定量检测乙型肝炎病毒表面抗原（HBsAg）大中型蛋白作为鉴定

StephenW

Hepatology
Original article
Quantification of large and middle proteins of hepatitis B virus surface antigen (HBsAg) as a novel tool for the identification of inactive HBV carriers

    Maria Pfefferkorn1, Stephan Böhm2, Tina Schott1, Danilo Deichsel1, Corinna M Bremer3, Kathrin Schröder3, Wolfram H Gerlich3, Dieter Glebe3, Thomas Berg1, Florian van Bömmel1

Author affiliations

    Section of Hepatology, Clinic for Gastroenterology and Rheumatology, University Hospital Leipzig, Leipzig, Germany
    Max von Pettenkofer—Institute for Hygiene and Clinical Microbiology, Ludwig-Maximilians-Universität, Munich, Germany
    National Reference Center for Hepatitis B and D Viruses, Institute for Medical Virology, German Centre for Infection Research (DZIF), Justus Liebig University Giessen, Giessen, Germany

    Correspondence to Dr. Florian van Bömmel, Section of Hepatology, Clinic for Gastroenterology and Rheumatology, University Hospital Leipzig AöR, Liebigstraße 20, 04103 Leipzig, Germany; [email protected]

Abstract

Objective Among individuals with chronic hepatitis B, those with hepatitis B e-antigen (HBeAg)-negative chronic hepatitis (CHB) can be difficult to distinguish from those with HBeAg-negative chronic HBV infection, also referred to as inactive HBV carriers (ICs), but both require different medical management. The level of HBV surface antigen (HBsAg) has been proposed as a marker to discriminate between chronic infection and hepatitis stages. HBsAg consists of large, middle and small HBs. The aim of this study was to determine whether the composition of HBsAg improved the identification of ICs among HBsAg-positive subjects with different phases of HBV infections.

Design HBV large surface proteins (LHBs) and HBV middle surface proteins (MHBs) were quantified in serum samples from 183 clinically well-characterised untreated patients with acute (n=14) HBV infection, ICs (n=44), CHBs (n=46), chronic HBeAg-positive phase (n=68) and hepatitis delta coinfection (n=11) using an ELISA, with well-defined monoclonal antibodies against the preS1 domain (LHBs) and the preS2-domain (MHBs). A Western blot analysis was used to verify the quantitation of the components of HBsAg. Total HBsAg was quantified using a modified commercially available assay (HBsAg V.6.0, Enzygnost, Siemens, Erlangen).

Results The composition of HBsAg showed specific patterns across different phases of hepatitis B. Individuals in the IC phase had significantly lower proportions of LHBs and MHBs than patients in acute or chronic phases irrespective of their HBV e-antigen status (p<0.0001) or HBsAg level. Both LHBs and MHBs ratios better predicted the IC phase than total HBsAg levels.

Conclusion Quantification of MHBs, particularly LHBs represents a novel tool for the identification of the IC stage.

http://dx.doi.org/10.1136/gutjnl-2017-313811

StephenW

肝病
来源文章
定量检测乙型肝炎病毒表面抗原（HBsAg）大中型蛋白作为鉴定非活动性HBV携带者的新工具

    Maria Pfefferkorn1，StephanBöhm2，Tina Schott1，Danilo Deichsel1，Corinna M Bremer3，KathrinSchröder3，Wolfram H Gerlich3，Dieter Glebe3，Thomas Berg1，Florian vanBömmel1

作者从属关系

    德国莱比锡莱比锡大学医院肝病科，胃肠病和风湿病临床科
    德国慕尼黑Ludwig-Maximilians-Universität卫生和临床微生物学研究所的Max von Pettenkofer研究所
    德国吉森公司德国吉森斯利比希大学吉森公司德国传染病研究中心医学病毒学研究所国家乙型和丙型肝炎病毒参考中心

    对应于德国莱比锡Liebigstraße20，04103 LeipzigAöR大学医院消化科和风湿科临床肝病学部门的Florian vanBömmel博士; [email protected]

抽象

目的在慢性乙型肝炎患者中，乙型肝炎e抗原（HBeAg）阴性慢性乙型肝炎（CHB）患者很难与HBeAg阴性的慢性HBV感染者（也称为非活动性HBV携带者（ICs））区分开来， ，但都需要不同的医疗管理。已提出HBV表面抗原（HBsAg）水平作为区分慢性感染和肝炎阶段的标志物。 HBsAg由大，中和小HBs组成。这项研究的目的是确定HBsAg的组成是否改善了乙型肝炎病毒感染不同阶段HBsAg阳性受试者中IC的鉴定。

在来自183名临床特征明显的未治疗的患有急性（n = 14）HBV感染，IC（44例），CHB（n = 14）HBV感染的患者的血清样品中量化HBV大表面蛋白（LHB） 46），慢性HBeAg阳性期（n = 68）和丁型肝炎合并感染（n = 11），以及针对preS1结构域（LHB）和preS2结构域（MHB）的良好定义的单克隆抗体。 Western印迹分析用于验证HBsAg组分的定量。使用改进的市售测定法（HBsAg V.6.0，Enzygnost，Siemens，Erlangen）定量总HBsAg。

结果HBsAg的组成在不同阶段的乙型肝炎中呈现出特异性模式。与乙型肝炎病毒e抗原状态（p <0.0001）或HBsAg无关，急性期和慢性期患者的IC期中LHBs和MHBs的比例显着低于患者水平。 LHBs和MHBs比值都比总HBsAg水平更能预测IC阶段。

结论定量MHBs，特别是LHBs是鉴定IC期的新工具。

http://dx.doi.org/10.1136/gutjnl-2017-313811