外阴阴道念珠菌病白念珠菌交配型基因分析及其致病性研究

发布时间：2018-08-21 07:19

【摘要】：目的:研究临床致病白念珠菌交配型基因MTL纯合子与杂合子的流行病学特点,分析其与外阴阴道念珠菌病患者的临床特征、白念珠菌致病力及毒力的关系。方法:通过普通PCR对临床外阴阴道念珠菌病患者阴道分泌物分离的致病白念珠菌MTL基因进行检测,应用实时荧光定量PCR反应分析MTL纯合子与杂合子中毒力相关基因ASL3、SAP1和HWP1基因的表达,并采用Rosco药片扩散法对白念珠菌进行体外药物敏感试验。结果:1338株白念珠菌中,1330株为MTLa/α杂合子,8株为MTL纯合子(7株MTLa/a纯合子,1株MTLα/α纯合子)。8株MTL纯合子所致外阴阴道念珠菌病患者中6例患者达到真菌学治愈。与杂合子相比,白念珠菌MTL纯合子对唑类药物耐药性较高(0~75%vs 0~2.7%,P0.05)。毒力相关基因ASL3在两者中的表达无明显统计学差异,SAP1在MTL杂合子中表达稍高(1.02±0.68 vs 0.83±0.31,P0.05),而HWP1在杂合子中表达明显增高(1.71±1.42 vs 1.20±0.62,P0.05)。结论:外阴阴道念珠菌病白念珠菌MTL纯合子在外阴阴道念珠菌病患者中流行率较低;与杂合子相比,MTL纯合子耐药性增加;而毒力相关基因HWP1、SAP1和ASL3在纯合子中表达降低,这与其临床特征相符。
[Abstract]:Objective: to study the epidemiological characteristics of MTL homozygote and heterozygote of clinical pathogenic Candida albicans mating gene, and to analyze its relationship with the clinical characteristics, pathogenicity and virulence of Candida albicans in patients with vulvovaginal candidiasis. Methods: the MTL gene of Candida albicans isolated from vaginal secretions of patients with vulvovaginal candidiasis was detected by ordinary PCR. The expression of MTL homozygous and heterozygous genes ASL3nSAP1 and HWP1 were analyzed by real-time fluorescence quantitative PCR reaction. The drug sensitivity of Candida albicans was tested by Rosco tablet diffusion method in vitro. Results among the 13 38 strains of Candida albicans, 1 330 were MTLa/ 伪 heterozygotes and 8 were MTL homozygotes (7 MTLa/a homozygotes 1 MTL 伪 / 伪 homozygote). 6 of 8 cases of vulvovaginal candidiasis caused by MTL homozygotes achieved mycological cure. Compared with heterozygote, MTL homozygote of Candida albicans was more resistant to azolium than that of heterozygote (P 0.05). There was no significant difference in the expression of virulence related gene ASL3 between them. The expression of SAP1 in MTL heterozygote was slightly higher than that in heterozygote (1.02 卤0.68 vs 0.83 卤0.31 P 0.05), while the expression of HWP1 in heterozygote was significantly higher (1.71 卤1.42 vs 1.20 卤0.62P 0.05). Conclusion: the prevalence rate of MTL homozygotes in vulvovaginal candidiasis patients is lower than that of heterozygotes, while the expression of virulence related genes HWP1SAP1 and ASL3 in the homozygotes is lower than that in heterozygotes. This is consistent with its clinical features.
【作者单位】：北京大学深圳医院妇产科;北京大学深圳医院检验科;深圳市科创委妇科疾病重点实验室;
【基金】：深圳科创委基础研究项目(No:201201001和JCYJ20140415162338813)
【分类号】：R711.31

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