CAJ | 학술논문

目的探讨Fcγ受体(FcγR)基因多态性与隐球菌病易感性的关系.方法非HIV相关隐球菌病患者198例作为病例组,门诊体格检查者190名作为健康对照组.隐球菌病患者中颅内感染者117例,颅外感染者81例.提取受试者外周血白细胞DNA,采用多重SNaPshot单核苷酸多态性(SNP)分型技术,对4种FcγR基因多态性FCGR2A 131H/R、FCGR3A 158F/V、FCGR3BNA1/NA2和FCGR2B 232I/T进行基因分型.比较病例组与健康对照组、颅内感染者与颅外感染者FcγR基因多态性的分布差异.病例组与健康对照组比较采用x2检验或Fisher确切概率检验.结果与健康对照组比较,FCGR2B 232I/I基因型在所有隐球菌脑膜炎患者中比例(65％比53％,x2 =4.27,P=0.039,OR=1.652,95％CI:1.02～2.67)及免疫功能正常隐球菌脑膜炎患者中比例(69％比53％,x2=4.53,P=0.033,OR=1.958,95％CI:1.05～3.66)均明显增加；FCGR2B 232I/T基因型在所有隐球菌脑膜炎患者中比例(27％比40％,x2=5.77,P=0.016,OR=0.542,95％CI:0.33～0.90)及免疫功能正常隐球菌脑膜炎患者中比例(24％比40％,x2=5.14,P=0.023,OR=0.467,95％CI:0.24～0.91)均明显减少.与颅外感染者比较,颅内感染者FCGR2A 131R/R基因型比例明显升高(19％比6％,x2=6.48,P=0.011,OR=3.52,95％CI:1.27～9.73)；在免疫功能正常颅内感染者中FCGR2B 232I/I基因型比例明显升高(69％比47％,x2=5.47,P=0.019,OR=2.479,95％ CI:1.15～5.34)；FCGR2B 232I/T基因型在所有颅内感染者中比例(27％比46％,x2=7.56,P=0.006,OR=0.431,95％CI:0.24～0.79)及免疫功能正常颅内感染者中比例(24％比51％,x2=8.66,P=0.003,OR=0.307,95％CI:0.14～0.68)均明显降低.结论隐球菌病患者中的颅内感染与FCGR2A 131H/R、FCGR2B 232I/T基因多态性存在相关,提示FcγRⅡA、FcγRⅡB这两种受体在隐球菌病的发生发展中可能起重要作用.
목적 탐토Fcγ수체(FcγR)기인다태성여은구균병역감성적관계.방법 비HIV상관은구균병환자198례작위병례조,문진체격검사자190명작위건강대조조.은구균병환자중로내감염자117례,로외감염자81례.제취수시자외주혈백세포DNA,채용다중SNaPshot단핵감산다태성(SNP)분형기술,대4충FcγR기인다태성FCGR2A 131H/R、FCGR3A 158F/V、FCGR3BNA1/NA2화FCGR2B 232I/T진행기인분형.비교병례조여건강대조조、로내감염자여로외감염자FcγR기인다태성적분포차이.병례조여건강대조조비교채용x2검험혹Fisher학절개솔검험.결과 여건강대조조비교,FCGR2B 232I/I기인형재소유은구균뇌막염환자중비례(65％비53％,x2 =4.27,P=0.039,OR=1.652,95％CI:1.02～2.67)급면역공능정상은구균뇌막염환자중비례(69％비53％,x2=4.53,P=0.033,OR=1.958,95％CI:1.05～3.66)균명현증가；FCGR2B 232I/T기인형재소유은구균뇌막염환자중비례(27％비40％,x2=5.77,P=0.016,OR=0.542,95％CI:0.33～0.90)급면역공능정상은구균뇌막염환자중비례(24％비40％,x2=5.14,P=0.023,OR=0.467,95％CI:0.24～0.91)균명현감소.여로외감염자비교,로내감염자FCGR2A 131R/R기인형비례명현승고(19％비6％,x2=6.48,P=0.011,OR=3.52,95％CI:1.27～9.73)；재면역공능정상로내감염자중FCGR2B 232I/I기인형비례명현승고(69％비47％,x2=5.47,P=0.019,OR=2.479,95％ CI:1.15～5.34)；FCGR2B 232I/T기인형재소유로내감염자중비례(27％비46％,x2=7.56,P=0.006,OR=0.431,95％CI:0.24～0.79)급면역공능정상로내감염자중비례(24％비51％,x2=8.66,P=0.003,OR=0.307,95％CI:0.14～0.68)균명현강저.결론 은구균병환자중적로내감염여FCGR2A 131H/R、FCGR2B 232I/T기인다태성존재상관,제시FcγRⅡA、FcγRⅡB저량충수체재은구균병적발생발전중가능기중요작용.
Objective To describe the distributions of FCGR polymorphisms in human immunodeficiency virus (HIV)-uninfected patients with cryptococcosis,and to investigate the association of FCGR polymorphisms with the susceptibility to cryptococcosis.Methods The distributions of the four functional polymorphisms,including FCGR2A 131H/R,FCGR3A 158F/V,FCGR3B NA1/NA2,and FCGR2B 232I/T were compared between 198 cryptococcosis patients and 190 healthy controls.The polymorphisms distribution patterns were also compared between patients with central nervous system (CNS) infection and those without CNS infection.Genotyping of eight single nucleotide polymorphism (SNP) in FCGR were performed by multiplex SNaPshot technology using DNA extracted from blood samples.The comparison between patients and controls was performed by chi square test or Fisher exact test.Results Compared to healthy controls,the frequency of FCGR2B 232I/I increased (65％ vs 53％,x2 =4.27,P=0.039,OR=1.652,95％CI:1.02-2.67) and that of FCGR2B 232I/T decreased (27％ vs 40％,x2 =5.77,P=0.016.OR=0.542,95％CI:0.33-0.90) in patients with cryptococcal meningitis.Among immunocompetent patients,the frequency of FCGR2B 232I/I was also over-presented (69％ vs 53％,x2=4.53,P =0.033,OR=1.958,95％CI:1.05-3.66) and the FCGR2B 232I/T genotype was also less frequently observed (24％ vs 40％,x2=5.14,P=0.023,OR=0.467,95％CI:0.24-0.91) compared to healthy controls.There were 117 cases with CNS infection and 81 non-CNS infection cases.The genotype of FCGR2A 131R/Rwas over-presented (19％ vs 6％,x2 =6.48,P=0.011,OR=3.52,95％CI:1.27-9.73) and the FCGR2B 232I/T genotype was under-presented (27 ％ vs 46 ％,x2 =7.56,P =0.006,OR=0.431,95％CI:0.24-0.79) in patients with CNS infection compared with those without CNS infection.Furthermore,the frequency of FCGR2B 232I/I genotypes increased (69％ vs47％,x2 =5.47,P=0.019,OR=2.479,95％CI:1.15-5.34) and the frequency of FCGR2B 232I/T decreased (24％ vs 51％,x2 =8.66,P=0.003,OR=0.307,95％CI:0.14-0.68) in immunocompetent patients with CNS infection compared with those without CNS infection.Conclusions FCGR2A 131H/R and FCGR2B 232I/T are associated with the susceptibility to cryptococcal CNS infection,which suggests that FcγRⅡA and FcγRⅡB may contribute to the pathogenesis of cryptococcosis.