补肾益气方对不明原因反复自然流产患者外周血Foxp3~+ Treg/Th1/Th17细胞的影响

为探讨补肾益气方对反复自然流产患者外周血Treg/Th1/Th17的影响,选取我院自然流产专科门诊30例反复自然流产(recurrent spontaneous abortion,RSA)患者,诊断为正常妊娠后开始服用补肾益气方中药,采用流式细胞仪检测服药前后Treg/Th1/Th17细胞数量,ELISA方法检测外周血TNF-α、IFN-γ、IL-4、IL-10及IL-17水平变化。结果显示中药治疗后RSA患者外周Treg细胞数量上升(5.85±2.76),明显高于服药前(3.26±1.19),P<0.05。Th1和Th17细胞数量下降(8.38±4.38和0.95±0.15),明显低于治疗前(23.59±8.14和1.58±0.71),P<0.05。IL-10和IL-4水平显著上升(P<0.05),TNF-α、IFN-γ和IL-17水平明显下降(P<0.05)。实验表明,补肾益气方中药能够调控Treg/Th1/Th17细胞水平,改变母体细胞因子分泌格局,保护胎儿不被排斥。     

早孕期弓形虫感染对大鼠胎盘IL-4、IL-10和IFN-γ表达水平的影响

研究早孕期弓形虫感染对Wistar大鼠胎盘IL-4、IL-10及IFN-γ表达水平的变化,从而探讨弓形虫感染致不良妊娠的分子免疫学机制。将Wistar孕鼠随机分为2组:①对照组12只;②早孕感染组12只。早孕感染组每只孕鼠于妊娠第5天腹腔注射1×105个弓形虫强毒株(RH株)速殖子,对照组不做任何处理。所有孕鼠均于孕19 d颈椎分离处死,无菌获取胎盘,采用实时荧光定量聚合酶链式反应(real-ti me PCR)及酶联免疫吸附测定(ELISA)检测其胎盘IL-4、IL-10及IFN-γ mRNA及蛋白表达水平的变化。结果:①实验组与对照组IL-4、IL-10及IFN-γmRNA相对表达水平分别为(0.006±0.010)、(0.119±0.080)、(0.82±0.354)和(0.596±0.444)、(0.478±0.224)、(0.297±0.180),三者之间均具有显著性差异(P<0.01);②实验组与对照组IL-4、IL-10及IFN-γ蛋白表达水平分别为(4.63±1.26)、(239.24±83.16)、(105.47±67.88)和(2.40±1.33)、(103.03±79.72)、(208.02±74.95),三者之间均具有显著性差异(P<0.01)、(P<0.05)、(P<0.05);③实验组与对照组mRNA水平IFN-γ/IL-4、IFN-γ/IL-10分别为(390.67±264.12)(37.65±21.10)和(1.31±0.96)、(0.79±0.60)两者之间均具有显著性差异(P<0.01);④实验组与对照组蛋白水平IFN-γ/IL-4、IFN-γ/IL-10分别为(176.51±212.95)、(7.26±8.81)和(23.09±12.95)、(0.44±0.21)。两者之间均具有显著性差异(P<0.01)、(P<0.05)。大鼠早孕期弓形虫感染后,胎盘局部Th1型细胞因子表达增高,Th2型细胞因子表达降低,打破了正常妊娠所需的Th1/Th2平衡状态,使平衡倾向于Th1,可能是弓形虫孕期感染致不良妊娠的重要分子机制之一。     

孟鲁司特对于小儿支气管哮喘的辅助治疗研究

目的:小儿支气管哮喘应用孟鲁司特辅助沙丁胺醇等药物治疗的效果观察.方法:选取2019年10月至2020年10月接收的小儿支气管哮喘患儿84例,随机分为对照组(布地奈德+沙丁胺醇)和观察组(布地奈德+沙丁胺醇+孟鲁司特),各42例,经过2周治疗后,对比两组患儿治疗有效性、治疗前后内皮素(Endothelin 1,ET-1)、半胱氨酰白三烯(cysteinyl leukotrienes,CysLTs)水平及不良反应发生率.结果:观察组治疗有效率95.42％,高于对照组的78.57％,两组有统计学差异(P<0.05);观察组和对照组患儿治疗后ET-1、CysLTs水平分别为(112.23±41.56)pg·mL-1、(124.25±14.21)pg·mL-1与(135.46±42.37)pg·mL-1、(151.42±17.69)pg·mL-1均显著低于治疗前水平(167.76±47.23)pg·mL-1、(182.54±34.35)pg·mL-1与(168.12±46.54)pg·mL-1、(185.36±35.55)pg·mL-1,两组有统计学差异(P<0.05);且治疗后观察组ET-1、CysLTs水平低于对照组,两组有统计学差异(P<0.05);两组不良反应发生率对比无差异P>0.05.结论:小儿支气管哮喘应用孟鲁司特辅助治疗可降低炎性反应,疗效确实,且安全性较好,值得借鉴.     

溃疡性结肠炎相关性结直肠癌大鼠Th1/Th2漂移与微血管密度的关系

为探讨溃疡性结肠炎相关性结直肠癌(ulcerative colitis-associated colorectal cancer,UC-CRC)大鼠Th1/Th2漂移与微血管密度(microvessel density,MVD)的关系,建立UC-CRC大鼠模型,于第14、16、18周分批处死,观察各组结肠组织病理学变化情况,并比较血清、结肠组织中Th2细胞因子IL-4、Th1细胞因子IFN-γ水平及结肠组织中CD4~+IL-4~+占比、CD4~+IFN-γ~+占比、CD4~+IFN-γ~+/CD4~+IL-4~+、MVD,分析MVD与IFN-γ、IL-4、IFN-γ/IL-4的相关性。结果显示,模型组大鼠建模后状态逐渐变差,持续2周后好转;模型组结肠细胞有明显的病理学变化;与对照组比较,模型组各时刻血清和组织中IL-4水平、CD4~+IL-4~+占比、MVD较高,IFN-γ水平、CD4~+IFN-γ~+占比、IFN-γ/IL-4、CD4~+IFN-γ~+/CD4~+IL-4~+较低(P0.05);模型组血清和组织中IL-4水平、CD4~+IL-4~+占比、MVD均随时间的延长呈升高趋势(P0.05),IFN-γ水平、CD4~+IFN-γ~+占比、IFN-γ/IL-4、CD4~+IFN-γ~+/CD4~+IL-4~+均随时间的延长呈下降趋势(P0.05),而对照组上述指标变化均不显著(P 0.05);不同时刻MVD与血清及组织中IL-4水平呈正相关(P0.05),与IFN-γ水平、IFN-γ/IL-4均呈负相关(P0.05)。提示UC-CRC大鼠Th1/Th2平衡向Th2漂移,MVD与Th2细胞因子呈正相关,与Th1细胞因子呈负相关,MVD与Th1/Th2漂移关系密切。     

接种纯化人用狂犬病疫苗对Th1/Th2类细胞因子谱的影响

目的 研究人用狂犬病纯化疫苗(RV)对人体抗原特异性Th1/Th2细胞因子谱的影响.方法 对20例暴露者进行RV的全程接种,在开始接种RV的第0天、14天、45天时分别采血并分离人外周血单个核细胞(PBMC)与RV进行培养,采用ELISA法检测血清抗狂犬病病毒抗体,体外培养检测淋巴细胞转化增殖能力(MTT法),流式微球分析技术(CBA)法检测细胞培养上清液中Th1类细胞因子(IFN-γ、TNF、IL-2)及Th2类细胞因子(IL4、IL-5、IL-10)的水平.结果 暴露组全程注射RV后,19例于第45天、1例于第60天检测血清抗狂犬病病毒抗体阳性,阳性率100%.RV刺激后,暴露组第14天、第45天淋巴细胞增殖能力显著增高,第45天淋巴细胞增殖能力明显高于第0天(P<0.05);当RV刺激后,暴露组第14天、第45天产生IFN-γ、IL-2、IL-4、IL-5的含量高于未刺激组及暴露组第0天水平(P<0.05);TNF、IL-10的含量各组间比较差异无统计学意义(P>0.05).结论 RV在刺激机体产生体液免疫的同时,可以诱导机体产生特异性细胞免疫,Th1的免疫应答尤为显著,提示细胞免疫在预防和控制狂犬病病毒感染中发挥重要的协同作用.     

慢性乙肝患者树突状细胞对Th1/Th2分化的影响

探讨慢性乙肝患者树突状细胞(dendritic cells,DC)对CD4+Th细胞亚群分化的影响。分离慢性乙肝患者外周血单个核细胞(PBMC),以rhIL-4(50 ng/ml)、rhGM-CSF(10 ng/ml)和rhTNF-α(100 u/ml)诱导培养DC。以流式细胞仪检测DC表面CD1a、CD83、CD80、CD86、HLA-DR分子表达情况。MTT法检测DC刺激同种异体淋巴细胞增殖能力。免疫磁珠分离外周血CD4+T细胞亚群,PMA+Ionomycin刺激后胞内荧光染色,流式细胞仪检测辅助性T细胞(helper T cell,Th)内特征性细胞因子IFN-γ/IL-4以判断Th1/Th2分化。ELISA法检测DC或Th细胞培养上清中IL-6、IL-12、IFN-γ和IL-4的含量。结果:慢性乙肝患者的DC表达CD1a、CD83、CD80、CD86、HLA-DR分子水平明显低于正常人(P<0.01);培养至第7天,慢性乙肝患者DC分泌的IL-12水平低于正常人(P<0.01),而分泌的IL-6水平增高(P<0.05)。与正常人相比,慢性乙肝患者外周血中Th1细胞占CD4+T细胞的百分比较低(P<0.01),其Th细胞培养上清中IFN-γ的量也较低(P<0.01)。患者DC与同种异体的健康人Th细胞共培养,刺激Th1型细胞因子IFN-γ产生的能力低于正常人(P<0.01)。慢性乙肝患者体内DC功能的异常可能导致了外周血Th1细胞分化不足。     

急性MCMV感染对小鼠脾Th1/Th2/Th17细胞亚群分化的影响

目的:在整体水平观察小鼠巨细胞病毒(MCMV)感染对小鼠脾Th1/Th2/Th17细胞亚群分化及其主要的效应性细胞因子(IFN-γ、IL-4、IL-17A)表达的影响.方法:建立MCMV感染模型,8只BALB/c小鼠分别于接种MCMV Smith株后3天和14天各处死4只;另设8只接种唾液腺匀浆的模拟感染小鼠作为对照.用空斑形成试验测定肝、脾和唾液腺组织病毒滴度;流式细胞术检测脾T淋巴细胞中Th1(CD4+ IFN-γ+)、Th2(CD4+ IL-4+)、Th17(CD4+IL-17A+)细胞比例,双抗体夹心ELISA法检测脾细胞培养上清中病毒特异性IFN-γ、IL-4、IL-17A水平.结果:MCMV感染早期肝、脾和唾液腺组织中病毒呈低水平复制,而感染后14天仅在唾液腺组织呈高水平复制;Th1细胞比例及病毒特异性IFN-γ主要在MCMV感染早期呈显著升高(P ＜0.01);Th2细胞及IL-4均无明显表达及改变;Th17细胞及病毒特异性IL-17A则主要在感染后14天升高(P＜0.05).结论:MCMV感染早期,机体通过上调Th1细胞分化比例及IFN-γ的表达发挥抗病毒效应,而MCMV诱导Th17细胞分化及IL-17A的高表达可能是MCMV感染致宿主特异性细胞免疫功能失调并逃避机体特异性细胞免疫攻击的原因之一.     

接种纯化人用狂犬病疫苗对妊娠期Th1/Th2类细胞因子谱的影响

目的研究人用狂犬病纯化疫苗（RV）对妊娠期Th1/Th2类细胞因子谱的影响。方法对所有可疑狂犬病毒暴露者进行RV的全程接种,在接种RV的第0、14、45天时采血并分离外周血单个核细胞与RV进行培养,采用ELISA法检测抗狂犬病病毒抗体,体外培养检测淋巴细胞增殖能力,CBA法检测细胞培养上清液中Th1类细胞因子：干扰素-γ（IFN-γ）、肿瘤坏死因子（TNF）、白细胞介素-2（IL-2）以及Th2类细胞因子：IL-4、IL-5、IL-10的水平。结果 17例暴露者于RV全程注射后17d（第45天）抗体检测阳性;RV刺激后,暴露者第45天淋巴细胞增殖能力明显高于第0天（P〈0.05）;当RV刺激后,暴露组第14天、第45天产生IL-2、IL-4、IL-5的含量显著高于未刺激组及暴露组第0天水平（P〈0.05）。结论妊娠期注射RV在刺激机体产生体液免疫的同时,可以有效地诱导Th1/Th2类细胞因子的产生。     

特发性血小板减少性紫癜患者Th1/Th2的细胞因子水平及临床意义

目的:检测特发性血小板减少性紫癜(ITP)患者外周血Th1(IL-2、IFN-γ)及Th2(IL-4、IL-10)细胞因子的变化,探讨ITP患者发病与Thl/Th2优势活化状态之间的关系.方法:通过酶联免疫吸附试验(ELISA)法检测30例ITP患者治疗前、治疗后及26例健康志愿者外周血清中IL-2、IFN-γ、IL-4、IL-10水平.结果:ITP患者治疗前IFN-γ及IL-2因子水平高于治疗后和对照组,差异有统计学意义(P＜0.05),而IL-4及IL-10因子治疗前水平低于治疗后和对照组,差异有统计学意义(P＜0.05).结论:Thl型细胞因子介导的免疫应答在ITP的发病机制中占主导地位,糖皮质激素治疗可调整Th1/Th2细胞因子的偏移状态.     

BALB/c小鼠感染弓形虫后Th1/Th2免疫漂移的实验研究

目的：动态分析BALB/c小鼠感染弓形虫后Th1/Th2免疫失衡及免疫漂移特点,并探讨转录因子T-bet和GA-TA-3在此过程中的改变及其意义。方法：90只BALB/c小鼠随机分为正常对照组30只,弓形虫感染组60只。于感染后奇数天每天处死感染组小鼠2只,对照组小鼠1只,采用ELISA法动态检测各组小鼠血清中IFN-γ和IL-4的水平,同时应用荧光定量PCR方法检测小鼠脾细胞中T-bet和GATA-3 mRNA的表达情况。结果：感染组小鼠中,血清IFN-γ于感染后第4天开始显著升高,第5~7天维持在高峰值,从第8天开始下降,第9天降至正常水平;IL-4于感染后第8天开始显著升高,第9天升至峰值,从第14天开始下降,第15天降至正常水平;脾细胞T-bet mRNA的表达在感染后第3天升高,第5天达高峰后于第9天降至正常水平;脾细胞GATA-3 mRNA的表达在感染后第7天升高,第11天达高峰,于第13天降至正常水平。正常对照组小鼠在实验期内IFN-γI、L-4水平没有明显变化,维持在正常的较低水平。结论：BALB/c小鼠感染弓形虫后诱导的免疫应答在感染急性期（第1~8天）以Th1应答为主,第9至13天,宿主免疫应答以Th2细胞应答为主,之后Th1/Th2应答基本恢复平衡。Th1应答向Th2应答的漂移与T-bet和GATA-3 mRNA的表达相关并受其调控,Th1/Th2型免疫应答的发生时相和效应强度可能影响弓形虫感染的最终结局。     

Stability of Th1 and Th2 populations

Using an in vitro model for the development of IFN-y-producIng(Th1) and IL-4-produclng (Th1) cells from CD4 T lymphocytesexpressing a transgenlc TCR, we show that IL-12 and IL-4 arethe most potent stimuli for the differentiation of naive T cellsto effector populations. When combinations of cytokines arepresent during T cell priming, the effect of IL-4 Is dominant.Furthermore, differentiated Th1 cells can be converted intoIL-4 producers by exposure to IL-4, but the Th2 phenotype Isnot reversible. The stability of Th2 populations may limit theability to regulate Th2-domlnant responses In pathologic situations.     

The Th1/Th2 paradigm

The Th1/Th2 paradigm provides a useful model for understanding the pathogenesis of several diseases, as well as for developing novel immunotherapeutic strategies. Here, Sergio Romagnani examines Th1/Th2 polarization in the context of associated pathophysiological conditions.     

Distribution of Th1, Th2, and Th0 and the Th1/Th2 cell ratios in human peripheral and endometrial T cells

PROBLEM: To examine whether normal pregnancy involves type 2 T-helper (Th2) immune condition or not. METHOD OF STUDY: We measured the percentage of Th0, Th1, and Th2 and the Th1/Th2 cell ratios of human peripheral blood and endometrial T cells using flow cytometry, which can analyze both the surface marker CD3, and intracellular cytokines, interleukin 4 (IL-4) and interferon gamma (IFNgamma). RESULTS: No significant differences were found in the percentages of Th1, Th2, and Th0 and the Th1/Th2 cell ratios in the peripheral blood T cells of nonpregnant women and women in early pregnancy. On the other hand, the percentage of Th1 cells was highest during the proliferative phase of the endometrium, followed by the secretory phase and early pregnancy decidua. The percentage of Th2 cells was highest in early pregnancy decidua and lowest during the proliferative phase of the endometrium. The Th1/Th2 ratio was 147.48+/-96.68 during the proliferative phase of the endometrium, 37.74+/-21.33 during the secretory phase, and 1.31+/-0.48 in the early pregnancy decidua. CONCLUSIONS: These data indicate that Th1 cells predominate in the nonpregnant endometrium, especially during the proliferative phase, while Th2 cells predominate in early pregnancy decidua.     

Development of Neonatal Th1/Th2 Function

Newborn animals generally mount poor T cell-mediated immune responses in vivo. As a result, neonates fall prey to infectious agents and diseases which have little impact on immunocompetent adult animals. For some time, it was believed that this phenomenon was due to an intrinsic inability of newborns to mount developmentally mature Th1 responses. Recent studies in mice have challenged that view; under certain conditions, adult-level Th1 function has been achieved in newborns. More often, however, neonates develop Th2-dominant responses. A major challenge in the field of developmental immunology is to understand why the ‘default’ response for neonates is Th2 function. Cell intrinsic as well as environmental influences may contribute to Th2 skewing in neonates.     

The paradigm of Th1 and Th2 cytokines

In the past few years, considerable evidence has accumulated to suggest the existence of functionally polarized responses by the CD4⁺ T helper (Th)—and the CD8⁺ T cytotoxic (Tc)—cell subsets that depend on the cytokines they produce. The Th1 and Th2 cellular immune response provide a useful model for explaining not only the different types of protection, but also the pathogenic mechanisms of several immunopathological disorders. The factors responsible for the polarization of specific immune response into a predominant Th1 or Th2 profile have been extensively investigated in mice and humans. Evidence has accumulated from animal models to suggest that Th1type lymphokines are involved in the genesis of organ-specific autoimmune diseases, such as experimental autoimmune uveitis, experimental allergic encephalomyelitis, or insulin-dependent diabetes mellitus. Accordingly, data so far available in human diseases favor a prevalent Th1 lymphokine profile in target organs of patients with organ-specific autoimmunity. By contrast, Th2-cell predominance was found in the skin of patients with chronic graft-versus host disease, progressive systemic sclerosis, systemic lupus erythematosus, and allergic diseases. The Th1/Th2 concept suggests that modulation of relative contribution of Th1 or Th2-type cytokines regulate the balance between protection and immunopathology, as well as the development and/or the severity of some immunologie disorders. In this review, we have discussed the paradigm of Th1 and Th2 cytokines in relation to autoimmunity and allergy.     

Development of neonatal Th1/Th2 function

Newborn animals generally mount poor T cell-mediated immune responses in vivo. As a result, neonates fall prey to infectious agents and diseases which have little impact on immunocompetent adult animals. For some time, it was believed that this phenomenon was due to an intrinsic inability of newborns to mount developmentally mature Th1 responses. Recent studies in mice have challenged that view; under certain conditions, adult-level Th1 function has been achieved in newborns. More often, however, neonates develop Th2-dominant responses. A major challenge in the field of developmental immunology is to understand why the 'default' response for neonates is Th2 function. Cell intrinsic as well as environmental influences may contribute to Th2 skewing in neonates.     

Th细胞及其分化调节

幼稚CD4^＋T细胞可分化为Th1和Th2细胞，Th1主要产生IL-2、IFN-γ、TNF，增强吞噬细胞介导的抗感染机制，促进细胞免疫，也在器官特异性自身免疫疾病中起作用；Th2细胞主要产生IL-4、IL-5、IL-10、IL-13，促进B细胞增殖、分化和产生抗体，增强B细胞介导的体液免疫应答，在变态反应和机体抗寄生虫免疫中发挥作用。Th细胞分化主要由局部环境中的细胞因子及细胞内关键转录因子调控。转录因子STAT1、STAT4、IRF1和T—bet促使Th1细胞分化；转录因子STAT6、IRF4和GATA-3促使Th2细胞分化。