慢加急性乙型肝炎肝衰竭患者乙型肝炎病毒前C/CP区变异研究进展*

doi:10.3969/j.issn.1672-5069.2016.02.035

实用肝脏病杂志 ›› 2016, Vol. 19 ›› Issue (2): 241-244.doi: 10.3969/j.issn.1672-5069.2016.02.035

慢加急性乙型肝炎肝衰竭患者乙型肝炎病毒前C/CP区变异研究进展^*

黄鹏宇(综述), 徐东平(审校)

524000 广东省湛江市广东医学院检验学院生物化学与分子生物学研究所（黄鹏宇）; 解放军第302医院临床研究管理中心（徐东平）

收稿日期:2015-07-28 出版日期:2016-03-10 发布日期:2016-03-04
通讯作者: 徐东平,E-mail:xudongping302@sina.com
作者简介:黄鹏宇,男,25岁,硕士研究生。主要从事乙型肝炎病毒变异的检测与临床意义研究
基金资助:
国家自然科学基金资助项目（No.81271847）

Precore and core promoter mutations of hepatitis B virus and their roles in acute-on-chronic liver failure

Huang Pengyu, Xu Dongping

Institute of Biochemistry and Molecular Biology,School of Laboratory Medicine,Guangdong Medical College,Zhanjiang 524000,Guangdong Province,China

Received:2015-07-28 Online:2016-03-10 Published:2016-03-04

摘要/Abstract

摘要： 慢加急性肝衰竭（ACLF）是我国肝衰竭的主要类型,其病情发展迅速、预后不良、病死率较高。在我国,乙型肝炎病毒（HBV）感染是导致ACLF的主要病因,其中HBV前C（PC）/核心启动子（CP）区基因变异与ACLF的发生密切相关。本文重点介绍HBV PC/CP区基本结构和功能、PC/CP区变异后生物学特性的改变、ACLF的免疫病理损伤机制、PC/CP区变异与ACLF疾病进展的临床意义等方面的研究进展。

关键词: 慢加急性肝衰竭, 乙型肝炎病毒, 前C区, 核心启动子, 变异

Abstract: Acute-on-chronic liver failure （ACLF） is common type of liver failure,with poor prognosis and high mortality. Hepatitis B virus（HBV）infection is the major cause of ACLF in China. HBV precore/core promoter（PC/CP） region gene mutation is closely related to the occurrence of ACLF. In this article,we reviewed the structure and functions, biological change by mutations of HBV precore/core promoter, and immunopathogenetic mechanisms of ACLF.

Key words: Acute-on-chronic liver failure, Hepatitis B virus, Precore region, Core promoter, Mutation

黄鹏宇(综述), 徐东平(审校). 慢加急性乙型肝炎肝衰竭患者乙型肝炎病毒前C/CP区变异研究进展^*[J]. 实用肝脏病杂志, 2016, 19(2): 241-244.

Huang Pengyu, Xu Dongping. Precore and core promoter mutations of hepatitis B virus and their roles in acute-on-chronic liver failure[J]. JOURNAL OF PRACTICAL HEPATOLOGY, 2016, 19(2): 241-244.

参考文献

[1] 中华医学会肝病学分会和感染病学分会.慢性乙型肝炎防治指南（2010年版）.实用肝脏病杂志,2011,14（2）：81-89.
[2] You SL, Rong YH, Zhu B, et al. Changing etiology of liver failure in 3916 patients from northern China:a 10-year survey. Hepatol Int,2013,7（2）:714-720.
[3] Chisari FV, Isogawa M, Wieland S. Pathogenesis of hepatitis B virus infection. Pathol Biol（Paris）,2010,58（4）:258-266.
[4] Olson JC, Kamath PS. Acute-on-chronic liver failure:concept, natural history, and prognosis. Curr Opin Crit Care,2011,17（2）:165-169.
[5] Jules L,Dienstag, MD. Hepatitis B Virus Infection. N Engl J Med,2008,359（14）:1486-1500.
[6] Malik A,Singhal DK,Albanyan A,et al. Hepatitis B virus gene mutations in liver diseases:a report from New Delhi. PLoS One,2012,7（6）:e39028.
[7] Lai CL,Yuen MF. Chronic hepatitis B-New goals, new treatment. N Engl J Med,2008,359（23）:2488-2491.
[8] Orito E,Ichida T,Sakugawa H,et al. Geographic distribution of hepatitis B virus（HBV） genotype in patients with chronic HBV infection in Japan.Hepatology,2001,34（3）:590-594.
[9] B-ttcher B,Wynne SA,Crowther RA. Determination of the fold of the core protein of hepatitis B virus by electron cryomicroscopy.Nature,1997,386（6620）:88-91.
[10] Zhang D,Ma SF,Zhang X,et al. Prevalent HBV point mutations and mutation combinations at BCP/preC region and their association with liver disease progression.BMC Infect Dis,2010,10:271.
[11] 骆抗先. 乙型肝炎基础和临床. 3版.北京:人民卫生出版社,2006:78-90.
[12] Carman WF,Zanetti AR,Karayiannis P,et al. Vaccine-induced escape mutant of hepatitis B virus.Lancet,1990,336（8711）:325-329.
[13] 徐东平. 乙型肝炎病毒的病毒学特点及其临床意义.解放军医学杂志,2009,34（6）:655-658.
[14] 李春青,荀运浩,过建春.HBV前C/BCP区变异与重型乙型肝炎相关性的研究进展.中西医结合肝病杂志,2010,20（5）:315-317.
[15] 任晓强,许智慧,刘志国,等. 958例乙型肝炎患者HBV前C/BCP区变异检测及其意义分析.解放军医学杂志,2009,34（6）:663-665.
[16] Tu WH,Lyu Y,Zhang YM,et al. Precore/basal core promoter mutants quantification throug-hout phases of hepatitis B virus-infection by Simpleprobe. World J Gastroenterol,2015,21（21）:6639-6648.
[17] 陈风娟,王甦. 肝细胞核因子4α在肝脏疾病中的研究进展. 医学理论,2013,26（5）:590-592.
[18] Okamoto H, Tsuda F,Akahane Y,et al. Hepatitis B virus with mutations in the e antigen-negative phenotype in carriers with e antibody to e antigen. Virology,1994,68（12）:8102-8110.
[19] Buckwold VE, Xu ZC,Chen M,et al. Effects of a naturally occurring mutation in the hepatitis B virus basal core promoter on precore gene expression and viral replication.V irology,1996,70（9）:5845-5851.
[20] Tang H,Banks KE,Anderson AL,et al. Hepatitis B virus transcription and replication. Drug News Prespect,2001,14（6）:325-334.
[21] 李梵,徐东平.乙型肝炎病毒基因突变与临床疾病进展的关系.实用肝脏病杂志,2014,17（2）:210-213.
[22] Peng Y,Liu B,Hou J,et al. Naturally occurring deletions/insertions in HBV core promoter tend to decrease in HBeAgpositive chronic hepatitis B patients during antiviral therapy.Antivir Ther,2015,10:3851/IMP2955.
[23] Qu L, Kuai X,Liu T,et al. Pre-S deletion and complex mutations of hepatitis B virus related to young age hepatocellular carcinoma in Qidong,China. PLoS One,2013,8（3）:e59583.
[24] Juniastuti D,Utsumi T,Aksono EB,et al. Predominance of precore mutations and clinical significance of basal core promoter mutations in chronic hepatitis B virus infection in Indonesia. Biomed Rep,2013,1（4）:522-528.
[25] 王耀,刘妍,许智慧,等. G1764A/C1766T/T1768A三联突变对HBV核心启动子活性的上调作用的研究.解放军医学杂志,2010,35（8）:954-957.
[26] Kitab B,Essaid El Feydi A,Afifi R,et al. Variability in the precore and core promoter regions of HBV strains in Morocco: Characterization and impact on liver disease progression. PLoS One,2012,7（8）:e42891.
[27] 中华医学会感染病学分会肝衰竭与人工肝学组.肝衰竭诊治指南（2012年版）. 实用肝脏病杂志,2013,16（3）:210-216.
[28] 黄湛镰,高志良.肝衰竭的三重打击及治疗策略.内科急危重症杂志,2014,20（3）:154-156.
[29] 李晓东,徐东平.HBV相关慢加急性肝衰竭免疫病理发病机制研究进展.实用肝脏病杂志,2015,18（3）:317-320.
[30] 杨玲,曾文铤,梁增伟,等.BCP/前C及A1846T变异与HBV导致的慢加急性肝衰竭发病相关研究.热带医学杂志,2013,13（9）:1095-1097.
[31] Ren X,Xu Z,Liu Y,et al. Hepatitis B virus genotype and basal core promoter/precore mutations are associated with hepatitis B related acute on chronic liver failure without preexisting liver cirrhosis. J Viral Hepat,2010,17（12）:887-895.
[32] Xu Z,Ren X,Liu Y,et al. Association of hepatitis B virus mutations in basal core promoter and precore regions with severity of liver disease: an investigation of793 Chinese patients with mild and severe chronic hepatitis B and acute on chronic liver failure.J Gastroenterol,2011,46（3）:391-400.
[33] Zhang A,Wan Z,You S,et al. Association of hepatitis B virus mutations of A1846T and C1913A/G with acute on chronic liver failure development from different underlying chronic liver diseases.Hepat Mon,2013,13（9）:e12445.
[34] Xiao L,Zhou B,Gao H,et al. Hepatitis B virus genotype B with G1896A and A1762T/G1764A mutations is associated with hepatitis B related acute on chronic liver Failure. J Med Virol,2011,83:1544-1550.
[35] Hu F, Bi S,Yan H,et al. Associations between hepatitis B virus basal core promoter/precore region mutations and the risk of acute on chronic liver failure:a meta-analysis. Virol J,2015,12:87.

慢加急性乙型肝炎肝衰竭患者乙型肝炎病毒前C/CP区变异研究进展^*

Precore and core promoter mutations of hepatitis B virus and their roles in acute-on-chronic liver failure

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