https://scholars.lib.ntu.edu.tw/handle/123456789/194442
Title: | B型肝炎病毒基因型及表面抗原T細胞抗原決定部位基因變異慢性B型肝炎病毒感染病程的影響(2/3) | Authors: | 張美惠 | Keywords: | 慢性B型肝炎病毒感染;肝細胞癌兒童;B型肝炎病毒表面抗原T細胞抗原決定點基因;B型肝炎病毒表面抗原B細胞抗原決定點基因;chronic hepatitis B virus infection;hepatocellular carcinoma in children;T cell epitope on hepatitis B surface gene;B cell epitope on hepatitis B surface gene | Issue Date: | 2003 | Publisher: | 臺北市:國立臺灣大學醫學院小兒科 | Abstract: | 在慢性B型肝炎病毒感染之自然過程中,其臨床過程及預後因宿主及病毒而 異。若能瞭解影響其臨床過程及預後之因子,有助於決定肝炎防治之策略。本計 畫之目的在 :(一)瞭解在長程追蹤中,帶原兒童B型肝炎病毒表面抗原T細胞 與B細胞抗原決定點基因變化的情形,以及其對臨床病程,B型肝炎病毒標記等 變化之影響。並與B肝最嚴重的合併症,亦即肝細胞癌之兒童做比較。(二)比 較B型肝炎病毒表面抗原T細胞及B細胞抗原決定點基因變異對臨床病程,及B 型肝炎病毒標記等變化之影響在未接受疫苗者與疫苗失敗者的異同。 我們比較長程追蹤的97 名 B型肝炎帶原兒童,及另15 名肝細胞癌兒童之B 型肝炎病毒表面抗原T細胞及B細胞抗原決定點基因在長程追蹤中變異的情 形,以及其對臨床病程,及B型肝炎病毒標記等變化的影響。另比較未接受疫苗 者與在嬰兒期接受B型肝炎預防注射者,其B型肝炎病毒表面抗原T細胞抗原 決定點基因變異之情形。結果發現肝細胞癌兒童之B型肝炎病毒表面抗原T細 胞抗原決定點基因之變異率比慢性B型肝炎病毒感染但無肝癌之兒童較高 (46.7% v.s. 6.2%, p=0.0013).此現象並未發生於B型肝炎病毒表面抗原B細胞抗原 決定點基因。B型肝炎病毒表面抗原B細胞抗原決定點基因之突變則較常發生於 接受過B 肝預防注射的兒童。 總之, 肝細胞癌兒童之B型肝炎病毒表面抗原T細胞抗原決定點基因比慢性 B型肝炎病毒感染但無肝癌之兒童有較高的變異率. 此間差異比成人之肝癌與非 肝癌帶原者相比更加顯著。兒童肝癌之早期癌形成與此B型肝炎病毒表面抗原 T細胞抗原決定點基因變異可能有關, 然而是因是果仍待進一步研究。 The aims of this study are (1) to investigate the role of mutation at the HLAclass I restricted T cell epitope and B cell epitope of hepatitis B surface antigen (HBsAg) gene in the natural course of children with chronic hepatitis B virus ( HBV) infection with and without hepatocellular carcinoma (HCC), and (2) to compare the mutation rates at the T cell epitope and the B cell epitope in children with chronic HBV infection and HCC with and without hepatitis B immunoprophylaxis in infancy. We have longitudinally followed 97 HBsAg carrier children, 53 did and 44 did not receive hepatitis B immunoprophylaxis during infancy. T cell epitope amino acids 28-51 at the HBV surface gene has been studied in those 97 children and another 15 children with HBV related HCC. Children with HCC showed a significantly higher rate of T cell epitope mutation at amino acid residue 40-49 than children without HCC (46.7% v.s. 6.2%, p=0.0013). No difference in the rate of B cell epitope mutation was found between children with and without HCC (p > 0.1). A trend of higher mutation rate in the B-cell epitope was observed in children who received HBV vaccination than in children without vaccination (22.4% v.s. 9.3%, p=0.063). No difference in the mutation rate at T cell epitope domain of the HBsAg gene was found between those who were unvaccinated and those who were vaccinated during infancy (p > 0.1 ). In conclusion, Mutations at the T cell epitope amino acid residue 40-49 were much more frequently found in childhood HCC than HBV carriers children. Its relationship with early hepatocarcinogenesis requires further investigation. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/22879 | Other Identifiers: | 912314B002149 | Rights: | 國立臺灣大學醫學院小兒科 |
Appears in Collections: | 醫學系 |
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