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丙型肝炎病毒(HCV)感染不仅引起急性和慢性病毒性肝炎,而且还与肝纤维化、肝细胞癌(HCC)的发生发展密切相关.除此之外,HCV的感染还引起肝脏脂肪变、冷球蛋白血症、B细胞淋巴瘤等,但是,这些病变形成的机制目前还不十分清楚.慢性丙型肝炎患者肝脏活检病理学特征,最明显的一点就是肝脏脂肪变,HCV慢性感染的黑猩猩肝脏病理学也有显著的脂肪变,HCV基因的转基因小鼠可引起明显的脂肪变,甚至HCV基因转染的细胞系也有脂滴的形成.所以,HCV感染引起肝脏脂肪变不是偶然的现象.在我们的肝炎病毒致病的分子生物学机制研究中,利用酵母双杂交技术,在国际上率先证实HCV核心蛋白可以与载脂蛋白AI(ApoAI)相结合,而且利用体外免疫共沉淀技术证实了这种结合作用,这一研究结果,促使我们重视HCV感染与慢性丙型病毒性肝炎与肝脏脂肪变的相关性.基于这一思路,我们对于159例慢性丙型肝炎患者肝组织脂肪变的临床与病理学特点、血清中各种脂蛋白、载脂蛋白等水平的改变进行了系统研究,除了在分子水平上证实了HCV感染引起肝脏脂肪变可能的分子生物学机制,而且利用HCV结构基因的转基因小鼠模型,对于HCV结构基因表达与肝脏脂肪变形成之间的相互关系进行了较为系统的观察.至此,在国内较早地系统研究了HCV感染引起的肝脏脂肪变的临床、病理学、血清生物化学、分子生物学和转基因小鼠的特点.虽然这些研究都还是初步的,有待于进一步加强,但是这些研究结果足以提示HCV感染肝脏脂肪变不是个别的现象,而是具有普遍的意义.特别是注意到HCV感染肝脏脂肪变与HCV感染者的肝脏纤维化及对抗病毒治疗的疗效应答有显著的影响,因此HCV感染肝脏脂肪变的研究也是探索HCV感染治疗新方法,乃至最终控制HCV感染,都有十分重要的意义.希望我们关于HCV感染与肝脏脂肪变的关系的研究,对于广大读者的慢性丙型肝炎的研究和临床工作有所裨益.
Hepatitis C virus (HCV) infection not only causes acute and chronic viral hepatitis, but also is closely related to the occurrence and development of liver fibrosis and hepatocellular carcinoma (HCC) .In addition, HCV infection also causes steatosis and cold Globulin, B-cell lymphoma, etc. However, the mechanism of the formation of these lesions is not yet clear.Characteristics of liver biopsy in patients with chronic hepatitis C, the most obvious point is the liver steatosis, HCV chronically infected chimpanzee liver Pathology also has significant steatosis, HCV transgenic mice can cause significant fatty degeneration, and even HCV gene transfected cell lines also have the formation of lipid droplets, so, HCV infection caused by hepatic steatosis is not accidental phenomenon.In our Hepatitis virus pathogenic molecular biology mechanism studies, the use of yeast two-hybrid technology, the first in the world to confirm that HCV core protein can be combined with apolipoprotein AI (ApoAI), and the use of co-immunoprecipitation in vitro confirmed this The results of this study prompted us to pay attention to the correlation between HCV infection and chronic hepatitis C and hepatic steatosis.Based on this idea, The clinical and pathological features of hepatic steatosis in 159 patients with chronic hepatitis C were studied systematically, and the changes of serum lipoproteins, apolipoproteins and other levels were systematically studied. In addition to the molecular level confirmed that the liver infection caused by fatty liver steatosis Possible molecular biology mechanism and make use of the transgenic mouse model of HCV structural gene to systematically observe the relationship between HCV structural gene expression and hepatic steatosis.Thus, Clinical, pathological, serum biochemistry, molecular biology and transgenic mouse characteristics of hepatic steatosis caused by HCV infection Although these studies are still preliminary and need to be further strengthened, these findings are enough to suggest that HCV infection with liver fat It is not a phenomenon but an universal phenomenon, especially since it is noticed that HCV-induced hepatic steatosis has a significant effect on liver fibrosis and the response to anti-viral therapy in HCV-infected patients, It is also of great importance to explore new ways of treating HCV infection and ultimately to control HCV infection It is hoped that our research on the relationship between HCV infection and steatosis will be beneficial to the research and clinical work of chronic hepatitis C patients.