Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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Detection of embB Gene Mutation of Mycobacterium tuberculosis by Reverse Hybridization Assay

역교잡 방법을 이용한 결핵균 embB 유전자 돌연변이 검출

  • Park, Young Kil (Korean Institute of Tuberculosis) ;
  • Yu, Hee Kyung (Korean Institute of Tuberculosis) ;
  • Park, Chan Hong (Korean Institute of Tuberculosis) ;
  • Ryu, Sung Weon (Korean Institute of Tuberculosis) ;
  • Lee, Seung Heon (Korean Institute of Tuberculosis) ;
  • Shim, Myung Sup (Korean Institute of Tuberculosis) ;
  • Lew, Woo Jin (Korean Institute of Tuberculosis) ;
  • Koh, Won-Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, O Jung (Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Cho, Sang Nae (Department of Microbiology, Yonsei University College of Medicine) ;
  • Bai, Gill Han (Korean Institute of Tuberculosis)
  • Received : 2004.10.27
  • Accepted : 2004.12.30
  • Published : 2005.02.28
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Abstract

Background : Ethambutol (EMB) is one of important first-line drug in the treatment of tuberculosis. Molecular techniques to detect embB gene mutations have been considered as an method to define the EMB resistance. We investigated the mutation rate within embB gene among EMB resistant strains using reverse hybridization techniques. Methods : We made 11 probes that had wild or mutated sequences containing codons 306, 406, or 497 within embB gene respectively. These probes were reverse-hybridized with PCR products amplified from embB gene which were isolated from 149 ethambutol resistant strains and 50 pan-susceptible strains. Results : Out of 149 ethambutol resistant strains, one hundred (67.1%) had mutation at least one base at codon 306, 406, or 497 in embB gene. Mutation at codon 306, 406, 497 were demonstrated in 75 (50.3%), 16 (10.7%), and 13 strains (8.7%) respectively. There were four strains that showed multi-mutation at codon 306 and codon 406 simultaneously. A high proportion (8.1%) had single mutation at codon 406. There was no mutation observed in embB gene among 50 pan-susceptible strains. Conclusion : Reverse hybridization will be useful technique for detection of gene mutation correlated to ethambutol resistance.

배 경 : 에탐부톨의 내성여부는 결핵 환자 처방 결정에 있어서 중요 변수의 하나가 된다. 에탐부톨 내성의 상당부분이 embB 유전자의 돌연변이와 관계가 있으므로 역교잡반응법으로 이 유전자의 돌연변이를 신속하게 검출하고자 하였다. 방 법 : 에탐부톨 내성에 관련된 embB 유전자의 306번, 406번, 497번 아미노산의 정상적인 염기서열과 돌연변이 염기서열에 대한 probe를 합성하였고, 약제감수성검사에서 에탐부톨 내성균으로 나타난 149균과 전약제 감수성으로 나타난 50개균을 대상으로 조사하였다. 결 과 : 149개의 에탐부톨 내성균 중에서 embB 유전자 전체에서 돌연변이가 나타난 균은 100균주(67.1%)였으며, 그 중 embB 유전자 중 306번 돌연변이를 가진 균주가 75주(50.3%), 406번 돌연변이를 가진 균주가 16주(10.7%), 497번 돌연변이가 있는 균주가 13주(8.7%)였다. 이 중 4균주는 306번과 406번 돌연변이를 동시에 가지고 있었다. 406번 돌연변이 하나만 가지고 있는 균은 12균주(8.1%)로 이는 다른 조사에서 볼 수 없었던 비교적 높은 수치이었다. 한편 에탐부톨 및 11가지 항결핵약제에서 감수성인 50개균에서는 embB 유전자의 돌연변이를 발견하지 못하였다. 결 론 : 역교잡반응법으로 에탐부톨 내성에 관련되어 있는 것으로 알려진 embB 유전자 돌연변이를 찾는 것이 가능하였으며, 에탐부톨 내성기전 및 관련 유전자가 더 발견되어 민감도가 향상된다면 신속한 에탐부톨내성균 검출이 가능할 것으로 본다.

Keywords

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