结核分支杆菌Ag85B基因在大肠杆菌中的高效表达

目的 通过结核分支杆菌Ag85B蛋白编码基因在大肠杆菌中稳定表达，以获得大量纯化的Ag85B蛋白。方法 采用DNA重组技术构建结核分支杆菌Ag85B基因的表达载体，双酶切和聚合酶链反应(PCR)鉴定重组子，阳性重组子转化大肠杆菌，并诱导表达外源蛋白。十二烷基磺酸钠聚丙烯酰胺凝胶电泳(SDSPAGE)鉴定Ag85B蛋白抗原在大肠杆菌中的表达，对染色的凝胶扫描，以测定目的蛋白表达水平。结果 菌体蛋白经SDSPAGE，含阳性重组质粒的菌体蛋白中出现一条新蛋白带，表达量占菌体总蛋白的33％～38％。Ag85B蛋白抗原在大肠杆菌中表达方式主要是包涵体形式。结论 构建的大肠杆菌重组体能高效表达结核分支杆菌Ag85B蛋白抗原。     

新辅助免疫治疗联合化疗在可手术的非小细胞肺癌的初步疗效评估

背景与目的初步研究证实新辅助免疫联合化疗对可手术非小细胞肺癌近期疗效显著，但国内相关临床试验较少。本研究回顾性分析应用新辅助免疫治疗联合化疗的可手术Ib期-IIIb期非小细胞肺癌的临床病理资料，初步评估新辅助免疫治疗联合化疗的疗效及安全性。方法回顾性分析2019年11月-2020年12月期间于首都医科大学附属北京胸科医院胸外科治疗的临床分期Ib期-IIIb期的非小细胞肺癌患者20例，术前应用免疫联合化疗新辅助治疗，根据影像学和病理学方法分别评估疗效。结果全组患者新辅助治疗后影像学评估疗效，客观有效率（objective response rate, ORR）为85.0%（完全缓解4例，部分缓解13例），疾病稳定1例（5.0%），疾病进展2例（10.0%）。其中17例后续接受手术治疗，16例达到R0（no residual tumor）切除，1例R1（microscopic residual tumor）切除。术后病理评估：主要病理缓解率（major pathologic response, MPR）为47.1%（8/17），其中完全病理缓解率（complete pathologic response, CPR）为29.4%（5/17）。主要不良反应：免疫相关性肺炎（Ⅳ级）1例，Ⅲ级及以上血液学毒性9例（45.0%）。结论新辅助免疫联合化疗对于可手术的非小细胞肺癌近期疗效显著，具有一定的安全性及有效性。但新辅助免疫联合化疗的远期疗效、最佳周期数以及理想预测免疫治疗效果的标记物仍有待研究。     

A multistage-polyepitope vaccine protects against Mycobacterium tuberculosis infection in HLA-DR3 transgenic mice

Mycobacterium tuberculosis (Mtb) is responsible for almost 2 million deaths annually. BCG, currently the only TB vaccine, induces variable protection and does not protect against reactivation of latent TB. Thus, efficient vaccines to supplement BCG are required urgently. Since Mtb's proteome differs qualitatively and quantitatively during bacterial replication stages from that expressed during dormancy, improved TB vaccines should drive immune responses to Mtb antigens expressed during multiple stages of infection. Consequently, such “multistage” vaccines should be composed of (immunodominant) antigens expressed during different phases of Mtb infection. As a concept multistage vaccine, we constructed a polyepitope by fusing five HLA-DR3-restricted T-cell epitopes derived from different Mtb proteins either expressed highly by replicating bacteria (Ag85B, hsp65, 19 kDa lipoprotein), or abundantly expressed by dormant bacilli and recognized preferentially by TST⁺ individuals (hsp16, Rv1733c). PBMC of HLA-DR3⁺ but not HLA-DR3⁻ cured TB patients and TST⁺ individuals responded well to the multistage-polyepitope in vitro. The in vivo immunogenicity and protective efficacy of the multistage-polyepitope were analyzed using HLA-DR3 transgenic mice lacking endogenous murine class II as a model. Immunization with the multistage-polyepitope adjuvanted with CpG generated high IgG levels as well as polyfunctional CD4⁺ T-cells producing IFN-γ, TNF and IL-2, specific for these HLA-DR3-restricted epitopes. Importantly, multistage-polyepitope immunization reduced the number of bacilli in the lungs after Mtb challenge when administered as prophylactic vaccine. Given the extensive repertoire of potential Mtb antigens available for immune recognition, the data of our model demonstrate the potential of multistage-polyepitope vaccines to protect against TB.     

A new TB vaccine, MVA85A, induces durable antigen-specific responses 14 months after vaccination in African infants

This study aimed to evaluate the durability of the immunogenicity of MVA85A beyond infancy. Participants in an immunogenicity study of MVA85A administered at age of 4 months had additional evaluation 14 months after initial vaccination for IFN-γ ELISPOT responses to Ag85A peptide and ESAT6/CFP-10 and tuberculin skin test (TST). 112 children participated in this study. The anthropometry, biochemical and haematological safety profile were similar between the MVA85A recipients and controls. MVA85A recipients still had significantly higher immune responses to Ag85A compared to the controls. The majority of these children had negative responses to the TST as well as the ESAT6/CFP-10 antigens. In summary, MVA85A-vaccinated children had a persistently higher Ag85A immune response 14 months following vaccination than controls. All the children had negligible evidence of latent infection with M. tuberculosis (Mtb), suggesting that deploying a prophylactic vaccine against Mtb infection at this age could still be effective in this setting.     

结核分枝杆菌Ag85B基因体外扩增、克隆及在耻垢分枝杆菌中的表达

目的体外扩增结核杆菌Ag85B基因,构建大肠埃希菌-分枝杆菌穿梭质粒ps3000-Ag85B,并重组耻垢分枝杆菌(Mycobacteriums megmatis mc2155)。方法采用聚合酶链式反应(PCR)方法,体外扩增结核杆菌Ag85B基因,克隆入pGEMT载体;构建亚克隆ps3000-Ag85B大肠埃希菌-分枝杆菌穿梭质粒,电转化方法将有Ag85B基因的穿梭质粒转化到耻垢分枝杆菌中。热诱导此重组耻垢分枝杆菌,用SDS-PAGE电泳观察Ag85B蛋白的表达,Western blot鉴定其生物学活性。结果PCR扩增结核杆菌Ag85B基因片段大小为990bp,构建的穿梭质粒ps3000-Ag85B酶切片段为990bp,与理论值相符。经Western blot检测,该重组耻垢杆菌表达蛋白能被结核病患者血清识别。结论Ag85B重组耻垢分枝杆菌构建成功,为下一步表达Ag85B蛋白的重组BCG(Bacilli Calmette-Guérin)疫苗的研究奠定了基础。     

Outcomes of liver-first strategy and classical strategy for synchronous colorectal liver metastases in Sweden

Background

Patients with synchronous colorectal liver metastases (sCRLM) are increasingly operated with liver resection before resection of the primary cancer. The aim of this study was to compare outcomes in patients following the liver-first strategy and the classical strategy (resection of the bowel first) using prospectively registered data from two nationwide registries.

Ventricular extrasystoles and intracellular electrolytes before and after potassium and magnesium infusions in patients on diuretic treatment.

Thirty-four patients suspected of being magnesium deficient were given intravenous infusions of potassium and magnesium. The muscle contents of sodium, potassium, magnesium, and chloride were determined by atomic absorption spectrophotometry on skeletal muscle samples obtained by percutaneous biopsies. The frequency of ventricular etopic beats (VEBs) was assessed from a 3-hour ECG tape recording before the infusions and after the completion of each infusion. The potassium infusions did not result in any changes in the cellular potassium content, nor in the frequency of VEBs. After the magnesium infusions, however, a significant increase was noted in the cellular potassium content and likewise a significant decrease in the frequency of VEBs. This emphasizes the importance of magnesium in potassium metabolism.