甲肝炎病毒乙肝炎病毒丙肝炎病毒丁肝炎病毒戊肝炎病毒己肝炎病毒庚型肝炎病毒引起肝炎的病毒:乙型肝炎病毒——HBV乙肝病毒的流行病学乙肝病毒的流行病学EpidemiologyofHBVEpidemiologyofHBV全球性的公共健康问题(全球性的公共健康问题(GlobalpublichealthGlobalpublichealthproblem)problem)¾¾引起乙型肝炎(引起乙型肝炎(leadstohepatitisB)leadstohepatitisB)¾¾80%80%的肝癌是由的肝癌是由HBVHBV所致(所致(causes80%ofcauses80%ofofofallliveralllivercancercancer))¾¾人群携带率人群携带率0.1%0.1%(西方人群)(西方人群)~15%~15%(亚洲和非洲人群)(亚洲和非洲人群)((carrierratesrangefrom0.1%inWesterncountriesto15%carrierratesrangefrom0.1%inWesterncountriesto15%issomeAsian&AfricannationsissomeAsian&Africannations))2006年全球慢性HBV感染的流行分布图PrevalenceofChronicHBVInfection,Worldwide,2006HBsAgPrevalence≥8%-High2-7%-Intermediate2%-Low乙肝病毒的流行病学(乙肝病毒的流行病学(EpidemiologyofHBVEpidemiologyofHBV))血清学证据显示全球血清学证据显示全球2020亿人感染过亿人感染过HBV(2BillionPeoplehaveHBV(2BillionPeoplehaveserologicevidenceofpastorpresentHBVinfection)serologicevidenceofpastorpresentHBVinfection)全球约全球约3.53.5亿人为慢性乙肝病毒携带者(亿人为慢性乙肝病毒携带者(350millionpeople350millionpeoplearecarrierschronicallyinfectedwithHBVarecarrierschronicallyinfectedwithHBV每年约每年约11百万以上的人死于百万以上的人死于HBVHBV引起的慢性肝病(引起的慢性肝病(1Million1MillionPeopleormoredieeachyearfromHBVPeopleormoredieeachyearfromHBV--relatedChronicLiverrelatedChronicLiverDiseasesDiseases))在实施疫苗接种的地方,在实施疫苗接种的地方,HBVHBV的感染率明显降低的感染率明显降低((VaccinationhasbeeneffectiveindecreasingtheincidenceofVaccinationhasbeeneffectiveindecreasingtheincidenceofHBVinfectionwhereimplementedHBVinfectionwhereimplemented))一、一、HBVHBV的分类及病毒粒子结构的分类及病毒粒子结构有三种HBV颗粒(Thereare3typesofparticles)•大球形颗粒(Daneparticle)•小球形颗粒(smallsphericalparticle)•管形颗粒(tubuloseparticle)outercapsid=envelope外衣壳=包膜(脂质双层+蛋白质)+HBsAg等innercapsid内衣壳:HBcAg、HBeAginternal内部:DNA---circular,double-stranded环状双链DNApolymerase多聚酶完整的病毒颗粒(Completeparticle,infectiveHBV)球形,双层衣壳。具有感染性Daneparticle的结构中表面抗原(Middlesurfaceantigen(HBsAg))核心抗原(Nucleocapsid(HBcAg))DNA聚合酶(DNAPolymerase)Envelope(HBsAg)Smallsurfaceantigen(HBsAg)大表面抗原(Largesurfaceantigen(HBsAg))基因组DNA(GenomicDNA)RNAprimerDaneparticle的结构HBV的小球形颗粒HBsAg-containingparticles过剩的衣壳蛋白装配而成HBV的管形颗粒小球形颗粒串联而成smallsphericalsmallsphericalparticleparticle二、HBV基因组及其编码的蛋白质1、HBV基因组结构2、HBV转录产物3、HBV转录的调控4、HBV编码区及产物长链的基因组为3020~3320核苷酸,负链(Thefull-lengthstrandgenomeis3020–3320nucleotideslong,negativechain)短链基因组为1700–2800核苷酸,正链(Theshortlength-strandis1700–2800nucleotideslong,positivechain)不完全双链环状DNA(Acircular,double-strandedDNAcontainingsingle-strandbreaks)1、HBV基因组结构短链和长链的5′端通过240bp配对维持环状结构。两条链互补区两侧各有一个11个碱基的直接重复序列(5’TTCAC-CTCTGC-3’),称DR1和DR2。HBV基因组结构2、HBV转录产物(TranscriptsofHepatitisBvirus)四种转录产物3.5kbRNA2.4kbRNA2.1kbRNA0.8kbRNA转录产物模板编码蛋白质3.5kbRNAL链核心蛋白、聚合酶2.4kbRNAS链S蛋白2.1kbRNAL链S1和S2蛋白0.8kbRNAS链X蛋白转录产物与模板及编码蛋白的关系3、HBV基因转录的调控(自学)(1)HBV有哪些顺式作用元件?(2)HBV有哪些增强子?(3)HBV有哪些反式作用因子?有何作用?含4个ORF,编码7个蛋白(fouropenreadingframesthatencodesevenpolypeptides)S编码区:HBsAg,Pre-s1,Pre-s2C编码区:HBcAg,HBeAgP编码区:polymerase聚合酶X编码区:HBxAg基因4、HBV的编码区及产物(1)S编码区编码:表面抗原主蛋白,S蛋白,226aa原S1抗原,108-115aa原S2抗原,55aa大抗原(largesurfaceantigen,S蛋白+原S1蛋白+原S2蛋白)中抗原(midlesurfaceantigen,原S蛋白+原S2蛋白)小抗原(smallsurfaceantigen,S蛋白)Middlesurfaceantigen(HBsAg)Nucleocapsid(HBcAg)DNApolymeraseEnvelope(HBsAg)Smallsurfaceantigen(HBsAg)Largesurfaceantigen(HBsAg)GenomicDNARNAprimer(2)P编码区编码:末端蛋白(引物酶)间隔区反转录酶/DNA聚合酶RNaseHP编码区的基因组织结构(3)C编码区编码病毒核心抗原(HBcAg)和e抗原(HBeAg)病毒核心抗原(HBcAg)和e抗原(HBeAg)的合成过程(4)X编码区编码X蛋白X蛋白:154aa反式调控作用激活同源或异源启动子或增强子与肝癌发生相关X-蛋白结构域三、乙肝病毒的复制HBVReplicationHBVReplication吸附、穿入肝细胞脱壳转译外衣壳蛋白转译内衣壳蛋白前基因组复制子代核酸组装释放乙肝病毒复制的基本过程HBsAgenvelopesPartiallydouble-strandedDNAA(n)感染性HBV病毒颗粒InfectiousHBVvirion(-)-DNA感染性HBV病毒颗粒InfectiousHBVvirionmRNA共价闭环DNAcccDNADNApolRT壳包裹前mRNAEncapsidatedpregenomicmRNA乙肝病毒的复制周期(ReplicationcycleforHBV)HBsAgenvelopesPartiallydouble-strandedDNAA(n)InfectiousHBVvirion(-)-DNAInfectiousHBVvirionmRNAcccDNADNApolRTEncapsidatedpregenomicmRNAHBVReplicationHBVReplication¾¾DaneDane颗粒与肝细胞受体结合(颗粒与肝细胞受体结合(DaneparticlebindstoareceptoronDaneparticlebindstoareceptoronhepatocytehepatocyte¾¾病毒外膜与肝细胞膜融合(病毒外膜与肝细胞膜融合(fusionofviralandhostmembranesfusionofviralandhostmembranes))¾¾HBVHBV核壳被转移到细胞核内(核壳被转移到细胞核内(nucleocapsidnucleocapsidistransportedtotheistransportedtothenucleusnucleus))¾DNA聚合酶修复正链缺失部分,形成共价闭环DNA(cccDNA)HBVReplicationHBVReplication乙肝病毒cccDNA形成的分子通路模式图ProposedmodelforthemolecularpathwayofhepadnaviruscccDNAformation.GuoHetal.J.Virol.2007;81:12472-12484HBVReplicationHBVReplication¾¾环状病毒环状病毒DNADNA被转换为共价连接的闭环被转换为共价连接的闭环DNA(CircularDNA(CircularviralDNAviralDNAisconvertedtocovalentlyclosedcircularDNA(isconvertedtocovalentlyclosedcircularDNA(cccDNAcccDNA))))HBsAgenvelopesPartiallydouble-strandedDNAA(n)InfectiousHBVvirion(-)-DNAInfectiousHBVvirionmRNAcccDNADNApolRTEncapsidatedpregenomicmRNAHBVReplicationHBVReplication¾¾cccDNAcccDNA作为病毒作为病毒RNARNA合成的模板(合成的模板(cccDNAcccDNAactsastemplateforactsastemplateforviralRNAsynthesis)viralRNAsynthesis)99合成合成mRNA(synthesismRNA(synthesisofmessengerRNA)ofmessengerRNA)99合成前病毒基因组合成前病毒基因组RNA(synthesisRNA(synthesisofofpregenomicpregenomicRNA)RNA)HBsAgenvelopesPartiallydouble-strandedDNAA(n)InfectiousHBVvirion(-)-DNAInfectiousHBVvirionmRNAcccDNADNApolRTEncapsidatedpregenomicmRNAH