炎症性肠病患者淋巴毒素α,白介素1受体拮抗剂基因多态性与肿瘤坏死…

测定中国炎症性肠病患者淋巴毒素α基因和白介素１受估拮抗剂基因多态性与肿瘤坏死因子α、可溶性白介素２受体以及白介素６产量的关系。２２例炎症 肠病患者（２０例溃疡性结肠炎，２例克隆病）和１０例健康对照者参加研究，淋巴毒素α基因和白介素１受体拮抗日且ＤＮＡＰＣＲ扩增而来，采用ＥＬＩＳＡ法测定周围血单个核细胞肿瘤坏死因子α，可溶性白介素２受体以及白介素６产量。结果：炎症性肠病淋巴毒素，α基因型１和２杂合子     

咪唑克生拮抗异丙肾上腺素对小鼠小肠运动的抑制

为了解去甲肾上腺素对小肠运动的抑制是否是因激动α２受体所致，试验了肾上腺素受体激动剂和拮抗剂对小鼠小肠转运印度墨汁的影响。药物均皮下注射。结果：α、β受体激动剂ＮＥ４ｍｇ／ｋｇ，β受体激动剂异丙肾上腺素（ＩＳＯ）１０ｍｇ／ｋｇ和α２受体激动剂噻拉嗪１．５ｍｇ／ｋｇ均抑制小肠运动；α２受体激动剂去氧肾上腺素１０ｍｇ／ｋｇ，甲氧明１０ｍｇ／ｋｇ，β１受体激动剂沙丁胺醇１０ｍｇ／ｋｇ皆无影响。ＮＥ和ＩＳＯ的这一作用被α２受体拮抗剂咪唑克生１ｍｇ／ｋｇ拮抗，而不被α１受体激动剂哌唑嗪１ｍｇ／ｋｇ和β受体拮抗剂普萘洛尔１０ｍｇ／ｋｇ拮抗。这提示，无论是ＮＥ或ＩＳＯ，都是作用于α２受体抑制小肠运动。     

Graves病患者血清可溶性白介素2受体的探讨

对２８例Ｇｒａｖｅｓ病的可溶性白介素２受体（ｓＩＬ２Ｒ）和各种甲状腺激素以及甲状腺自身抗体治疗前后比较，并进行逐步回归，结果表明：治疗后Ｇｒａｖｅｓ病患者除ＴＳＨ外，各种甲状腺激素及甲状腺自身抗体显著降低（Ｐ＜００１），并对ｓＩＬ２Ｒ的上升与下降呈显著相关。     

心脏移植受者IL—2,sIL—2R及TNF—α的动态观察

动态检测了１例接受同种异休心脏移体受者血清中溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）水平及末梢血淋巴细胞培养上清中的白细胞介素－２（ＩＬ－２）、肿瘤坏死因子－α（ＴＮＦ－α）的生物活性。结果表明，某些细胞因子及细胞因子受体与移植排斥反应有关。     

病毒性脑炎患者血清及脑脊液中可溶性白介素Ⅱ受体的水平

病毒性脑炎患者血清及脑脊液中可溶性白介素Ⅱ受体的水平邓艳春吴保仁杨毅宁粟秀初（第四军医大学西京医院神经内科西安７１００３３）关键词病毒性脑炎白介素Ⅱ脑脊液中图号Ｒ４４６．６２有文献报道［１］，一些病毒感染性疾病患者血清中可溶性白介素Ⅱ受体（ｓＩＬ－２...     

慢性乙型肝炎病毒感染者血清SICAM—1,TNFα,IL—6肝脏损伤的？…

目的：了解ＨＢＶ感染血清可溶性细胞粘附分子－１、肿瘤坏死因子α和细胞介素－６水平与肝细胞损伤的关系。方法：以ＥＬＩＳＡ法检测慢性乙型肝炎、肝硬化、慢性无症状ＨＢＶ携带和正常人血清可溶性细胞粘附分子－１、肿瘤坏死因子α、白细胞介素－６水平,并比较血清ＡＬＴ变化。结果：慢性乙直炎患和肝硬化患血甭可溶性细胞粘附分子－１、肿瘤坏死因子α、白细胞介素－６水平升高,并与ＡＬＴ升高成正比,而正常人和慢笥     

充血性心力衰竭患者血清肿瘤坏死因子、白介素-6及其受体水平的研究

测定了８６例充血性心力衰竭患者及３０例正常对照组的血清肿瘤坏死因子（ＴＮＦα）、白介素－６（ＩＬ－６）及其受体水平。结果表明，充血性心力衰竭患者血清ＴＮＦα、ＩＬ－６及其受体水平较正常对照组明显升高（Ｐ＜０．００１），且随着心功能的恶化逐渐升高，心功能Ⅰ～Ⅳ级各亚组间差别有显著性（Ｐ＜０．０１），提示具有生物活性的细胞因子在充血性心力衰竭的发病机制中起重要作用。     

肺心病急性发作期细胞免疫的变化

为了研究肺心病急性发作期细胞免疫的变化，对４０例肺心病急性发作期除测定血气分析外，测定血中肿瘤坏死因子，白细胞介素，可溶性白介素－２受体及Ｔ淋巴细胞因子，并与１０名正常人进行同样指标测定以作对照。经常规治疗后，再测定病人的血气分析与血中各项指标进行治疗前后比较。     

IL-12对炎症性肠病患者外周血和肠黏膜固有层淋巴细胞激活和炎症介质分泌的影响

目的:探讨IL-12对炎症性肠病患者外周血和肠黏膜固有层淋巴细胞激活和炎症介质分泌的影响。方法:收集并分离15例克罗恩病、21例溃疡性结肠炎和13例结肠镜检正常者(对照)外周血单个核细胞(PBMC)及肠黏膜固有层单个核细胞(LPMC),体外培养并用IL-12刺激,培养12h、24h、48h后,用流式细胞仪测PBMC或LPMCCD69表达情况;培养48h后,收集细胞培养上清液并用ELISA检测干扰素(IFN)-γ、IL-2和肿瘤坏死因子(TNF)-α的水平。结果:IL-12刺激后炎症性肠病患者外周血T细胞表达高水平的CD69。克罗恩病患者的PBMC和LPMCCD69表达水平及IFN-γ、IL-2和TNF-α分泌水平较溃疡性结肠炎和对照者明显增高(P<0.05)。结论:IL-12能直接刺激炎症性肠病患者外周血和肠黏膜固有层淋巴细胞激活,并产生大量促炎症介质。     

细胞因子及受体在多发性硬化发病中的作用

随着分子免疫学进展,细胞因子及受体在多发硬化（ＭＳ）免疫发病中的作用受到人们广泛的关注。为了解可溶性白细胞介素２受体（ｓＩＬ２Ｒ）、膜白细胞介素２受体（ｍＩＬ２Ｒ）及肿瘤坏死因子α（ＴＮＦα）在ＭＳ发病机制中的作用,我们对４８例确诊为ＭＳ患者血...     

Listeria meningitis complicating a patient with ulcerative colitis on concomitant infliximab and hydrocortisone

Infliximab, a monoclonal antibody directed against tumour necrosis factor, is an effective therapy for moderate-to-severe ulcerative colitis and Crohn’s disease. Uncommonly, serious opportunistic infections have occurred in patients after infliximab administration. Here, we describe meningitis caused by Listeria monocytogenes developing in a 37-year-old man with ulcerative colitis refractory to intravenous corticosteroids 10 days after receiving his first infusion of infliximab. With the increasing use of tumour necrosis factor-α-neutralizing agents, clinicians should be aware of the risk of opportunistic infections caused by L. monocytogenes in patients with inflammatory bowel disease following infliximab treatment. The half-life of infliximab is 9.5 days; therefore, patients tend to be more susceptible in the immediate period following infusion. Patients receiving anti-TNF therapy should be advised to avoid foods such as soft cheeses and unpasteurized dairy products.     

Soluble adhesion molecules in inflammatory bowel disease

Background

Soluble adhesion molecules are elevated in a number of inflammatory conditions.

Aims

To investigate the correlation of soluble intercellular adhesion molecule-1 (sICAM-1) and sE-selectin with the activity of inflammatory bowel disease (IBD).

Methods

sICAM-1 and sE-selectin were measured by an enzyme-linked immunosorbent assay (ELISA) in 53 patients with ulcerative colitis (UC) and 38 patients with Crohn’s disease (CD).

Results

Patients with active UC and CD had significantly higher sICAM-1 than patients with inactive disease and controls. Paients with pancolitis had significantly higher levels than patients with distal colitis. There was a significant difference in sE-selectin levels between paients with acive CD and control sICAM-1. sE-seiectin did not correlate with the Harvey Bradshaw index (HBI). C-reactive protein (CRP) and microalbuminuria were better markers than sICAM-1 or sE-selectin which correlated with serum tumour necrosis factor (TNF)-α.

Conclusion

sICAM-1 and sE-selecin are elevated in the serum of paients with IBD but CRP and microalbuminuria reflect clinical disease activity more accurately. This study does not support the routine use of soluble adhesion molecules as disease activity markers in IBD.     

炎症性肠病相关基因研究进展

炎症性肠病包括溃疡性结肠炎和克罗恩病,是一组病因未明的非特异性慢性肠道炎症性疾病,近年来发病呈上升趋势。越来越多的研究显示,相关基因的多态性在炎症性肠病的发病中起重要作用。很多文章从遗传学的角度讨论了与IBD有关的几组易感基因,如NOD2基因、白细胞介素相关基因、HLA基因、肿瘤坏死因子基因,以及近期内才被认为和IBD相关的MDR1(ABCB)基因、MY09B基因。     

血清sIL─2R水平变化与免疫相关性疾病的关系

对１７６例肿瘤或自身免疫性疾病患者及１５６例正常人血清可溶性白细胞介素Ⅱ受体（ｓＩＬ－２Ｒ）含量进行测定。结果表明，血清ｓＩＬ－２Ｒ水平的改变与器官移植排斥反应的发生，与肿瘤、肾病综合征或喘息性支气管炎等自身免疫性疾病的发生、发展都有相关性。血清ｓＩＬ－２Ｒ可以作为衡量机体免疫状态的辅助指标。     

重度溃疡性结肠炎合并卡波西肉瘤1例并文献综述

卡波西肉瘤是与人类疱疹病毒-8感染相关的血管增生性疾病,多见于免疫功能低下的人群,服用免疫抑制剂或糖皮质激素可能是导致人类免疫缺陷病毒阴性患者发生卡波西肉瘤的原因之一.本文报告1例接受糖皮质激素治疗的重度溃疡性结肠炎患者发生的皮肤卡波西肉瘤,并进行文献综述.患者男性,64岁,诊断溃疡性结肠炎1年,因重度溃疡性结肠炎发作接受激素治疗,4个多月后患者躯干,四肢出现多发暗紫色丘疹,结节,质地坚硬,下肢为著,经皮肤组织活检病理学检查提示皮肤卡波西肉瘤,免疫组织化学检测显示人类疱疹病毒-8染色阳性,经停用糖皮质激素,并行化疗后病情缓解.分别在万方数据知识服务平台和中国知网以"卡波西肉瘤"和"炎症性肠病"为检索词检索相关文献,未检索到中文文献.在PubMed上以("ulcerative colitis" OR "Crohn's disease" OR "inflammatory bowel disease") AND (Kaposi sarcoma)为检索词检索,共检索到38篇英文文献,另从相关文献中补充,共检索到25例与炎症性肠病相关的卡波西肉瘤,连同本例的26例患者中,男性占绝大多数(80.8%,21/26).平均年龄(51.1±16.4)岁,溃疡性结肠炎20例,克罗恩病6例.22例患者报告了人类免疫缺陷病毒检测结果,均为阴性.所有患者均使用过至少一种免疫功能调节剂,包括糖皮质激素,硫唑嘌呤/6-巯基嘌呤,氨甲喋呤,环孢菌素,抗肿瘤坏死因子α单克隆抗体.14例报告人疱疹病毒-8结果的患者中,13例阳性,1例阴性.病变单纯累及肠道者18例,单纯累及皮肤者3例,5例患者同时累及皮肤和肠道.25例报告了治疗方案,其中3例患者仅停用免疫调节剂,1例患者停药后接受放疗,1例患者停药后接受化疗,20例患者接受手术治疗,总体而言预后良好.炎症性肠病相关的卡波西肉瘤往往与使用激素,免疫抑制剂和生物制剂有关.鉴别卡波西肉瘤,炎症性肠病相关和药物相关的皮肤表现至关重要.此外,在诊疗过程中重视多学科团队的协同作用,能够更早,更准确地对少见病例做出诊断和治疗.     

重度溃疡性结肠炎合并卡波西肉瘤1例并文献综述

卡波西肉瘤是与人类疱疹病毒-8感染相关的血管增生性疾病,多见于免疫功能低下的人群,服用免疫抑制剂或糖皮质激素可能是导致人类免疫缺陷病毒阴性患者发生卡波西肉瘤的原因之一.本文报告1例接受糖皮质激素治疗的重度溃疡性结肠炎患者发生的皮肤卡波西肉瘤,并进行文献综述.患者男性,64岁,诊断溃疡性结肠炎1年,因重度溃疡性结肠炎发作接受激素治疗,4个多月后患者躯干,四肢出现多发暗紫色丘疹,结节,质地坚硬,下肢为著,经皮肤组织活检病理学检查提示皮肤卡波西肉瘤,免疫组织化学检测显示人类疱疹病毒-8染色阳性,经停用糖皮质激素,并行化疗后病情缓解.分别在万方数据知识服务平台和中国知网以"卡波西肉瘤"和"炎症性肠病"为检索词检索相关文献,未检索到中文文献.在PubMed上以("ulcerative colitis" OR "Crohn's disease" OR "inflammatory bowel disease") AND (Kaposi sarcoma)为检索词检索,共检索到38篇英文文献,另从相关文献中补充,共检索到25例与炎症性肠病相关的卡波西肉瘤,连同本例的26例患者中,男性占绝大多数(80.8%,21/26).平均年龄(51.1±16.4)岁,溃疡性结肠炎20例,克罗恩病6例.22例患者报告了人类免疫缺陷病毒检测结果,均为阴性.所有患者均使用过至少一种免疫功能调节剂,包括糖皮质激素,硫唑嘌呤/6-巯基嘌呤,氨甲喋呤,环孢菌素,抗肿瘤坏死因子α单克隆抗体.14例报告人疱疹病毒-8结果的患者中,13例阳性,1例阴性.病变单纯累及肠道者18例,单纯累及皮肤者3例,5例患者同时累及皮肤和肠道.25例报告了治疗方案,其中3例患者仅停用免疫调节剂,1例患者停药后接受放疗,1例患者停药后接受化疗,20例患者接受手术治疗,总体而言预后良好.炎症性肠病相关的卡波西肉瘤往往与使用激素,免疫抑制剂和生物制剂有关.鉴别卡波西肉瘤,炎症性肠病相关和药物相关的皮肤表现至关重要.此外,在诊疗过程中重视多学科团队的协同作用,能够更早,更准确地对少见病例做出诊断和治疗.     

白头翁汤干预溃疡性结肠炎中性粒细胞凋亡、IL-8研究

目的通过观察白头翁汤对溃疡性结肠炎患者血中性粒细胞凋亡及血清IL-8的变化,探讨白头翁汤干预溃结的效应机制。方法采用自身前后历史对照设计,30例符合纳入标准、诊断标准及排除标准的溃结患者,均予白头翁汤治疗4周。应用AnnexinV法检测治疗前后血中性粒细胞凋亡率变化,应用ELISA法检测治疗前后血清IL-8的变化。结果溃结患者以中性粒细胞凋亡延迟及血清IL-8的大量释放为特征,经予白头翁汤治疗后,溃结患者出现中性粒细胞凋亡率上升、血清IL-8水平下降,进行统计学比较,差异有统计学意义（P〈0.05）。结论白头翁可能通过诱导中性粒细胞凋亡,调节IL-8的释放,减少中性粒细胞向炎症部位趋化,达到缓解溃结的效应。     

Relative incidence of Crohn's disease and ulcerative colitis in six Melbourne hospitals

Information on the relative incidence of Crohn's disease and ulcerative colitis was obtained by a prospective investigation at six Melbourne teaching hospitals. One hundred and eleven patients who presented with chronic inflammatory bowel diseases between 1980-1981 were admitted to the study. Forty (36%) patients were diagnosed as having Crohn's disease and 63 (57%) patients as having ulcerative colitis. The type of chronic inflammatory bowel disease could not be determined in eight (7%) patients. These findings suggest that the relative frequency of Crohn's disease and ulcerative colitis in Melbourne hospitals is within the range that is reported for northern Europe and the United States.     

Association between the promoter polymorphism T/C at position -159 of the CD14 gene and anti-inflammatory therapy in patients with inflammatory bowel disease

Immune response to intestinal bacteria and genetic predisposition seem to play a crucial role in the pathogenesis of inflammatory bowel disease. A single nucleotide polymorphism in the promoter of the lipopolysaccharide-receptor CD14 gene (T/C at position -159) has recently been described. To evaluate the role of the CD14 gene in anti-inflammatory therapy, the functionally relevant T(-159)-->C promoter polymorphism has been genotyped in 72 patients with inflammatory bowel disease and associated with the cumulative steroid dose. Cumulative corticosteroid dose was significantly higher in ulcerative colitis patients with the TT genotype (2447.7 +/- 927.0 mg/yr) compared with the CT genotype (142.3 +/- 142.3 mg/yr, p=0.016) and the CC genotype (391.7 +/- 272.7 mg/yr, p=0.047). In contrast, in patients with Crohn's disease there was no significant difference of the cumulative corticosteroid doses between the various T(-159)-->C promoter CD14 genotypes. An altered immune response to lipopolysaccharides with influence on the anti-inflammatory therapy seems to play a role in the genetic predisposition to ulcerative colitis. Genetic stratification will lead to the development of individualized therapies in inflammatory bowel disease.     

自噬体基因ATG16L1多态性与炎症性肠病的相关性研究

目的 检测炎症性肠病(IBD)患者ATG16L1基因单核苷酸多态性(SNP)位点rs2241880的等位基因多态性与IBD易感性间的关系.方法 抽取80例IBD患者,其中40例克罗恩病(CD)患者、40例溃疡性结肠炎(UC)患者,50例健康者外周静脉血并提取DNA,根据目的 基因片断设计特异性引物,并应用PCR方法 扩增DNA样本中的目的 基因片断.并对扩增的目的 基因片断进行测序,其测序结果与正常序列进行比较并分析等位基因的多态性与疾病易感性之间的相关性.结果 CD和UC患者与正常对照组之间ATG16L1基因SNP位点rs2241880的等位基凼多态性之间无明显差异(X2=4.94,P=0.293).结论 国外文献报道的与CD相关的易感基因ATG16L1的多态性位点rs2241880,在本组CD患者中并未发现与CD易感性相关,国外发现的与CD易感性相关的ATG16L1基因的SNP位点可能不是中国CD患者的易感性基因位点.