广东地区慢性丙型肝炎患者IL28B基因多态性与抗病毒疗效的关系

目的 研究广东地区慢性丙型肝炎患者（CHC）白细胞介素28B（IL28B）基因单核苷酸多态性（single nucleotide polymorphism,SNP）的分布特点及其与抗病毒疗效之间的关系,为合理选择经济有效的个体化抗病毒治疗方案提供依据,提高CHC的治疗应答率.方法 对74例CHC患者给予聚乙二醇干扰素（PEG-IFN）联合利巴韦林（RBV）抗病毒治疗,疗程48周或72周,停药后随访24周.通过PCR测序,检测所有患者的IL28B（rs8099917、rs12979860、rs12980275）位点SNP,以快速病毒学应答率（RVR）及持续病毒学应答率（SVR）作为疗效的主要评价指标,比较IL28B不同基因型与抗病毒疗效的关系,评估IL28 BSNP在CHC患者治疗应答中的作用.结果 74例患者中,rs8099917位点基因型为TT、TG、GG各63（85.1％）、11（14.9％）、0（0％）例,rs12979860位点基因型为CC、CT、TT各60（81.1％）、14（18.9％）、0（0％）例,rs12980275位点基因型为AA、AG、GG各57 （77.0％）、17（23.0％）、0（0％）例.对HCV 1型患者,上述三个位点中仅rs12979860 CC型与SVR有关,结果有统计学差异（SVR组vs NonSVR组,88.4％ vs 58.3％,P＜0.05）;对非HCV1型患者,rs8099917、rs12979860、rs12980275三个位点与RVR和SVR无关,结果无统计学差异（P＞0.05）.结论 广东地区CHC患者IL28B基因rs8099917、rs12979860、rs12980275位点分别以TT、CC、AA为主;对于HCV 1型CHC患者,rs12979860位点的基因型可以作为治疗前SVR的一个重要预测因子.     

实时荧光PCR法检测HER2基因扩增方法的建立

目的探讨应用双标准曲线的实时荧光PCR法检测原癌基因人类表皮生长因子受体2（HER2）基因扩增在临床乳腺癌诊治中的可行性。方法收集500例乳腺癌术后新鲜组织标本,抽提组织DNA进行实时荧光PCR检测,采用双标准曲线法定量,通过计算目的基因浓度和内标基因浓度的比值来判断HER2基因的扩增情况。选择灵敏度和特异度均较高的荧光原位杂交方法作为对照方法。结果检测阳性标本72例,阴性样本419例。该方法检测的灵敏度为85.9%,特异度为98.79%,准确度为96.74。与荧光原位杂交法（FISH）检测结果相比,二者具有较好的一致性。结论双标准曲线的实时荧光PCR法用于检测HER2基因扩增相对准确可靠,有较好的临床应用前景。     

四引物突变特异性扩增系统法检测巨噬细胞移动抑制因子基因-173位点单核苷酸多态性分布

目的探讨中国浙江地区汉族人群巨噬细胞移动抑制因子（macmphage migration inhibitory factor，MW）基因-173位点单核苷酸多态性（single nucleotide polymorphism，SNP）分布。方法收集浙江地区142名无血缘关系健康个体的静脉血，提取DNA，分别应用四引物突变特异性扩增系统（amplification refractory mutation sysntem，ARMS）法和限制性片段长度多态性．PCR方法对MIF基因-173位点SNP多态性进行分型，并将PCR产物克隆及测序鉴定。结果MIF基因-173位点检测到3种基因型，其基因型分布皆符合Hardy-Weinberg平衡定律。四引物ARMS法和限制性片段长度多态性-PCR两种方法结果完全一致。统计分析显示，中国汉族人MIF基因-173位点等位基因和基因型频率分布与欧洲白人差异有统计学意义（P〈0．01），与日本人群的差异无统计学意义（P〉0．05）。结论四引物ARMS法是一种准确、快速和经济的SNP测定方法。MIF基因-173位点等位基因频率分布具有种族的差异性。     

多色荧光PCR法检测HBV耐药位点突变

目的 利用多色荧光PCR技术,建立一套快速检测HBV耐药位点突变的方法 ,并对临床收集的服药患者血清进行耐药位点检测.方法 建立2个反应体系,每个反应体系包含4个耐药位点.对新建的多色荧光PCR法进行灵敏度和特异性分析,并对30例临床收集的服药患者血清进行耐药检测.结果 构建了多色荧光PCR检测HBV耐药位点的体系,其特异性较好,分析灵敏度可达1×103拷贝/ml.30例样本中检测到YVDD 2例（占6.67%）,YIDD 1例（占3.33%）;1896位点变异5例,占总数的16.67%.其他位点未检测到耐药突变.结论 所构建的多色荧光PCR检测体系为临床医院提供快速、简便的HBV耐药位点突变检测手段.HBV基因前C区的1896位点变异率较高.     

IL-28B基因突变与慢性丙型肝炎治疗应答的相关性研究

目的 探讨白介素28B(IL-28B)基因型与慢性丙型肝炎(CHC)患者抗病毒治疗反应的相关性.方法 220例CHC患者均接受聚乙二醇干扰素(peg-IFN)联合利巴韦林(RBV)治疗48周,随访至停药后24周.检测IL-28B(rs8099917)位点,比较IL-28B基因型与抗病毒疗效的关系,评估IL-28B单核苷酸多态性(SNP)在CHC患者治疗应答中的作用.结果 TT、TG和GG基因型在持续应答组(SVR)中的比例分别是71.4％、25.0％和3.6％;在无应答组(NR)分别是15.8％、60.5％和23.7％;在复发组(RP)分别是38.1％、52.3％和9.6％;三组之间比较差异具有统计学意义(P＜0.001).NR与SVR组内基因型比较,TG vsTT的OR为7.67(P＜0.001,95％ CI:2.91～20.56),差异有统计学意义.RP与SVR组内基因型比较,TG vsTT的OR为3.10(P＜0.01,95％ CI:1.41～6.36),差异有统计学意义.结论 IL-28B(rs8099917)基因型与慢丙肝患者抗病毒应答密切相关,可作为治疗前的一个重要的预测因子.     

TaqMan探针实时PCR检测人MTHFR基因C677T多态性方法的建立

目的建立TaqMan探针实时PCR检测人MTHFR基因C677T多态性的方法。方法设计一对MTHFR基因C677T多态位点的引物及TaqMan探针,采用TaqMan探针实时PCR扩增SNP分型方法检测唇腭裂患者及其父母共100人的MTHFR基因C677T多态性,与常规PCR-RFLP方法进行一致率比较,并对其特异性、敏感性和重复性以及成本-效益等进行评价,同时对部分实时PCR产物样本进行测序验证。结果运用TaqMan探针实时荧光PCR技术对MTHFR基因C677T多态性检测结果准确,特异性好,与常规PCR-RFLP方法结果具有高度一致性,Kappa=0.922>0.75(P=0.000);检测灵敏度可达2×103拷贝;重复性好、高通量、无污染、安全性好;随机样品TaqMan探针分型结果与测序结果完全一致。结论成功建立了TaqMan探针实时PCR检测人MTHFR基因C677T多态性的方法;此方法是常规临床诊断及大规模群体研究的良好平台。     

Beta肾上腺素能受体3种亚型基因的5位点SNP基因型的组合分布

用 DNA提取试剂盒抽提 338例受试者外周血 DNA,用聚合酶链反应 -限制性片段长度多态性及等位基因特异性 PCR技术获得 Beta- AR3种亚型基因的 5个位点的 SNP基因型。用聚类分析技术获得了 338例受试者的 Beta- AR3种亚型基因的 5个位点的 SNP基因型组合的自然分布特征 ,共发现了 6 7种组合类型。SNP基因型组合的自然分布的前 5位有 :(1) B1- AR S/ S4 9 B1- AR R/ R389 B2 - AR R/ G16 B2 - AR Q/ E2 7 B3- AR W/W6 4有 4 0人 ,出现概率为 11.83%。 (2 ) B1- AR S/ S4 9 B1- AR R/ R389 B2 - AR R/ G16 B2 - AR Q/ Q2 7 B3- ARW/ W6 4有 33人 ,出现概率为 9.76 %。 (3) B1- AR S/ S4 9 B1- AR R/ G389 B2 - AR R/ G16 B2 - AR Q/ Q2 7 B3-AR W/ W6 4有 19人 ,出现概率为 5 .6 2 %。 (4) B1- AR S/ S4 9 B1- AR R/ G389 B2 - AR R/ G16 B2 - AR Q/ E2 7 B3- AR W/ W6 4有 16人 ,出现概率为 4 .74 %。 (5 ) B1- AR S/ G4 9 B1- AR R/ R389 B2 - AR R/ G16 B2 - AR Q/E2 7 B3- AR W/ W6 4有 13人 ,出现概率为 3.85 %。总样本与女、男亚组间及女、男亚组间的 SNP的组合分布间具有较好的相关性。     

建立单管双向荧光PCR方法检测NQO1基因609C/T多态性

目的 建立单管双向荧光PCR方法快速测定人NAD(P)H:醌氧化还原酶1[NAD(P)H:quinone oxidoreductase 1,NQO1]基因609C/T多态性.方法 以人NQO1基因中的609C/T位点,设计双向引物,优化反应条件,应用SYBR GreenⅠ双向荧光PCR扩增191份人基因组DNA标本,并通过对产物进行熔解曲线分析,根据产物Tm值进行等位基因单核苷酸多态性分型.对其中62份标本用经典的PCR-限制性片段长度多态方法进行基因型分型,验证结果准确性.结果 62份样本的单管双向荧光PCR方法的基因型结果与PCR-限制性片段长度多态法分型结果符合率100%.191份样本中,纯合野生型(CC)占28%,杂合型(CT)占50%,纯合突变型(TT)占22%.结论 单管双向荧光PCR方法检测NQO1基因609C/T多态性,操作简便、反应过程快速,结果直观,敏感性、准确性和稳定性好,适用于临床样本检测及流行病学调查研究.     

反转录酶活性检测实时荧光定量PCR方法的建立

目的 在传统产物增强性反转录酶(PERT)活性检测方法基础上建立检测反转录酶活性的实时荧光定量PCR方法.方法 以噬菌体MS2 RNA为模板,设计、合成引物和探针,并分别以连续10倍倍比稀释的AMV反转录酶(1×10-1～1×10-9 U/μl)标准品催化体外反转录反应合成相应cDNA.采用实时荧光定量PCR法检测底物cDNA模板量,并获得相应的PCR荧光值曲线,分析AMV反转录酶的相对活性.同时应用传统PERT方法对cDNA进行扩增,测定该方法的灵敏度.结果 将AMV反转录酶标准品连续10倍倍比稀释后催化反转录反应,实时荧光定量PCR分析所得的反转录产物cDNA,结果得到与理论值完全相符合的PCR标准荧光值曲线;定量分析结果显示,浓度为1×10-2～1×10-8U/μl的AMV反转录酶均可得到相应的荧光值.不同稀释度的AMV反转录酶,经传统PERT方法扩增后,结果显示浓度为1×10-3～1×10-7 U/μl的AMV反转录酶均可见大小为112 bp的阳性条带,检测灵敏度达到1×10-7U/μl.结论 成功建立了基于实时荧光定量PCR技术的检测反转录酶活性的新方法,实验操作简单,具有高精确性和无污染性,为生物制品外来污染尤其是反转录病毒污染的检测提供了参考指标.     

反转录酶活性检测实时荧光定量PCR方法的建立

目的在传统产物增强性反转录酶（PERT）活性检测方法基础上建立检测反转录酶活性的实时荧光定量PCR方法。方法以噬菌体MS2RNA为模板,设计、合成引物和探针,并分别以连续10倍倍比稀释的AMV反转录酶（1×10-1～1×10-9U/μl）标准品催化体外反转录反应合成相应cDNA。采用实时荧光定量PCR法检测底物cDNA模板量,并获得相应的PCR荧光值曲线,分析AMV反转录酶的相对活性。同时应用传统PERT方法对cDNA进行扩增,测定该方法的灵敏度。结果将AMV反转录酶标准品连续10倍倍比稀释后催化反转录反应,实时荧光定量PCR分析所得的反转录产物cDNA,结果得到与理论值完全相符合的PCR标准荧光值曲线;定量分析结果显示,浓度为1×10-2～1×10-8U/μl的AMV反转录酶均可得到相应的荧光值。不同稀释度的AMV反转录酶,经传统PERT方法扩增后,结果显示浓度为1×10-3～1×10-7U/μl的AMV反转录酶均可见大小为112bp的阳性条带,检测灵敏度达到1×10-7U/μl。结论成功建立了基于实时荧光定量PCR技术的检测反转录酶活性的新方法,实验操作简单,具有高精确性和无污染性,为生物制品外来污染尤其是反转录病毒污染的检测提供了参考指标。     

No association between the IL28B SNP and response to peginterferon plus ribavirin combination treatment in Korean chronic hepatitis C patients

Background/Aims

There are few available data regarding the association between the single nucleotide polymorphisms (SNPs) of the gene encoding interleukin 28B (IL28B) and a sustained virologic response (SVR) to peginterferon (PEG-IFN) plus ribavirin (RBV) therapy in Korean chronic hepatitis C patients.

Methods

This was a retrospective cohort study of 156 patients with chronic hepatitis C virus (HCV) infection who received combination treatment of PEG-IFN plus RBV. Blood samples from these patients were analyzed to identify the IL28B SNPs at rs12979860, rs12980275, rs8099917, and rs8103142. Association analyses were performed to evaluate the relationships between each IL28B SNP and SVRs.

Results

Seventy six patients with HCV genotype 1 and 80 with genotype non-1 were enrolled. The frequencies of rs12979860 CC and CT genotypes were 90.4% and 9.6%, respectively; those of rs12980275 AA and AG genotypes were 87.2% and 12.8%, respectively; those of rs8099917 TT and TG genotypes were 92.3% and 7.7%, respectively; and those of rs8103142 TT and CT genotypes were 90.4% and 9.6%, respectively. Among the patients with HCV genotype 1, the SVR rates were 69.7% and 80.0% for rs12979860 CC and CT, respectively (P=0.71). Among the HCV genotype non-1 patients, SVR rates were 88.0% and 100% for rs12979860 CC and CT (P=1.00), respectively.

Conclusions

Genotypes of the IL28B SNP that are known to be favorable were present in most of the Korean patients with chronic hepatitis C in this study. Moreover, the IL28B SNP did not influence the SVR rate in either the HCV genotype 1 or non-1 patients. Therefore, IL28B SNP analysis might be not useful for the initial assessment, prediction of treatment outcomes, or treatment decision-making of Korean chronic hepatitis C patients.     

应用扩增受阻突变检测系统（ARMS）检测HBV基因型

目的建立扩增受阻突变检测系统（ARMS）检测乙型肝炎病毒（HBV）基因型方法,并对慢性乙型肝炎（CHB）患者HBV基因型进行分析。方法通过对HBV全基因组序列比对分析,设计ARMS特异性引物和探针体系,建立检测HBVB和C基因型方法,对50例临床标本进行检测。结果50例临床样本中,B型的检出率为26％（13例）,C型为74％（37例）,其实验结果与测序结果完全一致。常州及周边地区乙型肝炎病毒C基因型HBV为优势株。C基因型患者A1762T／G1764A突变率为62％,明显高于B型。结论ARMS检测HBV基因型,快速、准确;常州及周边地区HBV基因型主要为B、C型,且C型携带A1762T／G1764A双突变率较高,与较为严重的肝病相关。     

Role of IL28B genotype in older hepatitis C virus-infected patients

The average age of hepatitis C virus (HCV)-infected individuals is becoming increasingly higher in Japan and steps should be taken to treat older individuals infected with HCV. Until an interferon-free regimen becomes available, peginterferon plus ribavirin will play a critical role in the treatment. The perception that older HCV-infected patients may be at higher risk than younger patients for adverse events from peginterferon plus ribavirin treatment but may obtain less clinical benefit from it may be based on the underrepresentation of older patients in clinical trials. A recent genome-wide association study revealed that interleukin-28B (IL28B) genotype closely correlates with the treatment response against HCV. The relationship of IL28B genotype with the treatment response in older HCV-infected patients is also unknown. In this review, we focused on the treatment response in older patients infected with HCV and the effects of IL28B genotype. IL28B major genotype is a useful predictor of sustained virological response in the interferon-including treatment of older patients infected with HCV. It also seems useful for avoiding adverse events, although the mechanisms of the effects of IL28B genotype on the treatment outcome are still poorly understood and are currently under investigation. Further studies will be needed.     

IL28B Is Associated with Outcomes of Chronic HBV Infection

Purpose

The role of IL28B gene variants and expression in hepatitis B virus (HBV) infections are not well understood. Here, we evaluated whether IL28B gene expression and rs12979860 variations are associated with HBV outcomes.

Materials and Methods

IL28B genetic variations (rs12979860) were genotyped by pyrosequencing of DNA samples from 137 individuals with chronic HBV infection [50 inactive carriers (IC), 34 chronic hepatitis B (CHB), 27 cirrhosis, 26 hepatocellular carcinoma (HCC)], and 19 healthy controls. IL28A/B mRNA expression in peripheral blood mononuclear cells was determined by qRT-PCR, and serum IL28B protein was measured by ELISA.

Results

Patients with IL28B C/C genotype had greater IL28A/B mRNA expression and higher IL28B protein levels than C/T patients. Within the various disease stages, compared to IC and healthy controls, IL28B expression was reduced in the CHB, cirrhosis, and HCC cohorts (CHB vs. IC, p=0.02; cirrhosis vs. IC, p=0.01; HCC vs. IC, p=0.001; CHB vs. controls, p<0.01; cirrhosis vs. controls, p<0.01; HCC vs. controls, p<0.01). When stratified with respect to serum HBV markers in the IC and CHB cohorts, IL28B mRNA and protein levels were higher in HBeAg-positive than negative individuals (p=0.01). Logistic regression analysis revealed that factors associated with high IL28B protein levels were C/C versus C/T genotype [p=0.016, odds ratio (OR)=0.25, 95% confidence interval (CI)=0.08-0.78], high alanine aminotransferase values (p<0.001, OR=8.02, 95% CI=2.64-24.4), and the IC stage of HBV infection (p<0.001).

Conclusion

Our data suggest that IL28B genetic variations may play an important role in long-term development of disease in chronic HBV infections.     

IL-28B基因多态性与丙型肝炎相关性研究进展

白细胞介素-28 B(Interleukin-28B,IL-28 B)属于Ⅲ型干扰素家族,是一种新型的白细胞介素.它通过活化JAK- STAT信号通路,调节干扰素刺激基因转录,发挥抗病毒等生物学效应.新近研究发现,IL-28B基因多态性与丙型病毒性肝炎的发病、抗病毒治疗应答和疾病转归等密切相关.因此,通过对二者相关性的研究,可能有助于临床医师更合理的选择丙型肝炎的治疗措施、开展个性化治疗、及早判断患者的预后.     

Roles of ITPA and IL28B genotypes in chronic Hepatitis C patients treated with peginterferon plus ribavirin in Tunisian population

BackgroundDespite considerable progress in the treatment of chronic hepatitis C, many countries do not have access to these new treatments.ObjectivesPredictive markers of response to treatment are therefore necessary before initiating with historical combination therapy (PEG-IFN + ribavirin) for these populations.Study designWe therefore evaluated the influence of IL28B polymorphisms on treatment response and Inosine Triphosphate (ITPA) polymorphisms on the incidence of anaemia in a population of 120 Tunisian patients infected with HCV genotype 1b and treated.ResultsThe frequencies of favourable IL28B genotypes were 47% (CC for rs12979860) and 63% (TT for rs8099117). Patients in whom favourable IL28B alleles were identified had a higher chance of successful therapy: 82% for CC (rs12979860) and 75% for TT (rs8099117). Viral load decline during the first twelve weeks of treatment was more pronounced in patients with a favourable genotype (p < 0.0001). For patients with an unfavourable genotype, the second phase of viral decline was more pronounced in patients with SVR. A viral load decline cut-off of 2.68 log IU/mL at week 12 was best suited to discriminate responders from non-responders with an odds ratio of 40 (95% CI:11.53–170.3). Analysis of ITPA polymorphisms revealed that 16% of Tunisian patients presented ITPase deficiency. None of these patients experienced a decline of ribavirin doses during treatment versus 67% for patients without ITPase deficiency (p < 0.001).ConclusionThese data obtained in a Tunisian population should optimize before and during treatment the chances of success for treatments currently available in Tunisia for chronic HCV infection.     

Myxovirus resistance,osteopontin and suppressor of cytokine signaling 3 polymorphisms predict hepatitis C virus therapy response in an admixed patient population: comparison with IL28B

OBJECTIVES:

Suppressor of cytokine signaling 3, myxovirus resistance protein and osteopontin gene polymorphisms may influence the therapeutic response in patients with chronic hepatitis C, and an association with IL28 might increase the power to predict sustained virologic response. Our aims were to evaluate the association between myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 gene polymorphisms in combination with IL28B and to assess the therapy response in hepatitis C patients treated with pegylated-interferon plus ribavirin.

METHOD:

Myxovirus resistance protein, osteopontin, suppressor of cytokine signaling 3 and IL28B polymorphisms were analyzed by PCR-restriction fragment length polymorphism, direct sequencing and real-time PCR. Ancestry was determined using genetic markers.

RESULTS:

We analyzed 181 individuals, including 52 who were sustained virologic responders. The protective genotype frequencies among the sustained virologic response group were as follows: the G/G suppressor of cytokine signaling 3 (rs4969170) (62.2%); T/T osteopontin (rs2853744) (60%); T/T osteopontin (rs11730582) (64.3%); and the G/T myxovirus resistance protein (rs2071430) genotype (54%). The patients who had ≥3 of the protective genotypes from the myxovirus resistance protein, the suppressor of cytokine signaling 3 and osteopontin had a greater than 90% probability of achieving a sustained response (p<0.0001). The C/C IL28B genotype was present in 58.8% of the subjects in this group. The sustained virological response rates increased to 85.7% and 91.7% by analyzing C/C IL28B with the T/T osteopontin genotype at rs11730582 and the G/G suppressor of cytokine signaling 3 genotype, respectively. Genetic ancestry analysis revealed an admixed population.

CONCLUSION:

Hepatitis C genotype 1 patients who were responders to interferon-based therapy had a high frequency of multiple protective polymorphisms in the myxovirus resistance protein, osteopontin and suppressor of cytokine signaling 3 genes. The combined analysis of the suppressor of cytokine signaling 3 and IL28B genotypes more effectively predicted sustained virologic response than IL28B analysis alone.     

Efficacy of peginterferon and ribavirin is associated with the IL28B gene in Korean patients with chronic hepatitis C

Background/Aims

Sustained virologic response (SVR) for the treatment of chronic hepatitis C (CHC) may differ with ethnicity due to differences in genetic traits. This study evaluated the efficacy of peginterferon and ribavirin, and the association between IL28B genotypes and the treatment efficacy in Korean CHC patients.

Methods

This was a retrospective cohort study using data from medical records. Eighty-five CHC patients were eligible for assessment of the efficacy of antiviral therapy, and 47 patients were available for an IL28B genetic study, which was performed using the Multiplex tetra-primer PCR method for rs12979860.

Results

Overall, the early virologic response rate was 87.1%: 84.9% in HCV genotype 1 and 90.6% in genotype 2. The overall end-of-treatment virologic response rate was 81.2%: 75.5% in genotype 1 and 90.6% in genotype 2. The overall SVR rate was 81.2%: 75.5% in genotype 1 and 90.6% in genotype 2. For rs12979860, the frequencies of polymorphisms were 89% for the CC type, 11% for the CT type, and 0% for the TT type. Their overall SVR rate was 87% (39/47): 90.5% (38/42) for the CC type and 20% (1/5) for the CT type. For genotype 1, SVR rates were 88% (21/24) for the CC type and 0% (0/4) for the CT type. Multivariate analysis revealed that the IL28B-CC type was a good predictor for SVR.

Conclusions

The SVR of the combination therapy in Koreans was higher than that observed in Western countries. This finding might be attributable to the high prevalence of IL28B-CC type among Koreans, which may be a good predictor of SVR.