HLA-A、B基因多态性与遵义地区汉族人群肾综合征出血热的相关性研究

目的 探讨HLA-A、B基因多态性与遵义地区汉族人群肾综合征出血热(HFRS)的关联性.方法 采用群体研究方法,应用聚合酶链反应-序列特异性引物(PCR-SSP)技术对100例肾综合征出血热患者和100例健康对照者进行HLA-A、B基因分型,比较其等位基因频率(GF),并计算其相对危险度(RR).结果 肾综合征出血热患者组中,HLA-A*31、B*58的等位基因的基因频率分别为4%、l2.5%,较健康对照组的0、5%明显增高,两组比较差异具有统计学意义(X2值分别为6.380和7.792,P<0.05,RR值分别为18.47、2.91);患者组中HLA-B*40等位基冈的基因频率(11%)显著低于健康对照组(19%),两者之问差异具有统计学意义(X2=6.095,P<0.01,RR值为0.47).结论 研究提示在遵义地区汉族人群中,初步认为HLA-A*31、B*58基因与HFRS呈正相关,HLA-B*40基因与HFRS呈负相关.     

HLA-DR、DQ基因多态性与遵义地区汉族流行性出血热相关性的研究

目的：探讨HIA-DR、DQ基因多态性与遵义地区汉族流行性出血热（EHF）的关联性。方法：采用群体研究方法，应用聚合酶链反应-序列特异性引物（PCR-SSP）技术对100例流行性出血热患者（患者组）和100例健康对照者（健康对照组）进行HIA-DR、DQ基因分型，比较其等位基因频率（GF），并计算其相对危险度（RR）。结果：EHF患者组HLA-DRB1＊16基因频率较对照组明显增高（Pat=3．58，χ^2=4．916，P=0．0266〈0．05）；患者组HIA-DQ各等位基因频率与对照组比较差异无显著性。结论：研究提示在遵义地区汉族人群中，HLA-DRB1＊16基因与EHF呈正相关，HLA-DRB1＊16基因可能是EHF的易感基因。     

遵义地区汉族HLA-DRB1、DQB1等位基因多态性的研究

目的：从基因水平调查遵义地区汉族人群HLA-DRB1、DQB1等位基因频率,并了解其多态性分布状况。方法：应用聚合酶链反应-序列特异性引物（PCR-SSP）方法对遵义汉族200名健康个体进行HLA-DRB1、DQB1等位基因分型。结果：遵义地区汉族HLA-DRB1、DQB1等位基因频率分布,在中低分辨水平,共检出13个DRB1基因,7个DQB1基因,DRB1＊09、DRB1＊08及DQB1＊05基因频率相对较高;DRB1＊10及DQB1＊04基因频率相对较低。与我国北方、南方汉族比较,更接近南方汉族人群。结论：遵义汉族人群HLA-DRB1、DQB1基因具有较为丰富的多态性,其分布符合南方汉族的特点,可能与重庆汉族人群有较为密切的民族融合。     

KIR及HLA-A、B基因多态性与急性淋巴细胞白血病的相关性

目的探讨急性淋巴细胞白血病患者的杀伤细胞免疫球蛋白样受体（killer cell immunoglobulin-like receptors,KIR）和人类白细胞抗原（human leukocyte antigen,HLA）HLA-A、B等位基因多态性。方法采用Luminex流式技术-序列特异性寡核苷酸探针反向杂交（flow cytometry-sequence specific oligonucleotide probe,FLOW-SSOP）方法对内蒙地区48例急性淋巴细胞白血病患者HLA-A、B等位基因多态性进行分析,PCR-SSP技术进行KIR抑制基因的低分辨率检测。以北方地区健康群体资料作为正常对照。结果 （1）在急性淋巴细胞白血病中HLA-A＊31XX,A＊6901等位基因频率高于对照组（1.955%,0.071%）,差异有统计学意义（P〈0.05）;A＊33XX等位基因频率低于对照组（5.825%）,差异有统计意义（P〈0.05）;（2）在HLA-B等位基因中,急性淋巴细胞白血病B＊07XX,＊27XX,＊38XX,＊41XX,＊49XX,＊59XX等位基因频率高于对照组（2.069%,0.968%,0.702%,0.091%,0.051%,0.061%）,差异有统计学意义（P〈0.05）;其中HLA-B＊59XX的相对危险度高（RR=35.156）,其它等位基因频率在两组之间无显著性差异。在急性白血病患者中,高频率KIR基因有KIR3DP1,2DP1,2DL1,2DL3,3DL1、2DL5,2DS4及3DS1。急性白血病组3DL1基因型频率比对照组的显著降低。结论 HLA-A＊31XX,A＊6901;B＊07XX,B＊27XX,B＊38XX,B＊41XX,B＊49XX,B＊59XX;等位基因与ALL相关联,有遗传易感作用。HLA-B＊59XX等位基因携带者,可能患ALL的危险度增高（RR=35.156）KIR3DL1和2DS4均与ALL呈关联。     

北方汉族HLA-DRB1、DQB1基因多态性的研究

目的从基因水平了解北方汉族ＨＬＡ－ＤＲＢ１、ＤＱＢ１多态性分布,获得更完整、更准确的遗传学数据。方法应用ＰＣＲ－ＳＳＰ方法对１０７名北方汉族健康人进行了ＨＬＡ－ＤＲＢ１、ＤＱＢ１等位基因分型。结果鉴定了１４个ＤＲＢ１等位基因,９个ＤＱＢ１等位基因,包括了ＤＲ、ＤＱ位点的全部血清学特异性。结论提供了一套比较完整准确的ＤＲＢ１、ＤＱＢ１等位基因的基因频率和连锁不平衡参数。对群体遗传和疾病关联的研究具有重要的意义。     

免疫调节基因的多态性与Graves病易感性的相关性研究进展

Graves病(GD)是一种遗传背景强的器官特异性自身免疫性疾病,其核心发病环节是免疫因素,但遗传因素在其发病机制中也起到重要作用。GD的易感基因主要分为免疫调节基因和甲状腺特异性基因,其中免疫调节基因多态性可通过各种机制影响GD的易感性,故可为进一步研究GD的易感基因及发病机制提供新的思路。     

PTPN22基因多态性与自身免疫甲状腺病的相关性

目的:检测PTPN22基因的单核苷酸多态性(SNP)及其与中国人自身免疫甲状腺病(AITD)的相关性, 并研究CTLA- 4基因SNP与PTPN22 SNP的相互关系.方法:采用PCR-RFLP技术分析231例AITD患者, 其中Graves'病(GD)149例, 桥本甲状腺炎(HT)82例和131例健康对照者PTPN22基因 1858 C>T及CTLA- 4基因49A>G位点的基因型.采用SASP-PCR技术分析PTPN22基因启动子-1123G>C的基因型.结果:(1)PTPN22基因的 1858C>T位点不存在多态性;(2)PTPN22基因-1123G>C SNP的等位基因和基因型分布频率在GD组与正常对照组间的差异有统计学意义(P值分别为0.040和0.013, OR值分别为1.44和2.33);(3) CTLA- 4基因 49A>G位点的等位基因和基因型分布频率在AITD组与正常组间有明显差异;(4)与携带PTPN22的G等位基因及CTLA- 4的AA基因型者相比, 携带PTPN22CC基因型与CTLA- 4 AG或GG基因型者发生GD的OR值=3.31(95%CI: 2.69-8.89).结论:PTPN22基因启动子-1123G>C SNP与GD的发生相关, 其CC基因型与CTLA- 4基因的G 等位基因对GD的发生起协同作用.     

山西地区HLA-Ⅱ类基因多态性与妊娠期糖尿病的相关性研究

目的探讨本地区人群HLA-Ⅱ类基因多态性与妊娠期糖尿病的相关性。方法以序列特异引物聚合酶链反应技术，对本地区39例GDM孕妇及42例同期正常健康孕妇的瑚A-Ⅱ类基因进行检测。结果GDM组DRB1＊0301、DQB1＊0201等位基因频率分别为38．5％和28,2％，明显高于对照组的16．7％和915％，两组比较有统计学意义；GDM组DQA1＊0103等位基因频率为7．7％，明显低于时照组的14．3％，两组比较有统计学意义。结论HLA—DRB1＊0301、DQB1＊0201等位基因可能是该地区妊娠期糖尿病的易感基因，而DQA1＊0103等位基因可能是该地区妊娠期糖尿病的保护基因。     

云南彝族2型糖尿病与HLA-DRB1等位基因多态性关联的研究

目的探讨云南彝族2型糖尿病与HLA-DRB1等位基因多态性的关联。方法采用聚合酶链反应-序列特异性引物技术,对云南楚雄地区彝族2型糖尿病患者79例和同地区47名彝族正常对照进行HLA-DRB1等位基因分型,做2型糖尿病与HLA-DRB1等位基因多态性关联分析。结果云南彝族2型糖尿病组与正常对照组相比,DR7、DR11等位基因频率均高于正常对照组,差异有统计学意义(P=0.009,RR=8.329;P=0.029,RR=7.734)。结论DR7、DR11等位基因可能是云南彝族2型糖尿病的易感基因。     

白细胞介素4受体Q576R基因多态性与支气管哮喘的相关性

目的　探讨白细胞介素4受体(inlerleukin- 4 receptor,IL- 4 R)基因Q5 76 R多态性与儿童支气管哮喘的相关性。方法　用聚合酶链反应-限制性片段长度多态性分析方法检测94例哮喘儿童和6 8名正常对照儿童IL - 4 R Q5 76 R的多态性,并进行χ2 检验。结果　IL - 4 R杂合突变基因型Q5 76 R、突变等位基因R5 76的分布频率在哮喘儿童及正常对照儿童中差异有统计学意义(P<0 .0 5 )。结论　IL - 4 R突变等位基因R5 76可能是儿童易感哮喘的一个候选基因。     

Association of MCP-1 promotor polymorphism with disease severity of Crimean-Congo hemorrhagic fever

Crimean-Congo hemorrhagic fever (CCHF) is a thick-borne viral zoonotic disease. The pathogenesis and the reasons why cases have a mild or severe course in CCHF have not yet been explained. In this study, we investigated the relationship between promoter -2518 A/G single-nucleotide polymorphism (SNP) of the MCP-1 gene and the clinical course of CCHF. The MCP-1-2518 A/G SNP (rs1024611) frequency was examined in 128 virologically/serologically confirmed CCHF patients and 181 healthy controls by using the PCR-RFLP method. When CCHF patients and controls were compared, no significant difference was found between genotype distributions and allele frequencies of the -2518 A/G SNP of MCP-1 gene (P > .05). Compared to the AA genotype, both AG (P = .016; OR = 2.57) and GG genotype (P = .039; OR = 3.43) were found with significantly higher frequencies in mild/moderate cases than in severe cases. Compared to the AG + GG genotype, AA showed a significant risk for severe CCHF (60.0% vs 38.4%, P = .02; OR = 2.41). In contrast, the AG genotype showed a significant protective effect against severe disease compared to AA + GG genotype (29.1% vs 47.9%, P = .013; OR = 2.58). Compared to mild/moderate cases, the A allele was found to be significantly higher in severe cases (0.745 vs 0.623, P = .039; OR = 1.77). However, no significant relationship was found between fatal and nonfatal cases in terms of genotype or allele frequencies (P > .05). In conclusion, both -2518 AA genotype and A allele of MCP-1 were associated with disease severity, and the AG genotype had a protective effect against a severe disease course in CCHF patients.     

Crimean-Congo hemorrhagic fever: An emerging threat for the intensivist

We present the case of a 55-year-old female, who presented with 15 days of fever with rash, pancytopenia, and altered behavior. She was investigated for routine causes of fever with rash and multi organ dysfunction and treated for the same. As she tested negative for all routine causes of such an illness and did not show improvement to therapy, she was investigated for Crimean-Congo hemorrhagic fever and tested positive for the same. She was started on ribavirin, but eventually succumbed to her illness. This disease has rarely been reported from the Northern India and we need to have high clinical suspicion for this deadly disease so that appropriate therapy can be started in time for the patient and prophylaxis given to all inadvertently exposed.     

Evaluation of patients with Crimean-Congo hemorrhagic fever in Bolu,Turkey

Background

Crimean-Congo hemorrhagic fever (CCHF), which is associated with a high mortality rate in the Black Sea region of Turkey, has received increasing attention.

Objective

In this study, the epidemiological features, clinical and laboratory findings, treatments, and outcomes of patients diagnosed with CCHF between 2006 and 2012 based on data obtained from the Bolu Provincial Directorate of Health (BPDH) were evaluated.

Methods

BPDH data were reviewed for the period between 1 January 2006 and 31 July 2012. The locations where the tick had attached to the patient, the site of the tick bite on the patient''s body, the dates of tick bite and removal, and the demographic characteristics of each patient were recorded. BPDH data on the total number of tick bites, patients with confirmed CCHF, and deaths due to CCHF in Bolu Province during the study period were also evaluated.

Results

A total of 46 patients with CCHF and 38 patients without CCHF but who had been bitten by ticks were admitted to the BPDH. Of the patients with CCHF, 54.3% were female. The mean age of the patients was 46.88 ± 2.05 years (range, 1–79 years). The mortality rate was 8.82%. Patients were predominantly observed in June and July. When the patients were distributed according to their occupations, the majority was houswife (48.6%), followed by animal husbandry worker (27.0%), farmer (10.8%), health worker (5.4%), and other (8.1%). The symptoms of the patients with CCHF included fatigue (60.9%), fever (60.9%), and myalgia (60.9%). Of those patients with CCHF, 41.3% were determined to have a high fever.

Conclusions

The probability of developing CCHF decreased as the duration of tick attachment increased. Moreover, although the clinical presentation is important, it is not diagnostic. Physical examination and laboratory findings become more specific in later stages.     

流行性出血热肾脏损伤及文献复习

目的探讨流行性出血热(EHF)肾脏损害的临床病理学特征及诊断。方法对1例以肾脏损伤为主要症状，行肾活检术病理诊断为EHF病例进行光镜、免疫荧光观察并结合文献进行分析。结果EHF的主要病理改变为肾间质显著性灶性出血和肾小管上皮细胞坏死，肾小球系膜细胞可伴有轻度增殖；免疫荧光显示IgM、IgG、IgA及C3沿肾小球毛细血管壁线形沉积。结论EHF临床上可仅表现为发热和肾脏损伤，易造成误诊、漏诊。其肾脏组织病理学表现对EHF诊断具有重要价值。     

广州市2009年肾综合征出血热监测分析

目的分析广州市肾综合征出血热（HFRS）的流行特征和规律,探讨防制对策。方法采用人间疫情监测、健康人群抗体水平监测、宿主动物监测方法,其中实验室用间接免疫荧光法检测血清特异性IgG抗体,直接免疫荧光法检测鼠肺汉坦病毒（HV）抗原。结果共报告HFRS71例,死亡1例,发病率为0.69/10万,病死率为1.41%;排查病例抗体阳性率为16.14%（188/1165）,健康人群抗体阳性率为0.50%（2/400）;鼠密度为4.60%（361/7856）,鼠肺抗原阳性率为8.31%（30/361）,鼠血清抗体阳性率为7.43%（26/350）,优势鼠种为褐家鼠。结论广州市HFRS疫情形势较为平稳,但仍然存在病例数上升的压力,应加强疫情监测,落实防鼠灭鼠为主的综合性预防控制措施。     

麻风病与HLA-A、HLA-B、HLA-DRB1、HLA-DQ等位基因关联性分析

目的 探讨中国山东人群HLA-A、HLA-B、HLA-DRB1、HLA-DQ等位基因与麻风病的相关性.方法 采用序列特异性引物聚合酶链反应法(PCR-SSP)对40例麻风病患者及20例健康对照者进行HLA-A、B、DRB1、DQ等位基因分型,x2检验基因频率差异.结果 麻风病患者HLA-B*13(x2=7.067,P=0.008)、DQ*02(x2 =4.156,P=0.041)基因频率较健康对照组低,有统计学意义(P＜0.05).LL型麻风患者HLA-B* 13(x2=7.159,P=0.007)等位基因频率降低、HLA-DRB1*15(x2=4.073,P=0.044)等位基因频率升高,与健康对照组相比均具有统计学意义(P＜0.05).TT型麻风病患者HLA-B *40(P =0.037)、DQ *05(x2 =5.147,P=0.023)等位基因频率高于健康对照组,差异具有统计学意义(P＜0.05).结论 HLA-B * 13、DQ*02基因可能对麻风病易感性有拮抗作用,可能是保护基因;HLA-B* 13可能是LL型拮抗基因、DRB1*15可能是LL型的易感基因;HLA-B* 40、DQ *05可能是TT型的易感基因.     

A simplified PCR-SSP method for HLA-A2 subtype in a population of Wuhan, China

HLA-A2 is the most frequent HLA-A allele in all ethnic populations, and an important restriction element for peptide presentation to T cells in infectious disease and cancer. However, the HLA-A2 supertype consisting of up to 75 subtypes, mutation studies and analyses using cytotoxic T lymphocytes suggest the functional relevance of subtype-specific differences in HLA-A2 molecules for peptide binding and T-cell recognition. Therefore, it is necessary for T-cell response study to discriminate the HLA-A2 subtypes and to understand the profile of HLA-A2 allellc distribution in a given population. In this study, we developed a simple, robust approach based on the nested polymerase chain reaction using sequence-specific primers （PCR-SSP） to discriminate 17 HLA-A2 subtypes which cover the most HLA-A2 alleles （〉 99% allele frequency） reported in Chinese, using 15 combinations of 19 allelic specific primers. In the first round of PCR, 3 combinations of 5 primers were used to determine whether the tested sample was HLA-A2 positive, meanwhile the subtypes of HLA-A＊0209 and HLA-A＊0215N were determined for the variant position of these two subtypes is in exon 4 instead of exon 2, 3. Samples of HLA-A2 positive were subtyped in the second round of PCR, using PCR products of the first round as templates. This strategy was applied to test the samples of 78 random HLA-A2 positive individuals for their HLA-A2 subtypes. Those samples were screened for HLA-A2 positive by the first round PCR-SSP from 154 healthy blood donors in Wuhan, China. The subtyping results were verified by using flow cytometric analysis （FCM） with HLA-A2 specific monoclonal antibody BB7.2 and DNA sequencing. The typing results of the samples show 50.7% random individuals in the population carry HLA-A2, HLA-A＊0201 ranks the first （allele frequency = 15.5%）, followed by A＊0207 （5.8%）, A＊0206 （4.7%）, A＊0203 （2.6%）, A＊0210 （0.7%）, and these 5 alleles account for 99.0% HLA-A2 subtypes of allele frequency. Our study indicates that the developed typing method is simple and reliable for HLA-A2 subtyping in Chinese, and the profile of allelic distribution of HLA-A2 subtypes is revealed in the population of Wuhan, China.