【摘要】：目的:研究臨床致病白念珠菌交配型基因MTL純合子與雜合子的流行病學(xué)特點(diǎn),分析其與外陰陰道念珠菌病患者的臨床特征、白念珠菌致病力及毒力的關(guān)系。方法:通過普通PCR對臨床外陰陰道念珠菌病患者陰道分泌物分離的致病白念珠菌MTL基因進(jìn)行檢測,應(yīng)用實(shí)時(shí)熒光定量PCR反應(yīng)分析MTL純合子與雜合子中毒力相關(guān)基因ASL3、SAP1和HWP1基因的表達(dá),并采用Rosco藥片擴(kuò)散法對白念珠菌進(jìn)行體外藥物敏感試驗(yàn)。結(jié)果:1338株白念珠菌中,1330株為MTLa/α雜合子,8株為MTL純合子(7株MTLa/a純合子,1株MTLα/α純合子)。8株MTL純合子所致外陰陰道念珠菌病患者中6例患者達(dá)到真菌學(xué)治愈。與雜合子相比,白念珠菌MTL純合子對唑類藥物耐藥性較高(0~75%vs 0~2.7%,P0.05)。毒力相關(guān)基因ASL3在兩者中的表達(dá)無明顯統(tǒng)計(jì)學(xué)差異,SAP1在MTL雜合子中表達(dá)稍高(1.02±0.68 vs 0.83±0.31,P0.05),而HWP1在雜合子中表達(dá)明顯增高(1.71±1.42 vs 1.20±0.62,P0.05)。結(jié)論:外陰陰道念珠菌病白念珠菌MTL純合子在外陰陰道念珠菌病患者中流行率較低;與雜合子相比,MTL純合子耐藥性增加;而毒力相關(guān)基因HWP1、SAP1和ASL3在純合子中表達(dá)降低,這與其臨床特征相符。
[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/ 偽 heterozygotes and 8 were MTL homozygotes (7 MTLa/a homozygotes 1 MTL 偽 / 偽 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 鹵0.68 vs 0.83 鹵0.31 P 0.05), while the expression of HWP1 in heterozygote was significantly higher (1.71 鹵1.42 vs 1.20 鹵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.
【作者單位】： 北京大學(xué)深圳醫(yī)院婦產(chǎn)科;北京大學(xué)深圳醫(yī)院檢驗(yàn)科;深圳市科創(chuàng)委婦科疾病重點(diǎn)實(shí)驗(yàn)室;
【基金】：深圳科創(chuàng)委基礎(chǔ)研究項(xiàng)目(No:201201001和JCYJ20140415162338813)
【分類號(hào)】：R711.31

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