EB病毒和巨细胞病毒感染与自身免疫性肝炎Ⅰ型的关系探讨

目的 探讨EB病毒(EBV)和巨细胞病毒(CMV)感染与Ⅰ型自身免疫性肝炎1型(AIH-I型)之间的关系.方法 采用酶联免疫吸附技术(ELISA)检测AIH-I型患者和对照组血清中EBV和CMV抗体IgG和IgM, CMV-IgM阳性者行聚合酶链反应(PCR)检测血清的CMV-DNA;EBV-IgM阳性者行肝组织活检免疫组织化学检测EBV抗原,再阳性者行原位杂交检测EBV特异基因,比较各对应组之间的差异.结果 在AIH-I型组和对照组之间,CMV-IgM、CMV-IgG、EBV-IgM和EBV-IgG比较差异均有统计学意义(P<0.05).AIH-I型组与对照组中CMV-IgM阳性者15例,其血清CMV-DNA均为阴性.AIH-I型组和对照组血清EBV-IgM阳性者21例,检测其肝组织中EBV抗原,阳性6例;对此6例原位杂交检测肝组织EBV基因(EBER),结果均为阴性.结论 自身免疫性肝炎患者CMV-IgG和EBV-IgG阳性率均比对照组高,推测AIH-I型患者既往感染该病毒;但IgM阳性率高于对照组并不能证明现症感染,提示IgM与自身免疫性肝炎患者某些自身抗原存在交叉免疫反应,并通过分子模拟机制诱发自身免疫性肝炎. Abstract： Objective The purpose of this study was to initially explore the relationship between the epstein-barr virus and cytomegalo virus infection and type I autoimmune hepatitis(type I AIH). Methods The IgG/IgM antibodies in EBV and CMV in serum between type I AIH group and the control group were detected by enzyme-labeled immunosorbent assay(ELISA). CMV-DNA was detected by polymerase chain reaction(PCR) in serum of CMV-IgM positive reaction. Immunohistochemistry was used to detect the EBV antigens in liver tissue which was obstained by liver biopsy.Situ hybridization was used to detect EBV -specific genes in liver tissue which also getted by liver biopsy.Then compared the differences in each other. Results Between the type I AIH group and the control group, there were significant difference in CMV-IgM, CMV-IgG, EBV-IgM and EBV-IgG (P<0.05). In the type Ⅰ AIH group and the control group, the serum CMV-DNA were negative in 15 cases CMV-IgM positive and 6 cases of 21 cases of serum EBV-IgM positive reaction in serum were positive by immunohistochemistry,but then negative by in situ hybridization.Conclusions CMV-IgG and EBV-IgG positive rate in type Ⅰ AIH group was higher than the control group, and it suggested that type Ⅰ AIH type patients had been infected with the virus.CMV-IgM and EBV-IgM positive rate in type Ⅰ AIH group was higher than the control group too, which could not prove present infection.These indicated that cross-immune response was existed between IgM antibodies of EBV and CMV in serum and certain self-antigen in patients with autoimmune hepatitis and suggested that autoimmune hepatitis may be induced by molecular simulation mechanism.

The relationship between EB virus and cytomegalo virus infection and type I autoimmune hepatitis

EBV Type Ⅰ AIH CMV In situ hybridization Molecular simulation