复制的指标之一。HBeAg是重要的生物原材料,广泛用于HBV感染者血清学检测的相关诊断用品的制备。重组HBeAg的表达和纯化技术较为成熟,已经在各种表达系统中成功地表达了目的蛋白。而影响其表达的关键因素包括前C区重要位点变异、载体选取以及RNA干扰（RNAi）的影响作用等。因此,提高重组HBeAg的表达量和纯度,避免与HBcAg交叉反应才能满足相关诊断制品的要求。高质量重组乙肝e抗原的获取,能为改善相关诊断制品奠定物质基础,为开发新型HBV治疗和预防性疫苗提供了依据,同时也为HBeAb检测方法学的优化提供可能。     

乙肝e抗原在大肠杆菌中的高效表达和优化

目的:探讨乙型肝炎病毒e抗原基因在大肠杆菌中进行高效融合表达,并对表达条件进行优化和影响因素的分析.方法:从乙肝患者阳性血清中提取DNA,设计引物扩增目的基因,按常规方法克隆入pET-GST载体谷胱甘肽-S-转移酶(GST)基因的下游,获得的重组质粒转化大肠杆菌BL21,用IPTG诱导目的基因片段的表达,经超声处理后SDS-PAGE电泳.对表达条件进行正交试验优化,并分析其影响因素的大小.结果:HBeAg以包涵体形式表达出来,其表达的GST融合蛋白的分子质量大约为44KD.最佳的表达条件为温度为30℃,IPTG浓度为0.6mmol/L,诱导时间为2h.其影响因素大小依次为诱导温度＞诱导时闻＞IPTG浓度.结论:乙肝e抗原基因在大肠杆茵中获得了高效表达.     

含不同长度前C序列的乙型肝炎病毒核心抗原基因在重组痘苗病毒中的表达

核酸序列分析表明,乙型肝炎(乙肝)病毒核心抗原基因(C基因)编码区内存在两个ATG。目前认为第二个ATG为乙肝病毒C抗原的起始密码子,两个ATG之间的序列称为前C序列,共87bp。Uy、Rutter、Roossinck及景新等的研究表明,含前C序列时,C基因在大肠杆菌中的表达是形成具有HBeAg活性的P25~e膜蛋白,在哺乳动物细胞中的表达则是形成分泌性的HBeAg;不含前C序列时,在大肠杆菌和哺乳动物细胞中均形成P21~e     

乙型肝炎病毒e抗原定量检测的性能验证和临床应用探索

乙型肝炎病毒e抗原(hepatitis B e antigen, HBeAg)的定量检测对乙型肝炎临床诊疗具有一定的重要性,但其定量检测还未成为常规检验项目。本研究对HBeAg定量检测系统进行性能验证,比较HBeAg定量和定性检测的相关性和一致性,分析HBeAg定量结果和乙型肝炎病毒DNA(hepatitis B virus DNA, HBV DNA)的关系,为HBeAg定量检测在临床诊疗的应用提供依据。通过收集710例2019年3月至5月于复旦大学附属华山医院就诊的慢性乙型肝炎患者血清样本,参照美国临床实验室标准化协会(The Clinical & Laboratory Standards Institute, CLSI)相关文件的要求,对雅培ARCHITECTi4000SR全自动免疫分析仪检测的HBeAg定量试剂的精密度、分析灵敏度、线性范围/可报告范围、携带污染率进行验证和评价;采用化学发光微粒子免疫检测技术(chemiluminescence microparticle immuno assay, CMIA)对618例患者进行HBeAg定性和定量检测;采用荧光定量PCR对慢性乙型肝炎患者进行HBV DNA检测,比较HBV DNA和HBeAg定量结果的相关性。本研究证实HBeAg定量试剂检测性能验证结果良好;HBeAg定量和定性检测相关性良好;126例同时有HBeAg定量检测和HBV DNA定量检测的结果显示,两种方法呈正相关且一致性良好。HBeAg定量检测可用于常规实验室检测来辅助HBV感染的临床诊疗。     

免疫预防阻断乙型肝炎病毒母婴传播效果的观察

阻断乙型肝炎病毒(HBV)母婴传播是控制乙型肝炎的重大问题。为探讨免疫预防对阻断HBV母婴传播的效果及影响因素,对667例HBV表面抗原(HBsAg)阳性孕妇及其婴儿进行研究。这些孕妇按HBVe抗原(HBeAg)和HBVDNA检测结果,分为HBeAg阳性组及阴性组、DNA阳性组及阴性组;按是否于孕晚期注射乙型肝炎免疫球蛋白(HBIG),分为注射组及未注射组。婴儿于出生24h内均肌内注射HBIG100IU,并按0、1、6方案注射10μg重组酵母HBV疫苗;8～12月龄后随访婴儿,并进行HBV标志物(HBV-M)检测。667个婴儿中,20例感染HBV,免疫阻断失败率为3.0%。孕妇HBeAg阳性组免疫阻断失败率为8.7%,阴性组为0.2%,两组差异显著(P<0.001);两组婴儿对疫苗免疫应答率分别为83.0%和83.1%,无显著差异(P=0.988)。孕妇DNA阳性组免疫阻断失败率为8.1%,HBVDNA均≥6log10copies/ml。孕期注射与未注射HBIG组婴儿免疫阻断失败率分别为3.7%和2.7%,无显著差异(P=0.479);两组婴儿对疫苗免疫应答率分别为84.4%和82.4%,无显著差异(P=0.519)。孕妇HBeAg阳性注射HBIG组与未注射组的免疫阻断失败率分别为8.4%和8.9%,无显著差异(P=0.892)。孕妇HBeAg阴性注射与未注射HBIG组的免疫阻断失败率分别为0.0%和0.3%,也无显著差异(P=0.538)。11例免疫阻断失败的婴儿中,10例出生时血清HBsAg已为阳性;8～12个月后随访,HBsAg仍持续阳性,提示为宫内感染。本研究证实,孕期注射HBIG未能提高婴儿对HBV疫苗加HBIG的免疫阻断效果。宫内感染可能是疫苗加HBIG免疫阻断失败的主要原因。采用降低孕妇血清HBVDNA的措施,如对孕妇进行抗HBV治疗,也许能降低HBV宫内感染率。     

抗原抗体复合物型治疗性疫苗(乙克)临床研究中患者血清乙型肝炎病毒表面抗原下降的分析与启示

近年来全球慢性乙型肝炎(chronic hepatitis B,CHB)防治指南提出了“功能性治愈”(functional cure)的概念,即患者经过治疗达到血清乙型肝炎病毒表面抗原(hepatitis B virus surface antigen,HBsAg)消失,但现有抗病毒治疗很难实现这一目标。本研究对既往临床试验中经抗原抗体复合物型治疗性疫苗(乙克)治疗后的CHB患者HBsAg下降情况进行了归纳分析,结果显示,经乙克治疗随访后达到乙型肝炎e抗原(hepatitis B e antigen,HBeAg)血清学转换者的HBsAg下降高达0.95log₁₀IU/mL,显著高于未达到HBeAg血清学转换者的0.32log₁₀IU/mL(P<0.01),而经氢氧化铝佐剂治疗随访后发生HBeAg血清学转换(0.49log₁₀IU/mL)者与未发生HBeAg血清学转换者(0.36log₁₀IU/mL)之间HBsAg下降无统计学差异。乙克组治疗过程中,丙氨酸氨基转移酶(alanine aminotransferase,ALT)骤升(ALT flare)在HBsAg下降>1.0log₁₀IU/mL者中较多见,氢氧化铝组未观察到此现象。回归分析显示,乙克治疗后HBsAg下降的影响因素有患者出现HBeAg血清学转换、感染的HBV为B基因型、治疗过程中ALT出现10倍增高,以及基线血清HBsAg为高水平。结果提示,乙克诱导的特异性免疫对降低CHB患者血清HBsAg水平有一定效果,采用“抗病毒药物治疗＋针对HBsAg的中和性抗体被动免疫＋乙克主动免疫”的“三明治”治疗策略可能会提高“功能性治愈”率。     

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.     

Patterns of circulating hepatitis B surface antigen variants among vaccinated children born to hepatitis B surface antigen carrier and non-carrier mothers

Hepatitis B virus (HBV) variants that possessed missense mutation within the neutralization epitope of the major S antigen as defined by amino acid residues (aa#) 124–147, termed the a determinant variants, were identified through a population-based serosurvey of 2,305 children of the vaccinated birth cohorts born after 1986. Data on the 678 nucleotides encoding the S antigen of HBV were available for 75 HBV strains that were collected from 63 vaccinated children and 12 unvaccinated or incompletely vaccinated children, and 21 HBV strains from 25 unvaccinated adults. Among the diverse patterns of one to three amino acid substitutions within the a determinant, 145-Arg occurred most frequently (5/14); other variants were: 126-Ala, 127-Thr, 126-Ser/131-Asn/133-Thr, 129-His, 129-Arg, 123-Asn/131-Ile, 133-Leu, 141-Glu, and 141-Arg/144-Ala. Only one of these variants occurred in the 16 hepatitis B surface antigen (HBsAg)-carrier children born to HBsAg-negative mothers, whereas 12 of these variants occurred in the 20 (50%) children born to HBsAg-positive mothers. In addition, early administration of HBV vaccine within the noenatal period increased the likelihood of the emergence of these variants to 64.7% (11/17). Five of the 21 (23.8%) unvaccinated HBsAg-carrier adults harbored the a determinant variants possessing mutations within aa# 125–136, i.e. the putative first loop formed by the cysteine disulfide bonds. Vaccinated children were likely to harbor HBV variants possessing mutations involving altered charge of side chains and/or its hydrophobicity of amino acid residues within the putative second loop between aa#140 and 146. Our data suggest that emergence of these HBV S gene mutants in the phase of HBV vaccination program would be most common among populations in whom perinatal/vertical transmission of HBV is most common, i.e. southeast Asian and the Taiwanese.     

Characterization of T cell clones specific to a determinant of hepatitis B virus core and e antigens in chronic type B hepatitis: Implication for a T cell mechanism of HBV immunopathogenesis

T cell clones specific for hepatitis B core (HBcAg) and e (HBeAg) antigens of hepatitis B virus (HBV) were generated from liver infiltrates of HBeAg-positive patients. Analyzed with a panel of overlapping synthetic peptides spanning the complete sequences of HBcAg and HBeAg, eight clones responded specifically to the e2 peptide (PAYRPPNAPIL; amino acid residues 130–140 of HBcAg and HBeAg), which was doubly restricted by class I and II molecules. A preferential usage of the T cell receptor (TCR) chain variable (V) gene was found: V12.1 for five HLA-Cw9(3)-restricted cytotoxic T lymphocyte (CTL) clones, and V7.1 for three other HLA-DRw52-restricted type 1 helper T cell (Th1) clones. Although heterogeneous in the usage of TCR chain joining region (J) segments, their junctional-region sequences revealed conserved hydrophilic serine residues in seven of the eight e2-specific T cell clones. Single alanine substitution of the centrally located and the only hydrophilic asparagine residue of e2 peptide abrogated T cell responsiveness. The nonstimulatory e2 analogue could competitively inhibit e2-specific responses. These results demonstrate that both CTL and Th1 clones recognizing a determinant of HBcAg and HBeAg are present in the liver of chronic hepatitis B patients. The preferential V gene usage and the expression of conserved residues in junctional-region sequences of TCR chains by viral-peptide-specific, intrahepatic T cells may provide a T cell mechanism of HBV immunopathogenesis.     

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。     

Human leukocyte antigen-DP loci are associated with the persistent infection of hepatitis B virus in Chinese population

A genome-wide association study recently showed that genetic variants in human leukocyte antigen (HLA)-DP loci were strongly associated with a risk of persistent infection of hepatitis B virus (HBV) in Japanese and Thai individuals and variants in interleukin 28B (IL-28B) have been associated with responses to anti-hepatitis C virus (HCV) treatment. The aim of this study was to investigate whether the HLA-DP loci and IL-28B were associated with different outcomes of chronic HBV infection (CHB) in Chinese subjects. The rs9277535 near HLA-DPB1,rs3077 near HLA-DPA1, and rs12979860 genotype near IL28B were genotyped by direct sequencing in 185 CHB patients and 193 self-limited hepatitis B virus (SLHBV)-infected subjects who recovered from HBV infection. The rs9277535 near HLA-DPB1 was strongly associated with CHB (P=0.0000181, OR=1.905). This association was observed independent of HBV e antigen (HBeAg) status and HBV viral loads in HBeAg-positive patients (P=0.0004, OR=1.956), in HBeAg-negative patients (P=0.0009, OR=1.857), and in HBeAg-negative individuals without detectable levels of HBV DNA in serum (P=0.0011, OR=2.05). The rs3077 near HLA-DPA1 was associated with CHB (P=0.0206, OR=0.6865) and HBeAg-positive infection status (P=0.0143, OR=0.6047). Meanwhile, a genetic variation of insertion-deletion (INDEL) polymorphism (rs361527, -/ATAAATGTTGA) near HLA-DPA1 was found to be associated with CHB (P=0.0307, OR=0.7028) and HBeAg-positive CHB infection status (P=0.0233, OR=0.619). However,the rs12979860 genotype near IL28B had no correlation with CHB. This study demonstrated that in the Han Chinese populations, HLA DP loci, but not IL-28B, was associated with persistence of infection in different outcomes of HBV infected patients; however, the mechanism needs to be further investigated.     

待孕夫妇乙肝表面抗原及乙肝表面抗体阳性情况分析

目的 分析与探讨待孕夫妇乙肝表面抗原及乙肝表面抗体检测结果,并研究其对临床孕前检查的影响及评价。方法 随机选取2015‒2017年度在我院进行孕前检查的夫妇2440对（4 880例）为研究对象,按照年度将待孕夫妇分为两组,每组2 440例,两组均加强孕前检查中的乙肝表面抗原（HBsAg）及乙肝表面抗体（HBsAb）的检测。A组为2015年3月‒2016年2月在我院进行乙肝表面抗原及乙肝表面抗体检查的待孕夫妇;B组为2016年3月‒2017年2月在我院进行乙肝表面抗原及乙肝表面抗体检查的待孕夫妇。比较两组待孕夫妇乙肝表面抗原及乙肝表面抗体检测的阳性结果。结果 B组HBsAg阳性率、HBsAb阳性率明显高于A组（6.43% vs 4.63%;62.99% vs 58.44%）,差异有统计学意义（P＜0.05）。B组、A组男性HBsAg阳性率明显高于同组女性（59.87% vs 40.13%;60.18% vs 39.82%）,HBsAb阳性率低于同组女性（46.52% vs 53.48%;47.41% vs 52.59%）,差异均有统计学意义（P＜0.05）。B组、A组高中及以上学历HBsAg阳性率明显低于同组高中以下学历（38.85% vs 61.95%;38.05% vs 61.15%）,高中及以上学历HBsAb阳性率高于同组高中以下学历（53.15% vs 46.84%;51.75% vs 48.25%）,差异均有统计学意义（P＜0.05）结论 目前夫妇乙肝感染仍处于增高趋势,对于进行孕前检查的待孕夫妇加强乙肝表面抗原及乙肝表面抗体的检测,有助于疾病的早期诊断、干预及治疗,能够减少乙肝传播,可有效降低新生儿乙肝发病率,促进优生优育,提高出生人口整体素质。     

Size-exclusion chromatographic study of the reduction of recombinant hepatitis B surface antigen

The reduction of the P. pastoris-derived hepatitis B surface antigen (HBsAg) has been investigated by size exclusion chromatography performed in a detergent solution containing 0.3% sodium dodecyl sulfate (SDS) and 0.1 M Tris–HCl, pH 7.0. The HBsAg, reduced under different conditions and passed through the TSK G4000 SW column (600×7.5 mm I.D.) at 0.9 ml min⁻¹, was resolved into two peaks corresponding to the reduced, monomeric, and non-reduced forms, respectively. Under these conditions, the antigen fraction corresponding to the HBsAg dimer can be separated and completely reduced to monomers by repeated reductive treatment with simultaneous lipid removal. The efficiency of reduction was maximal after sample treatment with an equal volume of a solution containing 417 mM dithiothreitol, 4.2% (w/v) SDS and 16% (v/v) 2-mercaptoethanol. In conclusion, complete reduction of recombinant HBsAg to monomer subunits is possible and depends on the efficiency of lipid removal during the reductive treatment.