摘要
目的 探讨微RNA-548ah （miR-548ah）和微RNA-4804 （miR-4804）在慢性HBV感染不同阶段的患者外周血单核细胞（PBMC）中的表达及临床意义.方法 选取南通大学附属泰州市人民医院2012年9月至2013年8月住院和门诊HBV感染者85例,其中慢性乙型肝炎（CHB）患者29例,慢性HBV携带者（HBVC） 30例,非活动性HBsAg携带者（IASC） 26例.另选同期健康体检者28名作为对照.采用反转录-实时荧光定量PCR （qRT-PCR）技术检测PBMC中miR-548ah和miR-4804的表达.miRNA分子诊断HBV感染免疫耐受期和清除期的价值采用受试者工作特征（ROC）曲线分析,微RNA （miRNA）分子与临床主要指标丙氨酸转氨酶（ALT）和HBV DNA的相关性采用Pearson分析.结果 miR-548ah和miR-4804在CHB组、HBVC组、IASC组和健康对照组患者PBMC中的表达差异有统计学意义（F=28.16和83.17,P＜0.01）.与健康对照组比较,miR-548ah的表达在CHB组明显上调（P＜0.01）,在HBVC及IASC组明显下调（P＜0.01）;miR-4804的表达在CHB组明显上调（P＜0.01）,在HBVC组明显下调（P＜0.01）,但在IASC组的表达与健康对照组比较差异无统计学意义（P＞0.05）.miR-548ah和miR-4804区分慢性HBV感染免疫耐受期和清除期的ROC曲线下面积（AUC）分别为0.966和0.997,敏感度分别为89.7％和96.6％,特异度分别为99.6％和100.0％.miR-548ah和miR-4804的表达水平与ALT和HBV DNA水平均无相关性（r=0.14,0.18,-0.20和-0.19,P＞0.05）.结论 miR-548ah和miR-4804的异常表达可能与CHB的免疫发病机制有关,且有助于区分CHB的免疫耐受期和清除期.
Objective To investigate the expression of microRNA-548ah （miR-548ah） and microRNA-4804 （miR-4804） in peripheral blood mononuclear cells （PBMCs） of patients with chronic hepatitis B virus infection and their clinical significance.Methods PBMCs were collected from 29 patients with chronic hepatitis B （CHB）,30 hepatitis B virus carriers （HBVC）,26 inactive HBsAg carriers （IASC） and 28 healthy controls in Taizhou People＇s Hospital during September 2012 and August 2013.Expressions of miR-548ah and miR-4804 in PBMCs were detected by fluorescence real-time quantitative RT-PCR （qRT-PCR）.Receiver operating characteristic （ROC） curve was used to evaluate the expression of miR-548ah and miR-4804 in distinguishing immune tolerance phase and clearance phase of HBV infection.Pearson correlation analysis was performed to assess the correlations of miRNAs expression with clinical markers alanine aminotrans ferase （ALT） and HBV DNA loads.Results There were significant differences in expressions of miR-548ah and miR-4804 in PBMCs between CHB,HBVC,IASC groups and control group （F =28.16 and 83.17,P ＜ 0.01）.Compared with control group,miR-548ah was up-regulated in CHB group（P ＜ 0.01）,and down-regulated in HBVC and IASC groups （P ＜ 0.01） ; miR-4804 was up-regulated in CHB group （P ＜ 0.01）,down-regulated in HBVC group （P ＜ 0.01）,while there was no significant difference between IASC group and control group in miR-4804 expressions（P ＞ 0.05）.The areas under ROC curve （AUCs） of miR-548ah and miR4804 in differentiation of immune tolerance and immune clearance were 0.966 and 0.997,and the sensitivities and specificities were 89.7％,96.6％ and 99.6％,100.0％,respectively.No significant correlation was found between the expression of miR-548ah,miR-4804 and ALT,HBV DNA loads （r=0.14,0.18,-0.20 and-0.19,P＞0.05）.Conclusion miR-548ah and miR-4804 may be involved in the immunopathogenesis of CHB,and their expression levels in PBMCs are helpful in differentiation of immune tolerance and immune clearance in HBV infection.
出处
《中华临床感染病杂志》
CAS
2014年第2期161-165,共5页
Chinese Journal of Clinical Infectious Diseases
基金
江苏省卫生厅医学科研面上项目（H201362）
