- 學位論文
人類微小病毒B19非結構蛋白抗體之研究
The Study of Antibody Response to Human Parvovirus B19 Non-Structural Protein
摘要
人類微小病毒B19是屬於小病毒科(Parvovirinae)中的紅血球病毒屬(Erythrovirus)，亦是可以感染人類的單股核苷酸病毒，基因長度約為5596 核酐酸，主要由殼體蛋白(VP)和非結構蛋白(NS1)所組成。先前文獻曾指出在持續或慢性感染B19的患者血清中可偵測到含有對抗B19非結構蛋白(NS1)的專一性抗體，並且發現抗NS1 IgG抗體和感染B19之關節病有關。而關節炎是自體免疫疾病常見的臨床症狀，因此在本論文主要分析80位疑似感染人類微小病毒B19患者及193位自體免疫疾病患者(95位全身性紅斑性狼瘡和98位類風濕性關節炎)中抗NS1抗體的表現。研究結果顯示在80位疑似B19感染病人中屬於最近感染[Recent infection, B19 IgM(+)]時期的病人較其他感染時期的病人較具有抗NS1 IgM抗體和抗NS1 IgG抗體(P<0.001)；而在95位全身性紅斑性狼瘡病人中屬於最近感染[Recent infection,B19 IgM(+)IgG(-)DNA(-)]、過去感染[Past infection,B19 IgM(-)IgG(+)DNA(-)]、持續感染[Persistent infection,B19 IgM(-)IgG(-)DNA (+)]時期的病人較具有抗NS1 IgM抗體和抗NS1 IgG抗體(P<0.05)；在98位類風濕性關節炎病人中屬於未曾感染[Seronegative, B19 IgM(-)IgG(-)DNA(-)]時期的病人較其他感染時期的病人較具有NS1 IgM抗體和NS1 IgG抗體(P<0.005)。綜合以上結果顯示偵測抗B19-NS1 IgM及IgG抗體的存在將可作為最近感染B19及關節炎之一項新的生物標記。
並列摘要
Human parvovirus B19 (B19) was classified as the Erythrovirus genus of the Parvoviridae family and the member known to be pathologic in hu-man. B19 is a single-stranded DNA virus with 5596 nucleotides, composed of capsid protein (VP) and non-structural (NS1) proteins. Previous studies have shown that the NS1-specific antibodies could be de-tected in B19 patients with chronic or persistent infection and associated with B19-related arthralgia. However, the role of anti-B19-NS1 antibody in patients with autoimmune diseases is still unknown. In this study nested PCR and ELISA were performed to determine the B19 diagnostic patterns by analyzing the serum samples of 95 patients with SLE, 98 patients with RA and 80 patients with clinical suspicion of B19 infection. Binding reactivity of B19-NS1 IgM and IgG antibodies were assessed by ELISA and Western blot. Our results shown that the prevalence of B19 IgM and IgG antibodies in B19 patients with recent infection [B19 IgM(+)IgG(-)DNA(-)] were significantly higher than other diagnostic patterns (P<0.001). In SLE, significantly higher prevalence of B19-NS1 IgM and IgG was observed in patients with recent infection [B19 IgM(+)IgG(-)DNA(-)], past infection [B19 IgM(-)IgG(+)DNA(-)] and persistent infection [B19 IgM(-)IgG(-)DNA(+)] rather than other diagnosis (P<0.05). In RA, significantly higher prevalence of B19-NS1 IgM and IgG was observed in patients with seronegative B19 diagnostic patterns [B19 IgM(-)IgG(-)DNA(-)] rather than other diagnosis (P<0.005). Altogether, the presence of both anti-B19-NS1 IgM and IgG antibodies could be an indicator in patients with recent B19 infection and B19-aasociated arthritis. Moreover IgM and IgG against B19-NS1 could be the biomarker on B19 infection and arthritis.