MBL基因多态性与多发性骨髓瘤患者诱导化疗期间感染的关联

Association of MBL gene polymorphism with infection during induction chemotherapy in patients with multiple myeloma

目的分析甘露聚糖结合凝集素(MBL)基因多态性与多发性骨髓瘤(MM)诱导化疗期间感染的关联。方法选择2017年12月—2019年12月于武汉市中西医结合医院行诱导化疗的MM患者137例,根据诱导化疗期间是否发生感染分为感染组79例和非感染组58例,采用聚合酶链式反应限制性片段长度多态性(PCR-RFLP)法检测MBL基因位点单核苷酸多态性,采用酶联免疫吸附测定法检测血清MBL含量水平。结果感染组MBL基因rs11003125位点H/H、H/L基因型频率及H、L等位基因频率与非感染组比较,差异有统计学意义(P<0.05);感染组MBL基因rs1800450位点A/A、A/B基因型频率及A、B等位基因频率与非感染组比较,差异有统计学意义(P<0.05);Logistic回归分析法结果显示,MBL基因启动子区rs11003125(H-550L)位点H/H基因型、外显子区rs1800450(A+230B)位点A/A基因型是MM诱导化疗期间感染的保护因素(P<0.05);两组患者MBL基因rs11003125位点、rs1800450位点不同基因型血清MBL含量水平比较,差异有统计学意义(P<0.05)。结论MBL基因rs11003125位点、rs1800450位点多态性与MM患者诱导化疗期间感染易感性有关,rs11003125位点H/H基因型和rs1800450位点A/A基因型携带者诱导化疗期间感染风险更低。

OBJECTIVE To analyze the association of mannose-binding lectin(MBL)gene polymorphism and infection during induction chemotherapy in patients with multiple myeloma(MM).METHODS A total of 137 patients with MM who underwent induction chemotherapy in Wuhan Hospital of Traditional Chinese and Western Medicine were selected from Dec.2017 to Dec.2019 and divided into an infection group of 79 cases and a non-infection group of 58 cases according to whether infection occurred during induction chemotherapy.The polymerase chain reaction restriction fragment length polymorphism(PCR-RFLP)was used to detect the single nucleotide polymorphisms(SNPs)of the MBL gene locus,and enzyme-linked immunosorbent assay was applied to detect serum MBL level.RESULTS There were significant differences in the frequencies of H/H and H/L genotypes and frequencies of H and L alleles at rs11003125 locus of MBL gene between infection group and non-infection group(P<0.05).The differences in the frequencies of A/A and A/B genotypes and frequencies of A and B alleles at rs1800450 locus of MBL gene were significant between infection group and non-infection group(P<0.05).Logistic regression analysis showed that the H/H genotype at rs11003125(H-550 L)locus of MBL gene promoter region and the A/A genotype at rs1800450(A+230 B)locus of MBL gene exon region were protective factors for infection during MM induction chemotherapy(P<0.05).There were significant differences in serum MBL levels of different genotypes at MBL gene rs11003125 locus and rs1800450 locus between the two groups(P<0.05).CONCLUSION The rs11003125 locus and rs1800450 locus polymorphisms of MBL gene are associated with the susceptibility to infection during induction chemotherapy in patients with MM.The risk of infection is lower during induction chemotherapy of patients carrying H/H genotype at rs11003125 locus and A/A genotype at rs1800450 locus.