Yuen M F, Lau C S, Lau Y L, Wong W M, Cheng C C, Lai C L
Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Hepatology. 1999 Apr;29(4):1248-51. doi: 10.1002/hep.510290417.
Mannose-binding lectin (MBL) plays an important role in immune defense. We examined the MBL gene mutations and MBL levels in Chinese hepatitis B and hepatitis C patients with and without symptomatic cirrhosis. We recruited 190 hepatitis B and C patients, and 117 normal Chinese as controls. Serum MBL levels were measured by enzyme-linked immunosorbent assay. MBL gene mutation at codons 52, 54, and 57 was detected by polymerase chain reaction (PCR) assay. In asymptomatic hepatitis B and C patients, there was no increase in codons 52, 54, and 57 mutation, but the MBL levels were significantly lower than those in the controls. Codon 54 mutation rate was increased to 44.4% (P =.007) in symptomatic hepatitis B cirrhosis and 64.3% (P =.0026) in patients with spontaneous bacterial peritonitis (SBP). There was no increase in codon 54 mutation rate in hepatitis B-related hepatocellular carcinoma (HCC). In chronic hepatitis B infection, the odds ratio for an individual with codon 54 mutation to develop cirrhosis was 1.84 (95% CI: 1.21-2. 81) and to develop SBP was 4.58 (95% CI: 1.73-12.16). Chronic hepatitis B and hepatitis C infection lowered the MBL levels, probably by suppressing MBL production. Codon 54 mutation of MBL was associated with progression of disease in chronic hepatitis B infection.
甘露糖结合凝集素(MBL)在免疫防御中发挥重要作用。我们检测了有或无症状性肝硬化的中国乙肝和丙肝患者的MBL基因突变及MBL水平。我们招募了190例乙肝和丙肝患者,以及117名正常中国人作为对照。采用酶联免疫吸附测定法检测血清MBL水平。通过聚合酶链反应(PCR)检测第52、54和57密码子处的MBL基因突变。在无症状乙肝和丙肝患者中,第52、54和57密码子的突变没有增加,但MBL水平显著低于对照组。在有症状的乙肝肝硬化患者中,第54密码子突变率增至44.4%(P = 0.007),在自发性细菌性腹膜炎(SBP)患者中增至64.3%(P = 0.0026)。在乙肝相关肝细胞癌(HCC)中,第54密码子突变率没有增加。在慢性乙肝感染中,第54密码子突变个体发生肝硬化的比值比为1.84(95%可信区间:1.21 - 2.81),发生SBP的比值比为4.58(95%可信区间:1.73 - 12.16)。慢性乙肝和丙肝感染可能通过抑制MBL产生而降低MBL水平。MBL第54密码子突变与慢性乙肝感染中疾病进展相关。