摘要
目的探讨维生素D受体(VDR)基因多态性与呼吸道合胞病毒(RSV)感染性毛细支气管炎的相关性。方法回顾性分析2023年1~6月佛山市妇幼保健院收治的60例RSV感染性毛细支气管炎患儿的临床资料,根据患儿临床表现分为轻症组(n=37)和重症组(n=23),另选择同期30例RSV阴性的健康体检儿童作为对照组。分别采用酶联免疫吸附法检测三组儿童的血清25-羟基维生素D[25(OH)D]、白细胞介素4(IL-4)、白细胞介素5(IL-5)水平,采用限制性片段长度多态性方法分析维生素D受体TaqI、FokI、ApaI、Bsm I基因多态位点,并比较三组儿童的基因型及等位基因频率情况。结果重症组患儿的血清25(OH)D水平为(52.67±12.22)nmol/L,明显低于轻症组的(65.57±13.54)nmol/L,而轻症组又明显低于对照组的(82.57±15.30)nmol/L,IL-4、IL-5分别为(152.28±22.47)ng/L、(51.83±9.83)ng/L,明显高于轻症组的(130.48±21.35)ng/L、(44.72±8.70)ng/L,而轻症组又明显高于对照组的(77.48±15.26)ng/L、(26.52±7.78)ng/L,差异均有统计学意义(P<0.05);经Hardy-Weinberg平衡定律检测不同组别间VDR基因序列等位基因分布的频率,数据均符合平衡定律(P<0.05);重症组患儿的VDR TaqI(rs731236)基因型TT及等位基因C均高于轻症组和对照组,基因型TC、等位基因T型频率均低于轻症组和对照组,差异均有统计学意义(P<0.05),但三组基因型的CC频率分布比较差异无统计学意义(P>0.05);三组儿童的VDR FokI(rs2228570)基因型频率分布比较差异均无统计学意义(P>0.05),但重症组患儿的等位基因C高于轻症组和对照组,T型频率低于轻症组和对照组,差异均有统计学意义(P<0.05);重症组患儿的VDR ApaI(rs7975232)基因型GG及等位基因G高于轻症组和对照组,基因型GT及等位基因A频率分布低于轻症组和对照组,差异均有统计学意义(P<0.05);重症组患儿的VDR Bsm I(rs1544410)基因型GA、AA及等位基因A均高于轻症组和对照组,基因型GG及等位基因G频率分布低于轻症组和对照组,差异均有统计学意义(P<0.05)。结论RSV感染性毛细支气管炎患儿的血清25(OH)D明显较低,VDR TaqI、FokI与患儿发病具有一定相关性,临床上可通过检测患儿VDR基因多态性状况,进一步分析患儿病情严重程度状况,并及时根据遗传体征状况提供针对性的预防和治疗方案。
Objective To explore the correlation between vitamin D receptor(VDR)gene polymorphism and respiratory syncytial virus(RSV)-induced bronchiolitis.Methods The clinical data of 60 children with RSV-induced bronchiolitis admitted to Foshan Maternal and Child Health Hospital from January 2023 to June 2023 were retrospectively analyzed.According to the clinical manifestations of the children,the patients were divided into a mild group(n=37)and a severe group(n=23).Another 30 healthy children who were RSV-negative in physical examination during the same period were selected as the control group.The serum levels of 25-hydroxyvitamin D[25(OH)D],interleukin-4(IL-4),and interleukin-5(IL-5)in the three groups were detected by enzyme-linked immunosorbent assay.The polymorphic sites of vitamin D receptors(TaqI,FokI,ApaI,and Bsm I gene)were analyzed by restriction fragment length polymorphism method.The genotype and allele frequency were compared among the three groups.Results The serum 25(OH)D level of children in the severe group was(52.67±12.22)nmol/L,which was significantly lower than(65.57±13.54)nmol/L of the mild group;the level in the mild group was significantly lower than(82.57±15.30)nmol/L of the control group;the IL-4 and IL-5 levels were(152.28±22.47)ng/L and(51.83±9.83)ng/L,which were significantly higher than(130.48±21.35)ng/L and(44.72±8.70)ng/L of the mild group,and the levels in the mild group were significantly higher than(77.48±15.26)ng/L and(26.52±7.78)ng/L of the control group;the differences were statistically significant(P<0.05).The distribution of allele frequencies of VDR gene sequences among different groups was detected by Hardy-Weinberg equilibrium law,and the data were in accordance with the equilibrium law(P<0.05).The VDR TaqI(rs731236)genotype TT and allele C in the severe group were higher than those in the mild group and the control group,and the genotype TC and allele T frequency were lower than those in the mild group and the control group,with statistically significant differences(P<0.05).There was no statistically significant difference in the CC frequency distribution among the three genotypes(P>0.05).There was no statistically significant difference in the VDR FokI(rs2228570)genotype frequency distribution among the three groups(P>0.05).The allele C frequency in the severe group was significantly higher than that in the mild group and the control group,and the T frequency was significantly lower than that in the mild group and the control group,with statistically significant differences(P<0.05).The genotype GG and allele G of VDR ApaI(rs7975232)in the severe group were significantly higher than those in the mild group and the control group,while the frequency distribution of genotype GT and allele A was significantly lower than that in the mild group and the control group,with statistically significant differences(P<0.05).The genotypes GA,AA,and allele A of VDR Bsm I(rs1544410)in the severe group were significantly higher than those in the mild group and the control group,while the frequency distribution of genotype GG and allele G was significantly lower than that in the mild group and the control group,with statistically significant differences(P<0.05).Conclusion Serum 25(OH)D levels in children with RSV-induced bronchiolitis are significantly reduced,and VDRTaqI and FokI have a certain correlation with the onset of the disease.In clinical practice,the VDR gene polymorphism status of children can be detected to further analyze the severity of the disease,and timely provide targeted prevention and treatment plans according to the genetic signs.
作者
肖成伟
胡金科
陈汉斌
XIAO Cheng-wei;HU Jin-ke;CHEN Han-bin(Department of Pediatric Critical Care Medicine,Foshan Maternal and Child Health Hospital,Foshan 528000,Guangdong,CHINA)
出处
《海南医学》
CAS
2024年第3期334-338,共5页
Hainan Medical Journal
基金
广东省佛山市自筹经费类科技创新计划项目(编号:2220001004498)。
