定量分析乙型肝炎病毒表面抗原（HBsAg）的大中型蛋白质，作

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
定量分析乙型肝炎病毒表面抗原（HBsAg）的大中型蛋白质，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，FlorianvanBömmel1

作者隶属关系

    德国莱比锡莱比锡大学医院消化内科和风湿病学肝脏病科
    Max von Pettenkofer-德国慕尼黑Ludwig-Maximilians-Universität卫生与临床微生物研究所
    国家乙型和乙型病毒参考中心，医学病毒学研究所，德国感染研究中心（DZIF），Justus Liebig University Giessen，Giessen，德国

    与FlorianvanBömmel博士的对应，莱比锡大学医院消化内科和风湿病学肝病学科，Liebigstraße20，04103 Leipzig，德国; [email protected]

抽象

目的在慢性乙型肝炎患者中，乙型肝炎e抗原（HBeAg）阴性慢性肝炎（CHB）患者难以与HBeAg阴性慢性HBV感染患者区分开来，也称为非活动性HBV携带者（ICs） ，但两者都需要不同的医疗管理。已提出HBV表面抗原（HBsAg）的水平作为区分慢性感染和肝炎阶段的标志物。 HBsAg由大，中，小型HB组成。本研究的目的是确定HBsAg的组成是否改善了HBs感染的HBsAg阳性受试者的ICs鉴定。

设计HBV大表面蛋白（LHBs）和HBV中表面蛋白（MHBs）的量化来自183名临床表征良好的未治疗患者，其中急性（n = 14）HBV感染，ICs（n = 44），CHBs（n = 46），慢性HBeAg阳性期（n = 68）和肝炎delta合并感染（n = 11）使用ELISA，具有明确定义的针对preS1结构域（LHBs）和preS2结构域（MHBs）的单克隆抗体。 Western印迹分析用于验证HBsAg组分的定量。使用改良的市售测定法（HBsAg V.6.0，Enzygnost，Siemens，Erlangen）定量总HBsAg。

结果HBsAg的组成在乙型肝炎的不同阶段表现出特异性模式。无论HBV e抗原状态（p <0.0001）或HBsAg如何，IC期患者的LHBs和MHBs比例明显低于急性或慢性期患者。水平。 LHB和MHBs比率均比HBsAg总水平更好地预测IC期。

结论MHBs的定量，特别是LHBs是鉴定IC阶段的新工具。

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