白细胞介素10-1082位点基因多态性与手足口病合并脑炎易感性研究

The relationship between single nucleotide polymorphism of IL-10 and the susceptibility of hand,foot and mouth disease

目的研究白细胞介素(IL)-10-1082位点单核苷酸多态性(SNP)及表达水平与手足口病(HFMD)合并脑炎易感性的关系。方法对2009年5月至8月青岛大学医学院附属医院临床诊断为HFMD的患儿178例进行肠道病毒(EV)、肠道病毒71型(EV71)和柯萨奇A组16型(CA16)检测。采用酶联免疫吸附(ELISA)法测定各组血中IL-10水平。通过顺序特异引物聚合酶链反应(PCR-SSP)方法检测各组IL-10-1082G/A位点多态性,进行统计学分析。对照组为本地区同时期儿外科手术患儿,无感染症状。结果 (1)178例患儿中检出EV1共62例,EV71共82例,CA16共67例。(2)EV71和CA16组IL-10均显著低于对照组。(3)EV71和CA16组分别与对照组比较,IL-10-1082基因型频率分布差异均有统计学意义,EV71组A等位基因频率显著高于对照组,而CA16组与对照组的频率分布差异无统计学意义;HFMD组和重症HFMD组基因型频率分布差异有统计学意义,重症HFMD组等位基因A频率较高。结论 HFMD患儿机体存在免疫紊乱,IL-10-1082位点基因多态性与HFMD有关,IL-10-1082位点A等位基因是HFMD并发脑炎的遗传易感因素。

Objective To explore the possible relationship between the level of IL-10 in blood plasma and hand, foot and mouth disease （HFMD） and to investigate whether the single nucleotide polymorphism （SNP） of IL-IO-1082 G/A correlates with HFMD. Methods By reverse transcription polymerase chain reaction （RT-PCR）, we used of specific primers to detect enterovirus71 （EV71） and coxsackievirus A16 （CA16） in the faeces of HFMD children. The levels of IL-10 in blood plasma were detected by enzyme-linked immunosorbent assay. The genotypes of IL-10 gene -1082 site G/ A were detected by the PCR techniques in EV71 patients, CA16 patients and normal children. Results （1）EV71 was detected positive in 82 specimens from 178 acute-stage children with HFMD. The positive rate was 46.07%. CA16 was detected positive in 67 specimens from 178 acute-stage children with HFMD. The positive rate was 37.64%.（2）Compared with the normal children, the level of IL-10 was significantly decreased （P 〈 0.05）. （3） The difference of IL-10 gene -1082 site genotypes was statistically significant in EV71 group, CA 16 group and control group（P 〈 0.05） ;A allele frequency was higher in EV71 group than in normal group（P 〈 0.05）, while A allele frequency was of no significant dif ference between CA16 group and control group （P 〉 0.05）. IL-10 gene -1082 site A allele frequency was higher in encephalitis group than in HFMD group （P 〈 0.05 ）. Conclusion Genotype of IL-10 gene -1082 site, the level of IL-10 in plasma might have relationship with the generation of HFMD, and A allele of IL-10 gene -1082 site might be the ge- netic risk factors of encephalitis occurrence.