iNOS和OPN在EAE中动态表达及依达拉奉保护作用研究

目的研究诱导型一氧化氮合酶(iNOS)和骨桥蛋白(OPN)在实验性自身免疫性脑脊髓炎(EAE)中的动态表达以及依达拉奉治疗和保护作用机制的探讨。方法将EAE大鼠随机分为实验组和依达拉奉治疗组,根据发病时间又分为发病前组、高峰期组和缓解期组。光镜下观察脊髓HE染色炎性细胞浸润情况,观察免疫组化染色iNOS和OPN阳性细胞数目。结果依达拉奉治疗组与实验组比较,发病时间延迟、发病率降低及神经功能评分减低(P<0.05)。依达拉奉治疗组脊髓炎症细胞浸润较实验组减少。免疫组化染色iNOS和OPN阳性细胞在EAE发病前期上升,高峰期达到峰值,缓解期随疾病好转而下降,依达拉奉组均较同时期实验组阳性细胞表达数目减少(P<0.05)。结论依达拉奉可以减轻EAE大鼠临床发病程度和病理炎症损害,并降低不同发病时期iNOS和OPN表达程度。推测依达拉奉通过抗氧化和抗炎的双重机制发挥神经保护作用。     

EAE大鼠胸腺CD4~+ CD25~+ Foxp3~+ Treg细胞的动态变化及α-硫辛酸的干预作用

目的探讨实验性变态反应性脑脊髓炎(EAE)大鼠不同病程中胸腺CD4+CD25+Foxp3+Treg细胞变化情况及α-硫辛酸对EAE大鼠胸腺的干预作用。方法取不同时期对照组、自然病程EAE组及α-硫辛酸EAE组大鼠的胸腺组织做流式细胞学,动态检测CD4+CD25+Foxp3+Treg细胞的变化情况。结果 EAE组大鼠急性期、复发期CD4+CD25+Foxp3+Treg细胞较同时期对照组明显减少(P<0.05),缓解期有所上升;α-硫辛酸组与同期EAE组相比CD4+CD25+Foxp3+Treg细胞无明显变化;半年期三组大鼠胸腺CD4+CD25+Foxp3+Treg细胞都明显下降,各组间无统计学差异。结论 CD4+CD25+Foxp3+Treg细胞参与了EAE的发病,与病程的发展密切相关;α-硫辛酸对EAE大鼠的干预作用并非通过CD4+CD25+Foxp3+Treg细胞发挥其治疗作用;随着年龄的增长,胸腺不再是机体的主要免疫器官。     

二甲双胍通过调节Treg细胞反应治疗实验性自身免疫性脑脊髓炎

目的给予实验性自身免疫性脑脊髓炎(EAE)小鼠应用二甲双胍(MET)干预性治疗。观察MET对EAE小鼠发病情况及体内Treg细胞反应的作用。方法将雌性C57BL/6小鼠随机分为正常对照组、EAE模型组和MET治疗组,采用髓鞘少突胶质细胞糖蛋白MOG35-55免疫小鼠建立EAE模型。自身免疫后第1天开始,按100mg·kg~(-1)·d~(-1)给予MET治疗组腹腔注射。正常对照组及EAE模型组小鼠给予等量的生理盐水每日腹腔注射作为对照。应用Knoz评分观察小鼠的神经功能评分,流式细胞学检测方法检测小鼠脾细胞中Treg细胞比例,ELISA方法检测脾细胞培养上清及血清中IL-10、TGF-β含量。qPCR方法检测小鼠脾及脊髓中Treg细胞转录因子Foxp3 mRNA表达水平。结果与EAE模型组相比,MET治疗组发病程度减轻(P0.01);脾细胞中Treg细胞比例增高(P0.01),脾细胞培养上清及血清中IL-10、TGF-β含量增加(P0.01);脾组织中Foxp3mRNA表达水平升高(P0.01);脊髓组织中Foxp3mRNA表达水平升高(P0.01)。结论 MET通过提高外周免疫器官及中枢神经系统的Treg细胞数量,增加抑制炎症因子的表达而达到对EAE模型小鼠的保护作用。     

雌二醇对实验性自身免疫性脑脊髓炎调节性T细胞及细胞因子的影响

目的 探讨雌二醇(E2)对实验性自身免疫性脑脊髓炎(EAE)大鼠调节性T细胞及细胞因子的影响.方法 将大鼠随机分为E2干预组和EAE对照组,记录其临床评分, 测定外周血CD4+CD25+、CD4+CD25+Foxp3+ T细胞水平以及TNF-α、IL-12表达水平,并观察腰膨大处炎细胞浸润情况.结果 (1)E2干预组发病率仅为30% ,低于EAE对照组(100%), 且发病高峰延迟;临床评分E2干预组[(1.8±1.3)分]比EAE对照组[(3.4±0.5)分]低, 差异有统计学意义(P<0.05);(2)E2干预组CD4+CD25+/CD4+ T细胞比值 (5.6±0.9)、CD4+CD25+Foxp3+/CD4+CD25+ T细胞比值(9.3±1.0)均高于EAE对照组[分别为(4.4±0.9)与(7.6±0.8)], 差异有统计学意义(均P<0.05);(3)血管"套袖"样改变EAE对照组较E2干预组明显;(4)E2干预组TNF-α及IL-12表达明显低于EAE对照组, 差异有统计学意义(均P<0.05).结论 E2可能通过改变调节性T细胞比例及细胞因子表达参与EAE免疫调节过程, 推测EAE临床症状缓解可能也与此机制相关.     

依达拉奉对大鼠急性脊髓损伤后神经细胞凋亡的影响

目的:观察依达拉奉对大鼠急性脊髓损伤后细胞凋亡的影响,探讨脊髓保护的作用机制。方法:120只SD雄性大鼠,Allen法建立脊髓损伤模型,随机分为依达拉奉组、假手术组和对照组（均n=40）。依达拉奉组给予依达拉奉10mg·kg^-1,每日2次腹腔注射,连续6d;对照组给予等量同次数的生理盐水腹腔灌注;假手术组仅行椎板切除,不损伤脊髓,不给药。在伤后第1、7、14、28天观察各组大鼠活动情况行BBB评分,取受伤脊髓节段检测抑制羟自由基能力、caspase-3蛋白表达、原位脱氧糖核苷酸末端转移酶介导的原位末端标记法（TUNEL法）标记凋亡细胞。结果:依达拉奉组抑制羟自由基能力明显高于假手术组和对照组（P<0.05）;依达拉奉组caspase-3与对照组比各时间点的表达明显降低（P<0.05）;依达拉奉组与对照组比各时间点凋亡细胞显著减少（P<0.05）。结论:依达拉奉能减少急性脊髓损伤部位的羟自由基,下调caspase-3表达,抑制脊髓神经细胞凋亡,对继发性脊髓损伤有保护作用。     

依达拉奉对脊髓缺血再灌注损伤后自由基及Oaspase-3表达的影响

目的探讨自由基清除剂依达拉奉对脊髓缺血再灌注损伤后自由基及Caspase-3蛋白表达的影响。方法采用腹主动脉夹闭法将3（）只家兔制作成脊髓缺血再灌注损伤模型,并随机分为2组,用腹腔注射法给予依达拉奉组注射依达拉奉,空白对照组注射生理盐水,共14d,检测家兔血清自由基（MDA、SOD、NO）水平的变化,采用病理及免疫组织化学方法评估脊髓损伤的病理变化以及Caspase-3表达情况,治疗结束后采用Jacobs法对家兔后肢运动功能评分。结果治疗后依达拉奉组家兔血清MDA、SOD、NO水平显著低于对照组,脊髓病理学也进一证实依达拉奉组脊髓损伤程度较对照组轻微,且损伤节段脊髓组织Caspase-3蛋白的表达水平明显低于对照组,依达拉奉组家兔双下肢Jacobs评分也明显高于对照组。结论依达拉奉能明显降低脊髓损伤后自由基水平,抑制Caspase-3蛋白的表达,可能对脊髓缺血再灌注损伤有保护性作用。     

依达拉奉激活Nrf2通路减轻脑出血后继发性损伤

目的探讨自由基清除剂依达拉奉对大鼠脑出血神经功能与脑水肿的疗效,并通过检测核因子相关因子2（Nrf2）通路及其下游抗氧化酶的表达变化,探索依达拉奉在脑出血中的抗氧化治疗机制。方法采用自体血立体定向注射建立大鼠脑出血模型,依达拉奉干预后24h分别行神经行为学评分及脑含水量测定,并检测Nrf2通路表达变化,脑组织切片行免疫荧光双标染色,判定Nrf2表达的细胞来源。结果依达拉奉干预脑出血大鼠后24h,前肢抬起及前肢对称实验较对照组均明显改善,脑含水量亦明显降低。依达拉奉组Nrf2及其下游抗氧化酶血红素加氧酶1（HO-1）、硫氧还蛋白（TRX）、谷胱甘肽-S-转移酶a1（GST-a1）、醌氧化还原酶1（NQ01）转录水平较对照组明显上调,依达拉奉组Nrf2及HO-1蛋白表达较对照组明显升高。脑组织切片免疫荧光双标染色表明,Nrf2主要在神经元中特异性表达。结论依达拉奉可明显减轻大鼠脑出血后神经功能障碍及脑水肿程度,其机制可能与激活内源性抗氧化系统Nrf2通路发挥对神经元的保护作用有关。     

实验性自身免疫性脑脊髓炎小鼠脑内主要组织相容性复合体Ⅱ类抗原和分化群3ε的变化

目的观察实验性自身免疫性脑脊髓炎(EAE)小鼠脑内主要组织相容性复合体Ⅱ类抗原(MHC-Ⅱ)和分化群3ε(CD3ε)的变化。方法 25只C57BL/6小鼠随机分为EAE组(n=13)和正常对照组(n=12)。应用髓鞘少突胶质细胞糖蛋白35-55抗原诱导小鼠EAE模型。观察记录小鼠行为学变化;采用常规及髓鞘染色方法观察脊髓损伤和炎症细胞浸润程度;荧光定量PCR检测脑MHC-Ⅱ和CD3εmRNA的表达。结果 EAE组小鼠发病后EAE症状评分逐渐增加;脊髓炎症细胞浸润明显;髓鞘脱失较多;脑组织MHC-Ⅱ和CD3εmRNA表达显著高于正常对照组(均P<0.01),并与EAE症状评分呈正相关。结论 EAE小鼠脑内MHC-Ⅱ及CD3εmRNA表达水平增高与其病情严重程度一致。     

补阳还五汤和依达拉奉联用对小鼠急性脑缺血损伤后脑保护机制的研究

目的探讨补阳还五汤和依达拉奉联用对急性脑缺血损伤后神经细胞凋亡及凋亡相关蛋白表达的影响,探讨其可能的脑保护机制。方法将60只小鼠随机分假手术组、模型组、补阳还五汤组、依达拉奉组以及补阳还五汤+依达拉奉组,每组12只。采用改良线栓法制作小鼠大脑中动脉缺血再灌注模型,给予补阳还五汤及依达拉奉药物干预。分别于再灌注后1d和7d,采用TUNEL法观察小鼠脑皮质缺血区神经细胞凋亡率,采用免疫组化方法观察小鼠脑皮质缺血区B淋巴细胞瘤2基因(bcl-2)、bcl-2相关X蛋白(bax)和半胱氨酸蛋白酶3(caspase-3)表达的阳性细胞数。结果与假手术组比较,模型组小鼠脑皮质缺血区凋亡指数升高(P0.01),且bcl-2、bax和caspase-3表达的阳性细胞亦均升高(P0.01);经补阳还五汤和(或)依达拉奉干预后,各药物组小鼠脑组织的凋亡指数及bax和caspase-3阳性细胞均较模型组下降(P0.01),而脑组织bcl-2阳性细胞均较模型组增加(P0.01),且补阳还五汤+依达拉奉联合用药组较单一用药组改变明显(P0.05)。结论补阳还五汤与依达拉奉联用能抑制脑缺血再灌注损伤后脑细胞中促凋亡蛋白bax、caspase-3的表达;促进具有神经元保护作用的bcl-2蛋白的表达,从而抑制神经细胞凋亡,协同发挥脑保护作用。     

抑郁症中糖皮质激素受体与CD4+CD25+调节性T细胞的关系及其所致免疫失衡机制的初步探讨

目的 研究抑郁症患者外周血细胞因子白介素-10(IL-10)、转化生长因子β(TG-β)的变化、CD4+CD25+调节性T细胞(Treg)的数量及其特征性标志叉头样转录因子P3(Foxp3)的表达与糖皮质激素受体(GR)的表达之间的关系,探讨抑郁症患者免疫失衡的可能机制.方法 纳入36例抑郁症患者和36名正常对照,根据Hamilton抑郁量表总分将患者划分为轻、中和重不同抑郁程度组;利用ELISA方法测定受试者外周血血清细胞因子IL-10、TGF-β浓度;逆转录-聚合酶链反应(RT-PCR)检测GR的α及β两种亚型(GRα、GRβ)、Foxp3 mRNA表达水平;免疫磁珠分离CD4+ CD25+ Treg,共聚焦显微镜观察Foxp3与GR在CD4+CD 25+ Treg上的共表达.结果 与正常对照组比较,患者组血清IL-10、TGF-β的水平降低(P＜0.05),外周血CD4+ CD25+ Treg数量及在CD4+T细胞中的比例明显少于对照组(P＜0.01),且重度抑郁组上述指标明显低于中度和轻度抑郁组(P＜0.01).抑郁各组单个核细胞GRamRNA和FoxP3 mRNA表达水平随抑郁程度而降低(P＜0.01),GRβmRNA却在重度抑郁组表达增加.共聚焦显微镜下可观察到重度抑郁患者CD4+CD25+Treg上GR与Foxp3表达显著减少.结论 糖皮质激素受体可能通过影响调节性T细胞的功能和数量在抑郁症患者免疫失衡的病理生理机制中发挥着重要的作用.     

The neuroendocrinology of stress and the pathophysiology and therapy of depression and anxiety

Clinical and preclinical studies have gathered substantial evidence that stress response alterations play a major role in the development of major depression, panic disorder, and post-traumatic stress disorder. The stress response, the hypothalamic pituitary adrenocortical (HPA) system and its modulation by corticotropin-releasing hormones (CRH),corticosteroids,and their receptors, and the roles of natriuretic peptides and neuroactive steroids are described. We review the role of the HPA system in major depression, panic disorder, and post-traumatic stress disorder and its possible relevance for treatment. Impaired glucocorticoid receptor function in major depression is associated with an excessive release of neurohormones such as CRH, to which a number of signs and symptoms characteristic of depression can be ascribed. In panic disorder, a role of central CRH in panic attacks has been suggested. Atrial natriuretic peptide (ANP) is causally involved in sodium lactate-induced panic attacks. Furthermore, preclinical and clinical data on its anxiolytic activity suggest that nonpeptidergic ANP receptor ligands may be potentially useful in the treatment of anxiety disorders. Post-traumatic stress disorder is characterized by a peripheral hyporesponsive HPA system and elevated CRH concentrations in the CSF. This dissociation is probably related to an increased risk of this disorder. We further review recent data that describe an important role of GABA(A)-receptor modulatory,3 alpha-reduced neuroactive steroids in major depression, anxiety, and its treatment. Antidepressants are effective in both depression and anxiety disorders and have major effects on the HPA system,especially on glucocorticoid and mineralocorticoid receptors. Normalization of HPA system abnormalities is a strong predictor of the clinical course, at least in major depression and panic disorder. Currently,CRH-R1 or glucocorticoid receptor antagonists and ANP receptor agonists are being studied and may provide future treatment options more closely related to the pathophysiology of these disorders.     

Polymorphisms of DRD4 and DRD3 and risk of avoidant and obsessive personality traits and disorders

We investigated whether polymorphisms of the dopamine D4 receptor (DRD4) and polymorphisms of the dopamine D3 receptor (DRD3) were associated with personality disorder symptomatology rather than with personality traits such as novelty seeking. DNA was obtained from 145 depressed patients in a clinical trial. These patients were assessed for the presence of personality disorder symptoms and disorders. The 2-repeat allele of the DRD4 exon III polymorphism was associated with increased rates of avoidant and obsessive personality disorder symptomatology. The T,T genotype of the DRD4 -521 C>T polymorphism was also associated with increased rates of avoidant and obsessive personality disorder symptomatology. The Gly9,Gly9 genotype of the DRD3 Ser9Gly polymorphism was associated with increased rates of obsessive personality disorder symptomatology. None of these three polymorphisms were associated with novelty seeking or other temperament traits on the Temperament and Character Inventory. Our results suggest that genetic polymorphisms of DRD4 and DRD3 may well be associated with personality traits, and that conflicting findings to date may arise from the problem of phenotype definition.     

Cultural Identity and Experiences of Prejudice and Discrimination of Afghan and Iranian Immigrant Youth

In culturally diverse and immigrant receiving societies, immigrant youth can be subject to prejudice and discrimination. Such experiences can impact on immigrant youth’s cultural identity and influence their psychosocial outcomes. This paper presents findings of a study that examined cultural identity and experiences of prejudice and discrimination among Afghan (N = 9) and Iranian (N = 17) immigrant youth in Canada. The study had a prospective, comparative, longitudinal qualitative design. Data was gathered through focus groups, interviews, journals and field logs. Four main themes emerged on participants’ experiences of prejudice and discrimination: (a) societal factors influencing prejudice; (b) personal experiences of discrimination; (c) fear of disclosure and silenced cultural identity; and (d) resiliency and strength of cultural identity. Drawing from Rosenberg’s (Conceiving the self, Basic Books, New York, 1979) self-concept framework and Romero and Roberts (J. Adolesc., 21:641–656, 1998) distinction between prejudice and discrimination, results indicated that youth’s extant and presenting cultural identity were affected. Inclusive policies and practices are needed to promote youth integration in multicultural and immigrant receiving settings.

躯体化障碍和未分化躯体形式障碍患者辅助检查项目和费用调查

目的 了解躯体化障碍和未分化躯体形式障碍患者辅助检查项目和费用及其相关因素.方法 对115例躯体化障碍或未分化躯体形式障碍的患者,采用自编既往就诊检查情况调查表、自编躯体症状自评清单、症状自评量表、汉密尔顿焦虑量表和汉密尔顿抑郁量表进行评估.结果 患者就诊前辅助检查总费用为 72～10 948 元(中位数 1 068 元);检查频度为 1 ～ 53 次(中位数9.0次);检查项目数为 1～13 项(中位数6.0项).重复检查频度为 0～44 次(中位数 3 次),重复项目数为 0 ～ 9 项(中位数 2 项).检查频度及重复频度较高的项目为血常规、B超、CT、尿常规、摄片、生化常规、MRI、心电图、粪常规.检查频度与病程、就诊科室数及HAMD总分均呈正相关(P＜0.05),检查总费用与检查频度呈正相关(P＜0.01). 结论躯体化障碍和未分化躯体形式障碍患者辅助检查种类多,重复检查多,应引起重视.     

Modulators and inhibitors of gamma- and beta-secretases

Most gene mutations associated with Alzheimer's disease point to the metabolism of amyloid precursor protein as a potential cause. The beta- and gamma-secretases are two executioners of amyloid precursor protein processing resulting in amyloid-beta. Significant progress has been made in the selective inhibition of both proteases, regardless of structural information for gamma-secretase. Several peptidic and nonpeptidic leads were identified for both targets.     

精神分裂症异质性及其与5—HT,NE相互作用研究

应用高压液相色谱（ＨＰＬＣ）对４２例阳性精神分裂症、２５例阴性精神分裂症和１０例健康正常对照组脑脊液中（ＣＳＦ）５—羟色胺（５—ＨＴ）、５—羟吲哚乙酸（５—ＨＩＡＡ）、去甲肾上腺素（ＮＥ）、３—甲基—４—羟基苯乙二醇（ＭＨＰＧ）进行测试。并以５—ＨＴ／ＮＥ、５—ＨＩＡＡ／ＭＨＰＧ为其相互作用指标，结果发现，阳性精神分裂症ＮＥ、ＭＨＰＧ、５—ＨＩＡＡ／ＭＨＰＧ显著低于正常对照组，而且ＮＥ、５—ＨＩＡＡ显著低于阴性精神分裂症，但是５—ＨＴ／ＮＥ则显著高于阴性精神分裂症。作者就此结果进行了讨论。