麻风分枝杆菌基因分型及其多个患者家庭内传播的研究

刘健; 王峥; 温艳; 田秀君; 陈小华; 李桓英; 翁小满

Abstract

刘健,王峥,温艳,田秀君,陈小华,李桓英,翁小满.麻风分枝杆菌基因分型及其多个患者家庭内传播的研究[J].Chinese journal of Epidemiology,2007,28(7):649-655

麻风分枝杆菌基因分型及其多个患者家庭内传播的研究

Study on genotyping of Mycobacterium leprae and families with multi-cases

Received:December 06, 2006 Revised:June 29, 2012

DOI：

KeyWord: 麻风病分子流行病学基因分型传播链

English Key Word: Leprosy Molecular epidemiology Genotyping Transmission chain

FundProject:NIH(5R01AI63457-3)和美国HEISER基金会资助

Author Name	Affiliation	E-mail
LIU Jian	Capital University of Medicine Affiliated Beijing Friendship Hospital,Beijing Tropical Medicine Institute,Beijing 100050,China	wengxiaoman@sina.com
WANG Zheng	Capital University of Medicine Affiliated Beijing Friendship Hospital,Beijing Tropical Medicine Institute,Beijing 100050,China
WEN Yan	Capital University of Medicine Affiliated Beijing Friendship Hospital,Beijing Tropical Medicine Institute,Beijing 100050,China
TIAN Xiu-jun	Capital University of Medicine Affiliated Beijing Friendship Hospital,Beijing Tropical Medicine Institute,Beijing 100050,China
CHEN Xiao-hua	Capital University of Medicine Affiliated Beijing Friendship Hospital,Beijing Tropical Medicine Institute,Beijing 100050,China
LI Huan-ying	Capital University of Medicine Affiliated Beijing Friendship Hospital,Beijing Tropical Medicine Institute,Beijing 100050,China
WENG Xiao-man	Capital University of Medicine Affiliated Beijing Friendship Hospital,Beijing Tropical Medicine Institute,Beijing 100050,China

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Abstract:

目的探讨在特定地区和时期内采用多位点可变串联重复序列(VNTR)分析(MLVA)对麻风菌基因分型,以评价麻风病传播链.方法从云南省丘北县2002-2006年收集的患者皮损中提取麻风菌DNA,采用AC9、6-7,GTA9,AT17,AC8a,AT15,AT18七个VNTR位点的MLVA基因分型,观察不同基因型与地理分布的关系;与现场流行病学调查结合,开展传播链的研究.结果 (1)系统发育树分析揭示:依据GTA9等位基因型的变化,可分为GTA9位点为9,11-13,15-26,>26的A、B、C、D和E菌株.A菌株的GTA9等位基因型均为9,命名为A株.A株聚集分布在该县的北部,B株聚集分布在西北部,但C、D和E菌株基因型多变,散在分布.(2)该县北、西北部的5个高发家庭内的菌株为相同的A株.同一高发家庭内的患者,其菌株VNTR基因型一致或相似,但其他高发家庭之间的菌株基因型不相同.(3)在总菌株中,A菌株占有较高比例,且地理分布聚集,近期仍在传播.结论无论从家庭内或较小区域内收集菌株的分型结果显示,VNTR基因分型适合麻风菌分型和短传播链的研究.优势菌株或聚集株均为高发家系中发现的,因此推测高发家系可能作为乡村中的麻风菌的疫源和传染源.但需要较长时期证实A菌株是否为优势株.

English Abstract:

Objective Multiple locus variable number-tandem repeat (VNTR) analysis (MLVA) had been proposed as a means of strain typing for tracking of source and studying the transmission chain of pathogens.However,empirical data for a defined population from scale and duration were lacking for studying the transmission chain of leprosy.Methods MLVA on 7 VNTR loci was applied to the strain typing on prevalent Mycobacterium leprae isolates collected from Qiubei county,Yunnan province during 2002-2006 in the study on the relationship between geographic distribution and genotypes of M.leprae. The strain typing,combined with conventional epidemiological investigation was performed to trace the transmission chain.Results (1) Phylogenetic analyses through application of PAUP 4.0,The M.leprae were grouped into A,B,C,D and E strains according to the aUelic range 9,11-13,15-26 and26 on the GTA9 locus.The strains with 9 copies on GTA9 locus,was named A.(2) Genotypes of strains from the five multi-case families located at North and North-West parts were similar and belonged to A strains. VNTR patterns of intra-family were identical or similar but not identical inter-family.(3) Not only A cluster appeared higher proportion in total isolates hut also distributes cluster,indicating ongoing transmission from recent findings.Conclusion VNTR strain typing was suitable to trace the short chain of transmission in both small area and intra-families.Multi-case families might constitute epidemic loci and source of M.leprae in villages,causing the predominant strain or cluster which tends to be those identified in multi-case families and resulted in the spreading of leprosy.A long-term study was underway to reveal whether A strain was predominant strain and to observe the evolution of M.leprae in this spatially and temporally defined endemic population.

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