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目的探讨乙型肝炎病毒X蛋白(Hepatitis Bvirus X protein,HBx)在肝组织中的表达与慢性乙型肝炎(Chronic hepatitis B,CHB)合并肝脂肪变性的关系及其可能的机制。方法对经病理证实的18例CHB及18例CHB合并肝脂肪变性的病例标本进行血脂、肝功能、血清病毒学及病理组织学指标分析,免疫组化法检测肝组织HBx、肝X受体(Liver X receptorα,LXRα)和脂肪酸合成酶(Fatty acid synthase,FAS)的表达。结果两组病例生化指标、HBV血清标志物及HBV-DNA载量、肝组织炎症活动度分级及纤维化程度分期的构成比差异均无统计学意义(P>0.05);HBx、LXRα和FAS表达的阳性率差异也无统计学意义(P>0.05);但CHB合并肝脂肪变性组HBx、LXRα和FAS的表达强度明显高于CHB组,且差异有统计学意义(P<0.05);在CHB合并肝脂肪变性组中,HBx与LXRα、LXRα与FAS及HBx与FAS的表达呈正相关。结论 HBx在CHB肝组织中广泛表达,在CHB合并肝脂肪变性组的表达明显增强,提示HBx可能通过诱导LXRα进而刺激FAS表达上调,参与CHB合并肝细胞脂肪变性的发生。
Objective To investigate the relationship between the expression of hepatitis B virus X protein (HBx) in liver tissue and hepatic steatosis of chronic hepatitis B (CHB) and its possible mechanism. Methods Serum lipids, liver function, serum virology and histopathological parameters were analyzed in 18 CHB patients and 18 CHB patients with hepatic steatosis confirmed by pathology. Immunohistochemistry was used to detect the expression of HBx and liver X receptor Liver X receptor alpha, LXR alpha) and Fatty acid synthase (FAS) expression. Results There were no significant differences in the biochemical indexes, HBV serum markers and HBV-DNA load, grade of liver inflammation and staging of fibrosis between the two groups (P> 0.05). HBx, LXRα and FAS (P> 0.05). However, the expression levels of HBx, LXRα and FAS in CHB with hepatic steatosis were significantly higher than those in CHB group (P <0.05) In the combined group of hepatic steatosis, the expression of HBx, LXRα, LXRα, FAS, HBx and FAS were positively correlated. Conclusions HBx is widely expressed in liver tissues of CHB patients and significantly increased in CHB patients with hepatic steatosis, suggesting that HBx could up-regulate the expression of FAS by inducing LXRα, which may be involved in the development of hepatocellular steatosis.