شناسایی ویروس هپاتیت B در بیماران همودیالیزی با استفاده از روش تکثیر همدمایی به واسطه حلقه (LAMP)
محورهای موضوعی : میکروب شناسی مولکولیمحمد حسن شاه حسینی 1 , زهره اسماعیلی 2 , الهام مسلمی 3 , پریچهر یغمایی 4
1 - دانشگاه آزاد اسلامی ، واحد شهر قدس ، گروه میکروبیولوژی
2 - دانشگاه آزاد اسلامی ، واحد علوم تحقیقات تهران، گروه زیست شناسی
3 - دانشگاه آزاد اسلامی ، واحد تهران شرق، گروه زیست شناسی
4 - دانشگاه آزاد اسلامی ، واحد علوم تحقیقات تهران، گروه زیست شناسی
کلید واژه: PCR, هپاتیت B, همودیالیز, LAMP,
چکیده مقاله :
سابقه و هدف: شناسایی بیماری هپاتیت B یکی از مشکلات اساسی مراکز همودیالیز محسوب میشود. هدف از این پژوهش راهاندازی و بهینهسازی روش مولکولی تکثیر همدمایی بهواسطه حلقه (LAMP) برای ارزیابی شیوع ویروس هپاتیت B در نمونههای سرمی افراد همودیالیزی است. مواد و روشها: این پژوهش بهصورت مقطعی-توصیفی بر روی سرم 136 بیمار مراجعه کننده به 3 مرکز همودیالیز بیمارستان مصطفی خمینی (53 نمونه)، بیمارستان چمران (54 نمونه) و بیمارستان عرفان (31 نمونه) انجام شد. پس از استخراج DNA با استفاده از 6 پرایمر اختصاصی ژن HBsAg شرایط واکنش و غلظت مواد برای تشخیص HBV بهینه سازی گردید. همچنین محصولات واکنش با استفاده از روش ژل الکتروفورز با استفاده از اتیدیوم بروماید و سایبرگرین ارزیابی گردید. یافته ها: در این مطالعه حساسیت روش بهینهسازی شده LAMP، 4 ذره ویروسی بود. همچنین این روش ویژگی بسیار بالایی داشت. از افراد مراجعه کننده به بیمارستان مصطفی خمینی 13 مورد بهوسیله تکنیک LAMP و 7 مورد بهوسیله PCR و از افراد مراجعه کننده به بیمارستان چمران 4 مورد بهوسیله تکنیک LAMP و 2 مورد بهوسیله PCR مثبت بودند. اما میزان شناسایی ویروس در افراد مراجعه کننده به بیمارستان عرفان با استفاده از هر دو تکنیک یکسان (2 مورد) بود. نتیجه گیری: برای شناسایی ویروس هپاتیت B، روش LAMP در مقایسه با روش PCR معمولی بسیار سریعتر، مقرون به صرفهتر و دقیقتر است.
Background and Objectives: Infections with Hepatitis B virus in hemodialysis centers still remain as a major problem. The propose of this study is optimization and development of LAMP technique for assessment of HBV infection in serum of hemodialysis patients. Material and Methods: This cross sectional study was performed on totally, 136 serum samples were obtained from the patients how referred to hemodyalis center in Tehran as: 52 serum samples from Mastafa khomaini hospital, 54 serum samples from Chamran hospital and 31 serum samples from Erfan hospital. After DNA extraction, 6 HBsAg specific primers were used for optimizing of reaction conditions and material concentration for LAMP. LAMP products were evaluated by adding 1% SYBER Green and electrophoresis stained by Ethidium-Bromide. Results: LAMP sensitivity was determined as 4 particles in this study. In addition, LAMP technique Showed a high specify for detecting the viruses. Totally, 13and 7 cases of the serum samples of Mastafa khomaini were positive by LAMP and PCR respectfully. Also, 4 and 2 samples for second group and 2 and 2 samples for third group were positive respectfully by LAMP and PCR. Conclusion: The LAMP technique is a more sensitive and cost friendly system to detect HBV in comparison to conventional PCR.
1. World Health Organization. Hepatitis B. World Health Organization Fact Sheet 2004 (Revised October 2000) WHO website, 2000; http://who.int/inf-fs/en/fact204.html.
2. Kew MC. Epidemiology of chronic hepatitis B virus infection, hepatocellular carcinoma,and hepatitis B virus-induced hepatocellular carcinoma. Patbio-2868; 2010. [Article in press].
3. Carrilho FJ, Moraes CR, Pinho JR, et al. Hepatitis B virus infection in Haemodialysis Centres from Santa Catarina State, Southern Brazil. Predictive risk factors for infection and molecular epidemiology. BMC Public Health, 2004; 4: 13.
4. Mahdavimazdeh M, Hosseini-Moghaddam SM, Alavian SM, Yahyazadeh H. hepatitis B infections in haemodialysis Patients in Tehran Province. Iran Hepatitis Monthly, 2009; 9(3): 206-210.
5. Harrion's (2005) Principles of Internal Medicine. 16th edition; Vol. 2. p.102-3.
6. Fabrizi F, Martin P. Hepatitis B virus infection in dialysis patients, Am J Nephrol, 2000; 20: 1-11.
7. Fallon MB, McGuire BM, Abrams GA, Arguedas MR.(2001) Cecil essentials of medicine, 5th ed, Philadelphia, W B Saunders; 376-84.
8. Saha D, Agarwal SK. Hepatitis and HIV infection during hemodialysis, J Indian Med Assoc, 2001; 99: 194-9.
9. Fabrizi F, Lunghi G, Martin P. Hepatitis B virus infection in hemodialysis: recent discoveries. J Nephrol, 2002; 15: 463-468.
10. Paraskevi M, Georgiadou SP, Rizos C, Dalekos GN, Rigopoulou EI. Prevalence of occult hepatitis B virus infection in haemodialysis patients from central Greece World J Gastroenterol; 2010; 16(2): 225-231.
11. Hilleman MR. Critical overview and outlook: pathogenesis, prevention, and reatment of hepatitis and hepatocarcinoma caused by hepatitis B virus. Vaccine, 2003; 21: 4626-4649.
12. Hollinger FB, Habibollahi P, Daneshmand A, Alavian SM. Occult Hepatitis B Infection in Chronic Hemodialysis Patients: Current Concepts and Strategy Hepat Mon; 2010; 10(3): 199-204.
13. Marzano A, Angelucci E, Andreone P, Brunetto M, Bruno R, Burra P, Caraceni P, Daniele B, Marcoh VD, Fabrizi F, Fagiuoli S, Grossi P, Lampertico P, Meliconim R, Mangia A, Puoti M, Raimondo G, Smedile A. Prophylaxis and treatment of hepatitis B in immunocompromised
patients. Digestive and Liver Disease, 2007; 39: 397-408.
14. Alavian, S.M., et al. Hepatitis B and C in dialysis units in Iran: changing the epidemiology. Hemodial Int, 2008; 12(3): 378-82.
15. Grob P, Jilg W, Bornhak H, Gerken G, Gerlich W, Gunther S, et al. Serological pattern ''anti-HBc alone'' Report on a workshop. J Med Virol, 2000; 62: 450-455.
16. Urdea M, Penny LA, Olmsted SS, Giovanni MY, Kaspar P, Shepherd A, et al. Requirements for high impact diagnostics in the developing world. Nature, 2006; 444(Suppl 1): 73-9.
17. Tsai TH, Huang CF, Wei JCC, et al. The study of IgG subclass profiles of anti-HBs in populations with different HBV infection status. Viral Immunol, 2006; 19(2): 277-84.
18. Fallahi s, Ravanshad M, Kenarkuhi O. Designing of a highly sensitive nested PCR procedure using a single closed tube for detection of Hepatitis C Virus. The j Modarres: Biopathology, 2010; 13(2): 33-42.
19. Mori Y, Notomi T. Loop-mediated isothermal amplifi cation (LAMP): a rapid, accurate, and cost-effective diagnostic method for infectious diseases. J Infect Chemother, 2009; 15: 62-69.
20. Notomi T, Okayama H, Masubuchi H, Yonekawa T, Watanabe K, Amino N, Hase T, Loopmediated isothermal amplification of DNA, Nucleic Acids Research, 2000; 28(12): e63.
21. Parida MM., Santhosh SR., Dash PK., Tripathi NK., Lakshmi V., Mamidi N., Shrivastva A., Gupta N., Saxena P., and Pradeep J. Rapid and realtime detection of chikungunya virus by reverse transcription loop mediated isothermal amplifi cation assay. J. Clin. Microbiol,
2007; 45: 351-357.
22. Nagamine K, Hase T and Notomi T. Accelerated reaction by loop-mediated isothermal amplifcation using loop primers. Molecular and Cellular Probes, 2002; 16: 223-229.
23. Mori Y, Nagamine K, Tomita N, Notomi T. Detection of loop-mediated isothermal amplification reaction by turbidity derived from magnesium pyrophosphate formation. J Biochem Biophys Res Commun; 2001; 289: 150-154.
24. Parida M, Sannarangaiah S, Kumar Dash P, Rao PVL, Morita K. Loop mediated isothermal amplification (LAMP) : a new generation of innovative gene amplification technique; perspectives in clinical diagnosis of infectious diseases. Rev Med Virol; 2008; 18: 407-421.
25. Mori Y., Kitao M., Tomita N., Notomi T. Real-time turbidimetry of LAMP reaction for quantifying template DNA. J. Biochem. Biophys Methods, 2004; 59: 145-157.
26. Mori Y., Hirano T., Notomi T. Sequence specific visual detection of LAMP reactions by addition of cationic polymers. BMC Biotech. 2006; 6:3; [Online]. http://www. biomedcentral.com/1472-6750/6/3.
27. Ott MJ, Aruda M. Hepatitis B vaccine. J Pediatr Health Care, 1999; 13: 211-6.
28. Mahdavi-Mazdeh M, Zamyadi M, Nafar M. Assessment of management and treatment responses in haemodialysis patients from Tehran province, Iran. Nephrol Dial Transplant; 2008; 23(1): 288-93.
29. Peces R, Laures AS. Persistence of immunologic memory in long-term hemodialysis patients and healthcare workers given hepatitis B vaccine: role of a booster dose on antibody response. Nephron, 2001; 89; 172-6.
30. Ulrich PP, Bhat RA, Seto B, Mack D, Sninsky J, Vvas Gn. Enzymatic amplification of hepatitis B virus in serum compared with infectivity testing in chimpanzees. J Infec Dis, 1989; 160: 37-43.
31. Parida MM. Rapid and real-time detection technologies for emerging viruses of biomedical importance. J Biosci, 2008; 33(4): 617-628.
32. Ganem D and Alfred M. mechanisms of disease Hepatitis B Virus Infection-Natural History and Clinical Consequences. N Engl J Med, 2004; 350: 1118-29.
33. Yoshida A, Nagashima S, Ansai T, Tachibana M, Kato H, Watari H, Notomi T, and Takehar T. Loop-Mediated Isothermal Amplification Method for Rapid Detectionof the Periodontopathic Bacteria Porphyromonas gingivalis, Tannerella forsythia and Treponema denticola. Journal of Clinical Microbiology; 2005; 43(5): 2418-2424.
34. Aonuma H, Yoshimura A, Perera N, Shinzawa N, Bando H, Oshiro S, Nelson B. Loopmediated isothermal amplification applied to filarial parasites detection in the mosquito vectors: Dirofilaria immitis as a study model. Parasit Vectors, 2009; 2: 15.
35. Teles SA, Martins RM, Vanderborght B, Stuyver L, Gaspar AM, Yoshida CF. Hepatitis B virus: genotypes and subtypes in Brazilian hemodialysis patients. Artif Organs; 1999; 23(12): 1074-8.
36. Minuk GY, Sun DF, Greenberg R, Zhang M, Hawkins K, Uhanova J, et al. Occult hepatitis B virus infection in a North American
adult hemodialysis patient population. Hepatology, 2004; 40(5): 1072-7.
37. Motta JS, Mello FC, Lago BV, Perez RM, Gomes SA, Figueiredo FF. Occult hepatitis B virus infection and lamivudine-resistant mutations in isolates from renal patients undergoing hemodialysis. J Gastroenterol Hepatol, 2010; 25(1): 101-6.
38. Aghakhani A, Banifazl M, Kalantar E, Eslamifar A, Ahmadi F, Razeghi E, Atabak S, Amini M, Khadem-Sadegh A, Ramezani A. Occult hepatitis B virus infection in hemodialysis patients with isolated hepatitis B core antibody: a multicenter study. Ther Apher Dial, 2010;
14(3): 349-53.
39. Lee SY, Lee CN, Mark H, Meldrum DR, Lin CW. Efficient, specific, compact hepatitis B diagnostic device: Optical detection of the hepatitis B virus by isothermal amplification. Sensors and Actuators B; 2007; 127: 598-605.
40. Cai T, Lou GQ, Yang J, Xu D, Meng ZH. Development and evaluation of real-time loopmediated isothermal amplification for hepatitis B virus DNA quantification: A new tool for HBV management. Journal of Clinical Virology, 2008; 41: 270-276.