ICAM-1基因多态性与HBV感染不同临床结局之间的关系

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ICAM-1 K469E位点位于第6外显子区域,此位点A→G突变导致第五免疫球蛋白样区域赖氨酸变为谷氨酸,从而影响其LFA-1的相互作用及B 细胞的黏附^{[ 4, 10 ]} ,而且有研究发现,此位点可通过改变细胞与细胞间的相互作用而调节细胞的凋亡^{[ 11 ]} 。我们研究发现,携带K469E位点KK基因型和K等位基因的患者容易使免疫激活进展为活动性肝病如慢性乙型肝炎甚至肝硬化,但在CH组和LC组之间以及AsC和SR组之间各基因型频率却无显著差异,表明ICAM-1 K469E位点A→G多态性与HBV感染后不同的临床结局具有明显的相关性, KK基因型和K等位基因可能分别是进展性肝病的易感基因型和等位基因。

HBV感染是一个非常复杂的多因素共同作用的过程,宿主基因多态性与HBV感染的相关性研究已成为近几年国内外研究的热点,目前已经发现许多基因的多态性与HBV感染的不同的临床结局有关,如: TNF-α、HLA-DQA1、HLA-DQB1等。本实验初步探索了ICAM-1基因多态性与HBV 感染之间的关系, 初步发现K469E位点不同基因型与HBV感染预后具有明显的相关性,但由于本实验还有许多不足,因此,还需要进一步的大样本研究以明确,以便为我们更深入地了解乙型病毒性肝炎的发病机理,寻找新的治疗方案提供依据。

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来源：胃肠病学和肝病学杂志作者：孙慧吴金明黄智铭吴建胜陈瑾林贤凡