树突状细胞与哮喘

树突状细胞 (DC)是强有力的抗原提呈细胞 (APC) ,是机体免疫反应的始动者 ,它能激活初始T细胞 (naiveTcells) ,调节Th1/Th2反应 ,参与免疫应答。支气管哮喘是气道的一种慢性变态反应性炎症性疾病 ,存在免疫异常。DC作为APC可通过多种途径参与哮喘发病 ,本文将对近年来DC与哮喘关系的研究作一综述。     

树突状细胞与哮喘

树突状细胞(DC)是强有力的抗原提呈细胞(APC)，是机体免疫反应的始动者，它能激活初始T细胞(raive T cells)，调节Th1／Th2反应，参与免疫应答。支气管哮喘是气道的一种慢性变态反应性炎症性疾病，存在免疫异常。DC作为APC可通过多种途径参与哮喘发病，本文将对近年来DC与哮喘关系的研究作一综述。     

Effect mechanism of severe asthma caused by smoking based on ABM

目的探讨吸烟影响重度哮喘的机制,为治疗由吸烟引起的重度哮喘奠定理论基础.方法本文以基本免疫仿真器(basic immune simulator,BIS)为平台,仿真出TH17对免疫系统影响的模型(agent based modeling,ABM),与BIS已仿真出的DCs模型对比,并结合吸烟的临床数据,验证模型的正确性.结果 本文提出吸烟引起重度哮喘可能的机制是:烟雾中的氧化物能激发成熟DCs细胞产生IL-8细胞因子,随着烟雾作用时间的延长,产生的IL-8增多,使吸烟的哮喘者加重病情.结论 DCs-IL23-TH17-IL8-嗜中性炎症可能是导致重度哮喘的路径.以TH17为靶标,减少DCs,切断IL23-TH17-IL8路径,可以控制吸烟引起重度哮喘的症状.     

热休克蛋白90调控抗原交叉提呈及其在支气管哮喘中的作用

树突状细胞(DC)是机体功能最强的专职抗原提呈细胞(APC).DC在启动、调控和维持免疫应答中发挥中心作用,促进初始型T细胞(Th0细胞)向不同的T细胞亚群分化.热休克蛋白是生物体中普遍存在和高度保守的蛋白质.表达于DC的热休克蛋白90(HSP90)在DC抗原提呈中起重要作用.支气管哮喘(简称哮喘)是多基因参与的具有遗传易感性的慢性气道炎症性疾病,其发病涉及多种炎症细胞、炎性介质和复杂的细胞因子网络,以血清IgE增高、肺组织嗜酸性粒细胞浸润和气道高反应性为显著的临床特征[1].现认为,哮喘系DC介导的Ⅱ型辅助性T细胞(Th2)优势免疫为特征的慢性气道变应性疾病[2].现就HSP90的生物学特性、DC交叉抗原提呈及其与哮喘关系的研究进展做一综述.     

黄芪在树突状细胞水平对哮喘TH 1/TH 2平衡的调节作用

目的 探讨黄芪在树突状细胞(DC)水平对过敏性哮喘TH/TH2平衡的调节作用.方法 用rhGM-CSF和rhIL-4诱导培养外周血来源的DC并予鉴定,ELISA法检测其分泌的细胞因子IL-12、IL-10以及与自身T细胞反应后,RT-PCR检测T-bet和GATA-3 mRNA含量,流式细胞术检测T细胞分泌的胞内细胞因子IL-4和IFN-γ水平.结果 哮喘患儿外周血DC分泌IL-10高于对照组(P＜0.05);黄芪干预后DC分泌IL-10降低,与哮喘组比较差异有统计学意义(P＜0.05).哮喘患儿外周血DC分泌IL-12低于对照组(P＜0.05);黄芪干预后DC分泌IL-12增加,但与哮喘组比较差异无统计学意义.混合培养第7天哮喘组T细胞内IL-4水平显著高于正常对照组(P＜0.01);而IFN-γ水平则显著低于正常对照组(P＜0.05);哮喘组IL-4/IFN-γ比值高于正常对照组(P＜0.01).黄芪干预后T细胞内IL-4水平与哮喘组比较差异无统计学意义,而IFN-γ水平增加,与哮喘组比较差异有统计学意义(P＜0.05),IL-4/IFN-γ比值降低,与哮喘组比较差异有统计学意义(P＜0.01).哮喘组T-bet mRNA的表达强度明显低于正常对照组(P＜0.01);而哮喘组GATA-3 mRNA的表达强度则明显高于正常对照组(P＜0.05);哮喘组GATA-3/T-bet比值高于正常对照组(P＜0.05).黄芪干预后T细胞GATA-3 mRNA的表达强度与哮喘组比较差异无统计学意义,而T-bet mRNA水平增加,与哮喘组比较差异有统计学意义(P＜0.05),GATA-3/T-bet比值降低,与哮喘组比较差异有统计学意义(P＜0.01).结论 哮喘患儿DC功能缺陷,产生IL-12减少、IL-10增加导致TH2优势分化,从而使TH1/TH2平衡向TH2倾斜,合成IFN-γ减少,进而造成气道慢性炎症、气道高反应性而致哮喘发作.黄芪对DC的调节主要通过降低IL-10的分泌水平,从而降低其抑制TH0细胞向TH 1分化的功能,即间接抑制了TH0细胞向TH2的分化.     

粉尘螨变应原(Der fI)对DC2.4细胞的作用及其诱发哮喘机制的初步研究

分别通过对DC2.4细胞白介素-12(IL-12)和IL-10的ELISA检测,蛋白酶激活受体(PAR-2)的基因表达和丝裂原活化蛋白酶(MAPK)p44/42的磷酸化来观察Der fI对DC2.4细胞的作用及其诱发哮喘机制的初步研究.Der fI作用于DC2.4细胞的结果显示,Der fI可促进DC2.4细胞IL-10的分泌(P<0.01),抑制IL-12的分泌(P<0.05),但信号通路抑制剂U0126可以逆转细胞因子的分泌模式;促进磷酸化p44/42MAPK的表达(尤其是促进p42的磷酸化);抑制PAR-2受体的表达并呈时间依赖性.Th1/Th2失衡及Th2细胞功能亢进是过敏性哮喘的免疫基础,Th2型免疫应答可能是哮喘发生的机制之一.本研究中由于Der fI 作用于DC2.4细胞后抑制初始T细胞向Th1细胞分化而促使其向Th2细胞分化从而促使Th2型免疫应答.进而诱发过敏性哮喘,信号通路p44/42 MAPK的磷酸化加强和PAR-2受体表达的抑制也在诱发过敏性哮喘过程中起到促进作用.     

腺病毒介导MOMP基因转染对树突状细胞免疫功能的影响

目的 探讨腺病毒(Ad)介导E型沙眼衣原体(Ct)主要外膜蛋白(MOMP)基因转染对树突状细胞(DC)的表型及体内免疫功能的影响.方法 用小鼠重组粒细胞一巨噬细胞集落刺激因子(GM-CSF)及白细胞介素4(IL-4)从小鼠骨髓干细胞中诱导培养DC,并用大肠杆菌脂多糖(LPS)促进DC的成熟,流式细胞仪检测DC表型.用不同感染滴度(MOI)的含增强绿色荧光蛋白(EGFP)基因的重组Ad转染DC,荧光显微镜下观察EGFP的表达细胞百分率,选择最佳MOI;用最佳MOI的含MOMP基因的重组腺病毒(Ad-MOMP)转染DC,流式细胞术检测转染前后DC表型变化,并用活细胞计数试剂盒8(CCK-8)检测转染前后DC刺激同种淋巴细胞增殖的能力;ELISA检测转染前后DC分泌细胞因子及DC、T细胞共同培养上清中细胞因子的水平.Ad-MOMP转染DC经尾静脉免疫小鼠,ELISA检测其脾脏淋巴细胞分泌的细胞因子.结果 诱导的DC形态典型,表面高表达CD11c、MHCⅡ类分子,中度表达CD80分子.MOI=1000为重组Ad转染DC最佳滴度,此时90%以上的DC表达荧光,Ad-MOMP转染DC后能检测到MOMP的表达.Ad-MOMP转染对DC表面的特征性表型CD11c无影响,而CD80及MHCⅡ表达上调;转染后的DC分泌大量IL-12,具有较强的刺激同种异体淋巴细胞增殖的能力,并刺激T细胞分泌大量IFN-γ.Ad-MOMP转染DC后尾静脉免疫小鼠,其脾细胞产生高水平的IFN-γ.结论 Ad载体能介导外源MOMP基因在DC中的表达,Ad-MOMP转染DC后MOMP基因的表达能增强DC抗原提呈功能,促进DC活化,转染后的DC与T细胞共孵育能诱导T细胞向TH1细胞分化,体内实验表明Ad-MOMP转染DC能诱导衣原体特异性TH1反应.这为Ad-MOMP转染的DC疫苗用于免疫治疗提供了理论依据和技术基础.     

IL-18在儿童哮喘免疫应答中的作用

支气管哮喘是儿童最常见的慢性呼吸道疾病之一，其发病机制较复杂。最近几年，随着对T辅助细胞（TH）功能的认识取得重大进展，哮喘的TH1／TH2失衡学说已占主导地位。TH1和TH2亚群以相互拮抗和自身促进的方式形成复杂有序的细胞因子网络，分别行使各自不同的生理功能，调节正常的免疫应答。TH2克隆在免疫应答中主导B细胞介导的体液免疫及Ⅰ型变态反应。TH1则介导细胞免疫应答，主要表现在胞内病原体感染的保护和介导迟发型超敏反应（DTH）。支气管哮喘时，上述免疫平衡被打破，导致TH2优势分化，使该亚群功能亢进而TH1亚群功能低下，引起异常免疫应答。对TH1／TH2失衡的进一步研究，以参与气道炎症反应的细胞因子为研究靶点很可能为哮喘的诊治带来新的生机。     

细胞因子信号抑制因子在支气管哮喘TH1/TH2细胞失衡中的作用

目的 探讨细胞因子信号抑制因子（SOCS）在支气管哮喘（简称哮喘）患儿TH细胞亚群（TH1／TH2）功能失衡中的作用，以及转录因子T-bet和GATA3与TH1／TH2反应的关系。方法 观察20例哮喘患儿及相同数量同龄对照，采用流式细胞术（FCM）检测哮喘患者外周血CD4^＋T淋巴细胞浆中白细胞介素4（IL-4）和γ干扰素（INF-γ）的表达，逆转录-聚合酶链反应（RT-PCR）和荧光定量聚合酶链反应（real time PCR）测定淋巴细胞SOCS3、SOCS5、T-bet、GATA3 mRNA表达水平。结果 急性发作期哮喘患儿TH1细胞比例显著下降，TH2细胞显著增高（P〈0．01）；哮喘患儿淋巴细胞SOCS3、GATA3 mRNA表达水平显著高于正常同龄对照（P〈0．01），SOCS5、T-bet mRNA表达显著下降（P〈0．01）。结论 SOCS3、SOCS5、T-bet和GATA3表达异常与哮喘患儿TH1／TH2失衡有关，其中SOCS3和SOCS5表达异常可能是重要的因素之一。     

人参皂甙对小鼠脾脏树突状细胞增殖的影响

树突状细胞 (DC )是已知机体内功能最强的抗原递呈细胞 (APC ) ,能在体内外直接激活初始 (naive)T细胞 ,是自体、异体混合淋巴细胞反应中重要的刺激细胞 ,其作用比其他APC强 10～ 10 0倍[1] 。目前DC在感染免疫、移植排斥、肿瘤免疫及免疫缺陷等病理过程中所起的作用越来越受到人们的重视。但DC数量极微 ,分离纯化困难 ,给DC的研究和应用带来极大困难。目前 ,体外扩增DC多采用GM CSF与IL 4联用[2 ,3 ] ,但其成本较高。本实验应用人参皂甙 (ginsensides,GS )观察其对小鼠脾脏DC增殖的影响 ,以期为DC的体外扩增提供新的方法。1　…     

Renal dysplasia and asplenia in two sibs

A family is reported in which two sibs, one male and the other female, both died within 24 hours of birth with enlarged polycystic kidneys. Postmortem histology in the second child showed gross renal dysplasia. In both children the pancreas was enlarged, nodular and cystic but the liver appeared macroscopically normal. In the second child, histological examination confirmed pancreatic fibrosis with cystic dilation of ducts, but showed portal fibrosis with bile duct proliferation in the liver.
This combination of findings is very reminiscent of those in a girl and her brother reported by Ivemark et al. (1959). The children reported here also showed absence or hypoplasia of the spleen, cardiac anomalies and other features of the Ivemark syndrome (Ivemark 1955), a quite different, usually sporadic, congenital disorder. It is suggested that the children described here have a distinct lethal congenital disorder, probably inherited in an autosomal recessive manner.     

Schizophrenia in a North Swedish geographical isolate, 1900–1977. Epidemiology, genetics and biochemistry

Over 200 schizophrenic patients belonging to three major and interrelated pedigree complexes have been investigated over the past 30 years in a North Swedish geographically isolated population, presently numbering about 6,000. An intensive investigation of a number of biochemical correlates and genetic markers in a few selected families belonging to one of the major pedigrees has indicated new strategies for the current research program.
Schizophrenia, as defined operationally, is significantly associated with decreased activities of two enzymes (1) blood platelet monoamine oxidase, (2) plasma dopamine-β-hydroxylase, and (3) with the genetic marker Gc² (group specific antigen). Both enzymes are subject to genetic variation. A positive score for linkage between schizophrenia and low plasma DBH activity has been calculated, but, so far, available data are insufficient for discrimination between linkage and partial contribution of genetically controlled low plasma DBH to the pathogenesis of the disease. Alternatively, both mechanisms could be involved.
As a model for continued research, schizophrenia is explained as based on a double dominant-recessive genotype (Aabb), representing a vulnerability which in about 50 % of cases develops into clinical schizophrenia. It is suggested that the dominant mutation (A) operates on or affects MAO activity, and that the recessive genotype (bb) is instrumental in low variates of DBH activity and very likely such variates within the normal range of physiological variation. Moreover, it is suggested that the combined effects of MAO- and DBH-reduced efficiency on the metabolism of e.g. dopamine could be an essential pathogenic mechanism for the schizophrenic illness which is segregating in this population.     

What will studies of Fulani individuals naturally exposed to malaria teach us about protective immunity to malaria?

There are an estimated over 200 million yearly cases of malaria worldwide. Despite concerted international effort to combat the disease, it still causes approximately half a million deaths every year, the majority of which are young children with Plasmodium falciparum infection in sub-Saharan Africa. Successes are largely attributed to malaria prevention strategies, such as insecticide-treated mosquito nets and indoor spraying, as well as improved access to existing treatments. One important hurdle to new approaches for the treatment and prevention of malaria is our limited understanding of the biology of Plasmodium infection and its complex interaction with the immune system of its human host. Therefore, the elimination of malaria in Africa not only relies on existing tools to reduce malaria burden, but also requires fundamental research to develop innovative approaches. Here, we summarize our discoveries from investigations of ethnic groups of West Africa who have different susceptibility to malaria.     

The universal muscular chain reaction,muscle spasm,Torsions, ruptures and extravasations. Chameleons of pathology and some manifestations of simple muscular disorders

Most bodily functions require the coordinated actions of complementary and supplementary paired muscle groups. Where this essential muscular cooperation is lacking, hollow organs may burst and others become literally screwed up, giving rise to many similar spastic diseases such as Torticollis, Twisted ovarian cyst, Torsion of the Testis, Volvulus of the intestines, Varicose Veins, Megacolon, Aortamegaly, Scoliosis, Erb's Palsy, Peyronie's Disease, Main-en-Griffe, Undescended Foot (Pes Cavus), Talipes, Strabismus. Spasm is “panenepidemic” and unclassified examples of Torsion Dystonia and Dyskinesia really are as common as debt and taxes.     

The dominant diseases of modernized societies as omega-3 essential fatty acid deficiency syndrome: Substrate beriberi

About 1900, modern food selection and processing caused widespread $\text{epidemics}$ of the B vitamin deficiency diseases of beriberi and pellagra which, for genetic reasons, often expressed as different diseases ranging from bowel and heart disease to dermatoses and psychoses. But the B vitamins merely help convert essential fatty acids (EFA) into the prostaglandin (PG) tissue regulators and it now turns out that, through hydrogenation, milling and selection of w3-poor southern foods, we have also been systematically depleting, by as much as 90%, a newly discovered trace Nordic EFA (w3) of special importance to primates and sole precursor of the PG3(4) series, even as a concurrent fiber deficiency increases body demand for EFA. Since substrate EFA is processed by many B vitamin catalysts, an EFA deficiency will mimic a $\text{panh}$ypovitaminosis B, i.e., a mixture of $\text{substrate}$ beriberi and $\text{substrate}$ pellagra resembling vitamin beriberi and pellagra but exhibiting as even more diverse $\text{endemic}$ disease. This would consitute a second stage of the Modern Malnutrition and explain why some workers now hold the dominant diseases of modermized societies to be new, nutritionally based, pellagraform yet lipid-related and to range, once again, from heart disease to psychosis. It is an assumption that our dominant diseases are unrelated to each other or are merely revealed by our diagnostic acumen and therapeutic success; and that hydrogenating millions of tons of food oils annually, to destroy the rancidity producing w3-EFA, is safe for $\text{primates}$. Extensive beriberiform disease is reported here in 32 typical cases taken from medical practice which responds strikingly to linseed oil supplements (60% w3-EFA) in confirmation of identical results in Capuchins.     

Hypo- und Hypermagnesämie aus kardiologischer Sicht

Zusammenfassung Eine Reihe pathologischer Zustände bedingen Magnesiummangel. Zustände mit Hypermagnesämie sind ebenfalls bekannt, doch wesentlich seltener. Für den Kardiologen beachtenswert ist, daß unter Therapie mit bestimmten Diuretica bei Herzinsuffizienz, bei Herzinfarkt, Kardiomyopathie, Digitalisintoxikation und bestimmten Herzrhythmusstörungen Hypomagnesämie beobachtet wurde. Leider kann in der klinischen Routine nur ein extracelluläres Magnesiumdefizit durch Serumbestimmungen gemessen werden; über Magnesiummangel einzelner Organe kann nichts ausgesagt werden. Hinweise für Magnesiummangel geben aber neben der Messung des Serumspiegels Anamnese, klinischer Befund, bestimmte EKG-Veränderungen wie auch evtl. Hypokalämie, ein Zustand, bei dem sich oft — besonders bei Aldosteronismus — parallele Veränderungen zeigten.Tierexperimente deuten darauf hin, daß infarktähnliche Läsionen unter Magnesiummangel entstehen, doch ob Herzinfarkt beim Menschen durch Magnesiummangel ausgelöst werden kann, ist noch ungeklärt. In Leichenherzen zeigte sich im Infarktgebiet neben Calciumakkumulation signifikanter Magnesiumverlust, wobei unklar blieb, ob sich Ursache oder Folge des Infarktes widerspiegelten. Falls ein ursächlicher Zusammenhang besteht, ist er im Myokardstoffwechsel selbst zu suchen, wie bei der Alkoholkardiomyopathie, wo myokardialer Magnesiummangel zumindest als pathogenetischer Teilfaktor anerkannt wird. Andererseits versucht man aber auch Beziehungen zwischen Atherosklerose, Blutgerinnung und Hypomagnesämie herzustellen, in der Meinung, daß Magnesiummangel auch über den coronaren Pathomechanismus des Herzinfarktes wirken könnte. Sicher scheint, daß gewisse EKG-Veränderungen und Herzrhythmusstörungen durch einen irritierten Magnesiumhaushalt bedingt sein können, da sie bei Gabe bzw. Entzug von Magnesium verschwinden. Daß Magnesiummangel die Glykosidtoleranz verringert, wird tierexperimentell bestätigt. Unter Hypomagnesämie bewirkt Acetylstrophanthidin eher und länger Rhythmusstörungen als ohne, außerdem lassen diese sich durch Magnesiumgaben eliminieren. Da in gewissen Fällen spontane und digitalisinduzierte Herzrythmusstörungen durch Magnesiuminjektionen beseitigt wurden, scheint Magnesium als Therapeuticum angebracht. Einsatz verschiedener Magnesiumsalze bei Angina pectoris, degenerativen Herzerkrankungen und Herzinsuffizienz ohne geprüften und offensichtlich gestörten Magnesiumhaushalt ist fragwürdig, weil keine eindeutigen klinischen Erfolgsbeweise vorliegen. Immerhin mag es aber larvierte, durch Serumbestimmungen nicht erfaßbare Mangelzustände geben. Allgemein erscheint es aus kardiologischer Sicht ratsam, den Magnesiumhaushalt zu überwachen und in entsprechenden Fällen auszugleichen, um möglichen Myokardläsionen oder fatalen Herzrhythmusstörungen entgegenzuwirken.     

Environmental risk factors and their role in the management of atopic dermatitis

Introduction: The etiology of atopic dermatitis (AD) is multifactorial with interaction between genetics, immune and environmental factors.

Areas covered: We review the role of prenatal exposures, irritants and pruritogens, pathogens, climate factors, including temperature, humidity, ultraviolet radiation, outdoor and indoor air pollutants, tobacco smoke exposure, water hardness, urban vs. rural living, diet, breastfeeding, probiotics and prebiotics on AD.

Expert commentary: The increased global prevalence of AD cannot be attributed to genetics alone, suggesting that evolving environmental exposures may trigger and/or flare disease in predisposed individuals. There is a complex interplay between different environmental factors, including individual use of personal care products and exposure to climate, pollution, food and other exogenous factors. Understanding these complex risk factors is crucial to developing targeted interventions to prevent the disease in millions. Moreover, patients require counseling on optimal regimens for minimization of exposure to irritants and pruritogens and other harmful exposures.     

Class II HLA in Georgia Caucasus Tbilisi Georgians and their Mediterranean ancestry: The Usko Mediterranean languages

Georgia (or Sakartvelo in its own language) is a South Caucasus Mts. country with its easternmost part is enigmatically named Iberia, like the Iberian Peninsula, which may refer to rivers “Kura” and “Ebro” or their valleys respectively. Most of their inhabitants speak Georgian which is included within Dene-Caucasian group and Usko-Mediterranean subgroup of languages. The latter includes Basque, Berber, ancient Iberian-Tartessian, Etruscan, Hittite, Minoan Lineal A and others. In the present paper, HLA class II -DRB1 and -DQB1 alleles has been studied and extended haplotypes calculated. Most frequent haplotypes are also of Mediterranean origin (i. e.: (A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*51)-DRB1*13:01-DQB1*06:03, or (A*24-B*35)-DRB1*01:01-DQB1*05:01) and DA genetic distances show that closest world populations to Georgians are Mediterraneans. Georgians also show common extended haplotypes ((A*02-B*51)-DRB1*11:01-DQB1*03:01, (A*02-B*13)-DRB1*07:01-DQB1*02:01 and (A*03-B*35)-DRB1*11:01-DQB1*03:01) with Svan people, a secluded population in North Georgia mountains. We can conclude that Georgians belong to a very old Mediterranean substratum according to both linguistics (Usko Mediterranean languages) and HLA genetics.     

'Very sore nights and days': the child's experience of illness in early modern England, c.1580-1720

Sick children were ubiquitous in early modern England, and yet they have received very little attention from historians. Taking the elusive perspective of the child, this article explores the physical, emotional, and spiritual experience of illness in England between approximately 1580 and 1720. What was it like being ill and suffering pain? How did the young respond emotionally to the anticipation of death? It is argued that children’s experiences were characterised by profound ambivalence: illness could be terrifying and distressing, but also a source of emotional and spiritual fulfilment and joy. This interpretation challenges the common assumption amongst medical historians that the experiences of early modern patients were utterly miserable. It also sheds light on children’s emotional feelings for their parents, a subject often overlooked in the historiography of childhood. The primary sources used in this article include diaries, autobiographies, letters, the biographies of pious children, printed possession cases, doctors’ casebooks, and theological treatises concerning the afterlife.