反向杂交法检测乙型肝炎病毒3种核苷(酸)类似物耐药突变

目的 建立一种同时检测HBV 3种核苷(酸)类似物耐药突变的方法.方法 以基因库公布的981条HBV基因序列为基础,设计2对地高辛标记的通用引物,扩增HBV聚合酶的逆转录区.针对拉米夫定、阿德福韦和恩替卡韦10个耐药位点上的氨基酸替换形式,设计26条特异性寡核苷酸探针,包括I169T,V173L/G,L180M,A181T/V,T184G,S202I/G,M204V/I,Q215S,N236T,M250V/I/L,并固定于带正电荷的尼龙膜上.利用地高辛标记的靶DNA扩增产物与固定于膜上的特异性探针的反向杂交,检测HBV 3种核苷(酸)类似物的耐药突变.应用反向杂交法分别检测HBV野生和耐药标准株,以及40例患者血清标本,观察其检测特异性和准确性.结果 反向杂交法检测HBV野生和耐药标准株,有效地区分了1169T,V173L,L180M,A1811T,T184G,S202I,M204V,Q215S,N236T,M250V 10个耐药位点上的特异性探针.40例患者血清标本中,37例临床病例的耐药检测结果 与直接测序法一致.结论 反向杂交法可以快速,准确的检测出HBV3种核苷类似物耐药突变,有助于这3种药物耐药的诊断和个体化治疗.

Detection of HBV resistant mutations related to lamivudine, adefovir and entecavir by reverse hybridization technique

Objective To establish a method for simultaneous detection of HBV resistant mutations associated with three kinds of nucleoside analogues. Methods According to 981 HBV complete sequences in GenBank, two pairs of conserved primers labeled with digoxigenin were synthesized to amplify the region of HBV reverse transcriptase. To detect non-synonymous amino acid substitutions associated with lamivudine, adefovir and entecavir, 26 specific oligonucleotide probes covering ten different codon positions, I169T, V173L/G, L180M, A181T/V, T184G, S202I/G, M204V/I, Q215S, N236T and M250V/I/L were synthesized and immobilized on nylon membranes charged positively. The oligonucleotide probes immobilized on nylon membranes were then hybridized with PCR products labeled with digoxigenin to detect three drug-resistant mutations. In order to observe specificity and accuracy of probes, HBV wild-type, resistant reference strains and patients serums were assayed by reverse hybridization technique, respectively. Results The specific probes of 10 codon positions related to HBV wild-type and resistant reference strains, including I169T, V173L, L180M, A181T, T184G, S202I, M204V, Q215S, N236T, M250V, were distinguished effectively by reverse hybridization method. The results results of 37 samples applicated the method were in accordance with that Of DNA sequencing. Conclusion Reverse hybridization technique can be applied to detect HBV resistant mutations associated with Lamivudine, Adefovir and Entecavir rapidly and accurately.