6 结语
目前, 临床不明原因非结合性胆红素增高主要依靠肝脏穿刺病理检查确诊, 其结果受到人员和技术水平限制, 很多患者最终难以确诊。分子水平诊断非结合性高胆红素血症具有客观、精确、敏感度高的特点, 为明确诊断提供了新的方向, 可以减少患者不必要的痛苦和经济负担, 具有广泛的推广价值。而对于需要治疗的非结合型胆红素增高血症, 基因治疗因其经济、高效、安全的特点而具有极高的研究和应用价值。
参考文献
[1] 骆抗先. 乙型肝炎基础与临床[M]. 北京: 人民卫生出版社, 2006:301- 302.
[2] 姚光弼. 临床肝脏病学[M]. 上海: 上海科学技术出版社, 2004:581-585.
[3] Miners J O, McKinnon R A,Mackenzie P I. Genetic polymorphismsof UDPglucuronosyltransferases and their functional significance[J]. Toxicology,2002,181:453- 456.
[4] Mackenzie P I, Miners J O,McKinnon R A. Polymorphisms in UDPlucuronosyl transferase genes: functional consequences and clinicalelevance[J]. Clin Chem Lab Med, 2000,38:889- 892.
[5] Ritter J K, Crawford J M, Owens I S. Cloning of two human liverbilirubin UDPglucuronosyltransferase cDNAs with expressionin COS1 cells[J]. J Biol Chem, 1991,266:1043- 1047.
[6] Bock K W. Vertebrate UDP glucuronosyltransferases :functionalandevolutionary aspects[J]. Biochem Pharmacol, 2003,66:691- 696.
[7] Kaplan M, Hammerman C, Maisels M J. Bilirubin genetics for thenon geneticist: hereditary defects of neonatal bilirubin conjugation[J]. Pediatrics, 2003,111:886- 893.
[8] Miners J O, McKinnon R A, Mackenzie P I. Genetic polymorphismsoUDP glucuronosyltransferases and their functional significance[J]. Toxicology, 2002,181:453- 456.
[9] 钟丹妮, 刘悠南, 刘义, 等. 广西新生儿胆红素尿苷二磷酸葡萄糖醛酸转移酶基因Gly71Arg 突变的研究[J]. 中华儿科杂志, 2002,40(10):579- 591.
[10] Aono S, Adachi Y, UyamaE, et al. Analysis of genes forbilirubinUDP glucuronosyltransferase in Gilbert′ssyndrome[J]. Lancet, 1995,345:958- 959.
[11] Hsieh S Y, Wu Y H, Lin D Y, et al. Correlation of mutationalanalysis to clinic al features in Taiwanese patients with Gilbert ssyndrome[J]. Am J Gastroenterol, 2001,96:1188- 1193.
[12] Maruo Y, Sato H, Yamano T, et al. Gilbert syndrome caused by ahomozygous missense mutation (Tyr486Asp) of bilirubin UDP glucuronosyltransferasegene[J]. J Pediatr, 1998,132:1045- 1047.
[13] Servedio V, dApolito M, Maiorano N, et al. Spectrum of UGT1A1mutations in Crigler- Najjar(CN) syndrome patients: identification oftwelve novel alleles and genotype- phenotype correlation [J]. HumMutat, 2005,25(3):325.
[14] Sappal B S, Ghosh S S, Shneider B, et al. A novel intronic mutationresult in the use of a cryptic splice acceptor site within thecoding region of UGT1A1, causingCriglar- Najjar syndrome type Ⅰ[J]. Mol Gen Met, 2002,75,134- 142.
[15] Gantla S, Bakker C T M, Deocharan B. Splice- site mutations: anovel genetic mechanism for crigler najjar syndrom type Ⅰ[J]. AmJ Hum Gen, 1998, 62:585- 592.
[16] Nong S H, Xie Y M, Chan K W, et al. Severe hyperbilirubinaemiain a Chinese girl with type I Crigler- Najjar syndrome: first caseever reported in Mainland China[J]. J Paediatr Child Health, 2005,41(5- 6):300- 302.
[17] Takeuchi K, Kobayashi Y, Tamaki S, et al. Genetic polymorphismsof bilirubin uridine diphosphate - glucuronosyltransferase gene inJapanese patients with Crigler - Najjar syndrome or Gilbert s syndromeas well as in healthy Japanese subjects [J]. J GastroenterolHepatol, 2004,19(9):1023- 1028.
[18] Parkin J D, Mayall B C. Use of double gradient denaturing gradientgel electrophoresis to detect (AT)n polymorphisms in the UDPglucuronosyltransferase1 gene promoter associated with Gilbert ssyndrome[J]. Electrophoresis, 1999,20(14):2841- 2843.
[19] Francoual J, Trioche P, Mokrani C, et al. Prenatal diagnosis ofCrigler- Najjar syndrome type I by single- strand conformation polymorphism(SSCP)[J]. Prenat Diagn, 2002,22(10):914- 916.
[20] Harraway J R. Use of fully denaturing HPLC for UGTIAI genotypingin Gilbert syndrome[J]. Clin Chem, 2005,51(11):2183- 2185.
[21] Fox I J, Chowdhury J R, Kaufman S S, et al. Treatment of theCrigler- Najjar syndrome type I with hepatocyte transplantation[J]. NEngl J Med, 1998,338:1422- 1426.
[22] Tada K, Roy- Chowdhury N, Prasad V, et al. Long- term ameliorationof bilirubin glucuronidation defect in Gunn rats by transplantinggenetically modified immortalized autologous hepatocytes[J]. CellTransplant, 1998,7(6):607- 616.
[23] Jia Z, Danko I. Long- term correction of hyperbilirubinemia in theGunn rat by repeated intravenous delivery of naked plasmid DNAinto muscle[J]. Mol Ther, 2005,12(5):860- 866.
[24] Jia Z, Danko I. Single hepatic venous injection of liver- specificnaked plasmid vector expressing human UGT1A1 leads to longtermcorrection of hyperbilirubinemia and prevention of chronicbilirubin toxicity in Gunn rats[J]. Hum Gene Ther, 2005,16(8):985-
995.
[25] van der Wegen P, Louwen R, Imam A M, et al. Successful treatmentof UGT1A1 deficiency in a rat model of Crigler- Najjar diseaseby intravenous administration of a liver- specific lentiviral vector[J]. Mol Ther, 2006,13(2):374- 381.
[26] Seppen J, van Til N P, van der Rijt R, et al. Immune response tolentiviralbilirubin UDP- glucuronosyltransferase gene transfer in fetaland neonatal rats[J]. Gene Ther, 2006,13(8):672- 677.
来源:生物技术通讯 作者:栾翔凌 辛绍杰