CAJ | 학술논문

目的：探讨慢性HBV感染者外周血白细胞内质网应激相关基因糖调节蛋白78（GRP78）、CCAAT增强子结合蛋白同源蛋白（CHOP）和X盒结合蛋白l（XBP1）mRNA水平及其与临床指标的相关性。方法采用实时荧光定量PCR技术检测40例正常人（NC）、43例慢性无症状HBV携带者（ASC）、47例慢性乙型肝炎（CHB）、41例乙型肝炎肝硬化（LC）和35例乙型肝炎相关肝细胞癌（HCC）患者外周血白细胞GRP78、CHOP和XBP1 mRNA水平，分析其与病毒学和生化学指标的相关性。结果 ASC、CHB、LC和HCC患者外周血白细胞GRP78 mRNA水平和XBP1 mRNA水平分别为（0.58±0.53）和（0.76±0.57）、（0.59±0.67）和（0.50±0.64）、（1.07±1.09）和（1.44±1.00）和（1.17±1.69）和（0.90±1.33），均显著高于健康人[分别为（0.01±0.61）和（0.01±0.97），P＜0.01和P＜0.05]；在HBsAg＜1500IU/ml、1500～20000IU/ml和>20000IU/ml组患者，GRP78 mRNA水平分别为（0.48±0.59）、（0.76±0.56）和（0.74±0.56），三组间差异有统计学意义（P＜0.05）；HBV DNA水平为1×103～105copies/ml组XBP1 mRNA水平为（0.86±1.13），显著低于HBV DNA>1×105copies/ml组[（1.44±1.31），P＜0.05]；在不同转氨酶水平间、HBeAg阳性与阴性组间和胆红素正常与升高组间，以上三种基因 mRNA 水平差异均无统计学意义（P＞0.05）。结论内质网应激可能与慢性HBV感染后的疾病进展相关。
목적：탐토만성HBV감염자외주혈백세포내질망응격상관기인당조절단백78（GRP78）、CCAAT증강자결합단백동원단백（CHOP）화X합결합단백l（XBP1）mRNA수평급기여림상지표적상관성。방법채용실시형광정량PCR기술검측40례정상인（NC）、43례만성무증상HBV휴대자（ASC）、47례만성을형간염（CHB）、41례을형간염간경화（LC）화35례을형간염상관간세포암（HCC）환자외주혈백세포GRP78、CHOP화XBP1 mRNA수평，분석기여병독학화생화학지표적상관성。결과 ASC、CHB、LC화HCC환자외주혈백세포GRP78 mRNA수평화XBP1 mRNA수평분별위（0.58±0.53）화（0.76±0.57）、（0.59±0.67）화（0.50±0.64）、（1.07±1.09）화（1.44±1.00）화（1.17±1.69）화（0.90±1.33），균현저고우건강인[분별위（0.01±0.61）화（0.01±0.97），P＜0.01화P＜0.05]；재HBsAg＜1500IU/ml、1500～20000IU/ml화>20000IU/ml조환자，GRP78 mRNA수평분별위（0.48±0.59）、（0.76±0.56）화（0.74±0.56），삼조간차이유통계학의의（P＜0.05）；HBV DNA수평위1×103～105copies/ml조XBP1 mRNA수평위（0.86±1.13），현저저우HBV DNA>1×105copies/ml조[（1.44±1.31），P＜0.05]；재불동전안매수평간、HBeAg양성여음성조간화담홍소정상여승고조간，이상삼충기인 mRNA 수평차이균무통계학의의（P＞0.05）。결론내질망응격가능여만성HBV감염후적질병진전상관。
Objective To investigate the changes of glucose regulated protein 78 (GRP78),a endoplasmic reticulum stress (ERS) related gene,C/ enhancer-binding protein homologous protein (CHOP) and X-box binding protein (XBP) 1 mRNA in peripheral leukocytes in patients with chronic hepatitis B viral infections. Methods The mRNA levels in peripheral leukocytes were measured by real time PCR in 43 individuals with asymptomatic hepatitis B virus carriers,47 patients with chronic hepatitis B,41 with hepatitis B related liver cirrhosis,35 with hepatitis B related hepatocellular carcinoma (HCC) and 40 normal healthy persons. Results The GRP78 mRNA levels in hepatitis B virus carriers,in patients with chronic hepatitis B,liver cirrhosis and hepatocellular carcinoma were higher than that in healthy controls[(0.58±0.53),(0.76±0.57),(0.59±0.67) and (0.50±0.64) vs.(0.01±0.61), P<0.01 for all];the XBP 1 mRNA in hepatitis B virus carriers,in patients with chronic hepatitis B,liver cirrhosis and hepatocellular carcinoma were also higher than that in health controls [(1.07±1.09),(1.44±1.00),(1.17±1.69) and (0.90±1.33) vs. (0.01±0.97),P<0.05 for all];The GRP78 mRNA (0.48±0.59) in patients with serum HBsAg levels of <1500 IU/ml were much lower than in with serum 1500~20000 IU/ml [(0.76±0.56),P<0.05] or >20000 IU/ml [(0.74 ±0.56),P<0.05];The XBP 1 mRNA levels in patients with serum HBV DNA levels of 1 ×103 to 105copies/ml was lower than in patients with higher serum HBV DNA load (>1 ×105copies/ml)[(0.86 ±1.13) vs. (1.44±1.31),P<0.05];However,there existed no statis-tical differences as respect to the three mRNA levels among patients with different serum alanine amino-transferase,nor between patients with normal or ab-normal serum bilirubin,nor between HBeAg-positive and HBeAg-negative patients. Conclusion Endoplas-mic reticulum stress may be associated with the dis-ease progression in patients with chronic HBV infection.