Lai Ming-Wei, Yeh Chau-Ting
Department of Pediatric Gastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan.
Antivir Ther. 2008;13(7):875-9.
Previously, a less prevalent lamivudine-resistant mutant (rtA181T) was discovered in Taiwanese patients, in which a stop codon in the surface gene concomitantly occurred, leading to impaired secretion of hepatitis B virus (HBV) surface antigen. The rtA181T mutant also conferred drug resistance to adefovir. We discovered a 39-year-old patient with advanced hepatocellular carcionoma, who was seropositive for HBV e antigen but seronegative for HBV surface antigen. Nucleotide sequence analysis revealed the presence of polymerase rtA1 81T/surface truncation mutant in both the serum and hepatoma samples. Surprisingly, this patient has never received lamivudine or adefovir antiviral therapy. Here, we aimed to evaluate the oncogenic potential of HBV rtA181T/surface truncation mutant.
Site-directed mutagenesis experiments followed by transactivation assays were performed in HepG2 cells to evaluate the transactivation activities of the corresponding pre-S/S truncation mutant for c-Mye, c-Fos and Simian virus 40 promoters. NIH3T3 cells stably expressing the mutant were used to assess the tumourigenicity in nude mice.
Transactivation experiments revealed that the corresponding pre-S/S truncation mutant was capable of transactivating the Simian virus 40 and human c-Mye promoters but not the c-Fos promoter. NIH3T3 cells stably expressing this mutant were tumourigenic in four of the five nude mice tested.
Our data indicate that an HBV polymerase rtA181T/surface truncation mutant could emerge spontaneously without previous antiviral treatment. The presence of this mutant in a patient with advanced hepatocellular carcinoma as well as its oncogenic potential warrants careful re-evaluation of the current strategy of prolonged antiviral therapy.
此前,在台湾患者中发现了一种不太常见的拉米夫定耐药突变体(rtA181T),其中表面基因出现了一个终止密码子,导致乙型肝炎病毒(HBV)表面抗原分泌受损。rtA181T突变体对阿德福韦也具有耐药性。我们发现了一名39岁的晚期肝细胞癌患者,其乙肝e抗原血清学阳性,但乙肝表面抗原血清学阴性。核苷酸序列分析显示,血清和肝癌样本中均存在聚合酶rtA181T/表面截短突变体。令人惊讶的是,该患者从未接受过拉米夫定或阿德福韦抗病毒治疗。在此,我们旨在评估HBV rtA181T/表面截短突变体的致癌潜力。
在HepG2细胞中进行定点诱变实验,随后进行反式激活分析,以评估相应的前S/S截短突变体对c-Mye、c-Fos和猿猴病毒40启动子的反式激活活性。使用稳定表达该突变体的NIH3T3细胞评估在裸鼠中的致瘤性。
反式激活实验表明,相应的前S/S截短突变体能够反式激活猿猴病毒40和人c-Mye启动子,但不能激活c-Fos启动子。在测试的五只裸鼠中,有四只裸鼠体内稳定表达该突变体的NIH3T3细胞具有致瘤性。
我们的数据表明,HBV聚合酶rtA181T/表面截短突变体可能在未进行过抗病毒治疗的情况下自发出现。该突变体在晚期肝细胞癌患者中的存在及其致癌潜力值得对当前延长抗病毒治疗策略进行仔细重新评估。