TIM-1和TIM-4 mRNA在HAV患者中的表达及其临床意义

摘要

目的 观察典型病程甲型病毒性肝炎(HAV)患者外周血中T细胞免疫球蛋白域蛋白-1 (TIM-1)和T细胞免疫球蛋白域蛋白-4(TIM-4)mRNA的表达水平,探讨HAV患者病情进展的不同时期TIM-1和TIM-4 mRNA水平与HAV RNA含量,HAV免疫球蛋白M(IgM)、免疫球蛋白G(IgG)浓度及肝功能指标的关系.方法 选取HAV典型病程的30例患者作为HAV组,分别于潜伏期或黄疸前期、黄疸期及恢复期留取血液标本,以同期30例健康体检者作为对照组,收集血液标本.采用实时荧光定量聚合酶链反应检测TIM-1和TIM-4 mRNA表达水平,同时检测HAV患者外周血HAV RNA含量,酶联免疫吸附法检测HAV患者外周血HAV抗体IgM、IgG滴度水平,全自动生化分析仪检测肝功能指标谷丙转氨酶、谷草转氨酶及总胆红素.结果 HAV组患者外周血TIM-1和TIM-4 mRNA表达水平高于对照组患者(P <0.05).随着疾病进程的继续,TIM-1及TIM-4 mRNA表达水平于黄疸期达峰值,恢复期下降.TIM-1 mRNA表达水平与HAV患者IgM滴度、AST及TBIL呈正相关(P <0.05),与IgG滴度无关(P >0.05).结论 HAV患者外周血中TIM-1和TIM-4 mRNA的表达水平与HAV的疾病进展有较好的拟合性,TIM-1和TIM-4 mRNA可能在HAV的发生、发展中发挥作用.%Objective To observe the expression levels of T cell immunoglobulin domain and mucin domain 1 (TIM-1) and TIM-4 mRNAs in peripheral blood of the patients with typical courses of viral hepatitis A, and to investigate the relationships of TIM-1 and TIM-4 mRNAs with RNA content of HAV, concentrations of anti-HAV IgM and IgG, and parameters of hepatic function. Methods Blood specimens were taken from 30 patients with typical courses of viral hepatitis A in incubation or pre-icterus stage, icterus stage and recovery stage and 30 healthy controls. TIM-1 and TIM-4 mRNA levels in the peripheral blood were assayed by RT-PCR. Also the HAV RNA content in the peripheral blood was detected. The concentrations of HAV antibody IgM and IgG in the peripheral blood of the viral hepatitis A patients were assayed by ELISA. The parameters of hepatic function (ALT, T-bil and D-bil) were assayed by the Hitachi 7600 Auto-biochemical Analyzer. Results The expression levels of TIM-1 and TIM-4 mRNAs in the peripheral blood of the hepatitis A patients were dramatically higher than those of the control group (P < 0.05), reached the peak value at the icterus stage and declined during the recovery stage. The expression levels of TIM-1 and TIM-4 mRNAs were in positive correlations with the titer of anti-HAV IgM and the parameters of hepatic function in the hepatitis A patients (P < 0.05), but did not have correlation with the titer of anti-HAV IgG (P > 0.05). Conclusions Expression levels of TIM-1 and TIM-4 mRNAs in the peripheral blood of hepatitis A patients have high degree to match the development of hepatitis A. TIM-1 and TIM-4 mRNAs are likely related to the incidence and development of hepatitis A.