母-儿细胞转运在HBV宫内感染机制中的作用

目的探索HBsAg阳性孕妇细胞是否可进入胎儿血循环,HBV通过细胞转运使胎儿发生宫内感染的机制。方法以2001年12月至2003年10月由太原市传染病院妇产科进行产前检查并分娩的HBsAg阳性孕妇及其新生儿各123例为研究对象。用等位基因特异性PCR(ASPCR)和半巢式PCR(heminPCR)方法检测母儿细胞转运。结果以GSTM1、ACE基因作为母亲的特异性等位基因,收集到42对信息病例对,其中26例新生儿发生了母儿细胞转运,占61.90%(2642);母儿细胞转运与HBV宫内感染显著相关(χ2=8.58,P<0.01);母儿细胞转运与新生儿PBMCHBVDNA显著相关(χ2=10.10,P<0.01)。结论母儿细胞转运是HBV宫内感染的一个原因,PBMC可能介导HBV穿过胎盘屏障感染胎儿。

Role of the cell transportion from mother to baby in the mechanism of HBV intrauterine infection

OBJECTIVE: To explore the route that the HBsAg positive pregnant women's cell entered fetal circulation, and to study the mechanism of HBV intrauterine transmission that the cell transported HBV to fetus and infected fetus. METHODS: 123 pregnant women and 123 newborns were collected from December, 2001 to October, 2003 in Taiyuan Infectious Hospital. The cell transportion from mother to baby were determined by allele-specific PCR (AS-PCR) and heminested PCR(hemi-nPCR). RESULTS: Regarding GSTM1, ACE as maternal specific alleles: 42 mother-baby pairs were recruited from hemocyte specimens as informative cases, then examining 26 (61.90%) newborns' blood cell out of 42 informative cases had maternal cell DNA. There was significantly association between the cell transportion and HBV intrauterine infection (chi2 = 8.58, P < 0.01). There was significantly association between the cell transportion and HBV DNA positive in the newborns' PBMC (chi2 = 10.10, P < 0.01) . CONCLUSION: One factor of HBV intrauterine infection is in the result of the cell transportion from mother to baby; PBMC carrying HBV probably passed through placent barrier into fetus and infected them.