血清IL-17与IL-17-197A/G位点单核苷酸多态性和乙型病毒性肝炎易感性研究

Serum IL-17 and IL-17-197A/G locus single nucleotide polymorphism and susceptibility to hepatitis B virus

目的探究血清白细胞介素-17(IL-17)及IL-17-197A/G位点单核苷酸多态性与乙型病毒性肝炎易感性。方法选择2017年1月-2019年3月于华中科技大学同济医学院附属武汉中心医院就诊的乙型肝炎病毒(Hepatitis B virus,HBV)感染患者200例为研究对象,其中自限性HBV感染组48例、无症状慢性HBV携带组31例、慢性乙型肝炎组75例、慢性乙型肝炎肝硬化组46例。采用PCR技术检测IL-17-197G/A位点的单核苷酸多态性;采用荧光定量PCR检测HBV-DNA载量;检测肝功能指标[丙氨酸氨基转移酶(Alanine aminotransferase,ALT)、天冬氨酸氨基转移酶(Aspartate aminotransferase,AST)、总胆红素(Total bilirubin,TBIL)]和血清IL-17水平。结果慢性乙型肝炎肝硬化组患者的AA、AG、GG基因型频率分别为73.91%(34/46)、15.22%(7/46)、10.87%(5/46)与其他三组比较,差异有统计学意义(P<0.05);慢性乙型肝炎肝硬化组的A等位基因频率为81.52%高于自限性HBV感染组15.63%和慢性乙型肝炎组36.67%(P<0.05);慢性乙型肝炎肝硬化组高病毒载量者的IL-17为(6.68±0.72)pg/ml高于低病毒载量者(P<0.05);慢性乙型肝炎肝硬化组ALT>40 U/L、AST>40 U/L、TBIL>20μmol/L患者的IL-17分别为(6.92±0.74)U/L、(8.97±0.69)U/L、(6.96±0.67)μmol/L高于ALT、AST、TBIL低水平者(P<0.05)。结论IL-17高水平与乙型肝炎病毒感染慢性化进程有关,IL-17-197G/A位点基因型单核苷酸多态性可能与HBV感染有关,A等位基因可能为易感基因,AA基因型可能增加了HBV感染的不良转归。

OBJECTIVE To explore serum IL-17 levels and single nucleotide polymorphisms in IL-17-197 A/G locus and susceptibility to hepatitis B virus.METHODS Two hundred patients with hepatitis B virus(HBV)infection who were treated at Wuhan Central Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from Jan.2017 to Mar.2019 were selected as the research subjects,including 48 cases of self-limiting HBV infection group,31 cases of asymptomatic chronic HBV carrying group,75 cases of chronic hepatitis B group and 46 cases of chronic hepatitis B cirrhosis group.The single nucleotide polymorphisms at the IL-17-197 G/A site were detected by PCR,HBV-DNA load were measured by fluorescent quantitative PCR,and the parameters of liver function such as(ALT,AST,TBIL,and serum IL-17)levels were detected.RESULTS The AA,AG,and GG genotype frequencies of patients with chronic hepatitis B cirrhosis were 73.91%(34/46),15.22%(7/46),and 10.87%(5/46),respectively,and the differences were significant compared with the other three groups(P<0.05).The A allele frequency of chronic hepatitis B cirrhosis group was 81.52%,higher than that of self-limiting HBV infection group(15.63%)and chronic hepatitis B group(36.67%)(P<0.05).The IL-17 of patients with high viral load in chronic hepatitis B cirrhosis group was(6.68±0.72)pg/ml,significantly higher than that of patients with low viral load(P<0.05).The IL-17 of patients with ALT>40 U/L,AST>40 U/L,and TBIL>20 in the chronic hepatitis B cirrhosis group were(6.92±0.74)U/L,(6.96±0.67)U/L and(6.96±0.67)μmol/L,respectively,significantly higher than those with low levels of ALT,AST,and TBIL(P<0.05).CONCLUSION The high level of IL-17 is associated with the chronic process of hepatitis B virus infection.The single nucleotide polymorphism at IL-17-197 G/A site may berelated to HBV infection.The A allele may be a susceptible gene and AA genotype may increase the adverse outcome of HBV infection.