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浙江大学学报（医学版）
浙江大学学报（医学版）  2017, Vol. 46 Issue (5): 563-569    DOI: 10.3785/j.issn.1008-9292.2017.10.18
综述     
耶氏肺孢子菌对磺胺类药物耐药相关基因突变的研究进展
王梦嫣, 朱彪
浙江大学医学院附属第一医院感染病中心 传染病诊治国家重点实验室 感染病诊治 协同创新中心, 浙江 杭州 310003
Research progress on genes mutations related to sulfa drug resistance in Pneumocystis jirovecii
WANG Mengyan, ZHU Biao
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Infection Diseases, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
 全文: PDF(946 KB)  
摘要：

肺孢子菌肺炎是由耶氏肺孢子菌引起的，发生在免疫功能低下人群中的机会性感染。大量证据表明，耶氏肺孢子菌对磺胺类药物耐药性增加与二氢叶酸合成酶（DHPS）基因和二氢叶酸还原酶（DHFR）基因突变有关，但具体机制尚不清楚。DHPS和DHFR基因突变增加可能是药物选择性压力所致，也可能是耶氏肺孢子菌基因多态性自然发展和传播的结果。本文对耶氏肺孢子菌DHPS和DHFR基因突变产生的原因、分子流行病学研究进展及其与临床结局的关系进行了综述。
关键词： 肺囊虫性/病理生理学;  突变;  基因;  四氢叶酸脱氢酶;  综述;  肺炎;  磺胺类/药理学;  抗药性;  细菌/遗传学    
Abstract:

Pneumocystis jirovecii pneumonia is an opportunistic infection among immunocompromised people. Studies have found that the increased resistance to sulfa drugs of Pneumocystis jirovecii may be associated with the mutation of dihydropteroate synthase (DHPS) gene and dihydrofolate reductase (DHFR) genes, but the mechanism is still unclear. The mutation of DHPS and DHFR genes may be the result of sulfa drugs selection or spontaneous genetic polymorphism, and it can be acquired from person-to-person transmission. This article reviews the cause, molecular epidemiology of DHPS and DHFR gene mutation, and the relationship between DHPS and DHFR gene mutation and clinical outcomes.
Key words: Drug resistance,bacterial/genetics    Pneumonia,pneumocystis/physiopathology    Tetrahydrofolate dehydrogenase    Sulfonamides/pharmacology    Genes    Mutation    Review
收稿日期: 2017-02-20 出版日期: 2017-10-25
CLC:  R379.9  
基金资助:

国家科技重大专项（2014ZX10001002-002-002，2017ZX10202102-002-002）
通讯作者: 朱彪(1965-),男,博士,主任医师,硕士生导师,主要从事艾滋病相关研究;E-mail:zhubiao1327@zju.edu.cn;http://orcid.org/0000-0001-6288-4575     E-mail: zhubiao1327@zju.edu.cn
作者简介: 王梦嫣(1993-),女,硕士研究生,主要从事艾滋病相关研究;E-mail:21618054@zju.edu.cn;http://orcid.org/0000-0002-8813-2555
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引用本文:

王梦嫣 等. 耶氏肺孢子菌对磺胺类药物耐药相关基因突变的研究进展[J]. 浙江大学学报（医学版）, 2017, 46(5): 563-569.

WANG Mengyan, ZHU Biao. Research progress on genes mutations related to sulfa drug resistance in Pneumocystis jirovecii. Journal of ZheJiang University(Medical Science), 2017, 46(5): 563-569.

链接本文:

http://www.zjujournals.com/xueshu/med/CN/10.3785/j.issn.1008-9292.2017.10.18    或    http://www.zjujournals.com/xueshu/med/CN/Y2017/V46/I5/563

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