Specific immunotherapeutic strategy for myasthenia gravis: targeted antigen-presenting cells

The pathogenesis of myasthenia gravis (MG) involves a T cell-dependent antibody-mediated autoimmune response directed against acetylcholine receptors (AChR). Inactivation of AChR-specific T cells should interrupt the immune response, resulting in therapeutic benefit. Since each individual's repertoire of T cells responds to a heterogeneous and unique spectrum of AChR epitopes presented in association with self-major histocompatibility complex (MHC) class II, an individualized approach is required to target all relevant AChR-specific T cells. The individual's own antigen-presenting cells (APC) can be used for this purpose, since they process and present the antigen appropriately, and express the correct MHC class II. A novel method of binding AChR to surface immunoglobulin with a heterobifunctional antibody conjugate allows us to use all B cells as APC. Conjugate-plus-AChR-treated B cells (AChR-APC) effectively targeted AChR-specific T cells, stimulating vigorous proliferative responses in a rat cell culture system. If APCs are 'fixed' with cross-linking reagents, they induce long-lasting or permanent 'anergy' of the specific T cells. We prepared AChR-APC, allowed them to process AChR in vitro, and fixed them with paraformaldehyde. Pre-culture of these fixed AChR-APC with AChR-specific T cells induced anergy: when restimulated with fresh AChR-APC, the T cells exhibited markedly reduced proliferative responses and IL-2 production, compared with responses of T cells pre-cultured with control fixed B cells. Implications for the design of antigen-specific therapeutic strategies for MG and other immune disorders will be discussed.     

病毒性脑炎患者S-100b蛋白浓度与临床的相关性

目的 观察病毒性脑炎急性和恢复期患者血液和脑脊液的S-100b蛋白浓度变化，探讨其与异常脑电图和影像学低密度灶体积等方面的相关性。方法 42例病毒性脑炎住院患者为观察组，25例与观察组相匹配的阑尾或胆囊摘除手术病人以及健康体检者为对照组，采用双抗体夹心ELISA法，检测其血液及脑脊液100b蛋白浓度；并应用SPSS10．0统计软件包进行统计学分析。结果病毒性脑炎急性期患者血液和脑脊液S-100b蛋白显著高于恢复期患者和对照组（P〈0．01）；血液和脑脊液S-100b蛋白浓度与低密度灶体积均呈显著正相关（rCSF=0．756，P〈0．01；r血液=0．685，P〈0．01）；轻度、中度及重度异常脑电图患者脑脊液S-100b蛋白浓度均高于血液（P〈0．01）；重度、中度异常脑电图患者血液及脑脊液S-100b蛋白浓度均高于轻度（P〈0．01）。结论脑脊液或血液中的S-100b蛋白浓度反映了神经胶质细胞的损害程度，也是脑组织破坏后较合适的生化标记物，对监测病毒性脑炎患者的病情变化和疗效观察具有重要价值。     

流行性乙型脑炎病毒结构蛋白编码基因的重组构建

目的:建立流行性乙型脑炎病毒(JEV)C、prME,E等结构蛋白编码基因克隆.方法:病毒感染C6/36细胞,RT-PCR法依次获取该病毒结构蛋白基因并进行DNA测序分析,PCR克隆法将PCR产物分别构建于真核表达载体pcDNA 3.1的BamHI与EcoRI酶切位点并依次命名为pJC、pJME与pJE,通过DNA测序、电泳以及限制性内切酶分析加以鉴定.结果:JEV C、prME与E基因片段分别为380、2001以及1 500bp,各基因测序结果与发表的JEV JaGAr-01株相对应序列相一致,从重组质粒释出的插入子分别与各基因大小相符合.结论:pJC、pJME与pJE重组质粒分别含有C、prME与E蛋白编码基因.     

Fatal encephalitis in a patient with refractory celiac disease presenting with myorhythmia and carpal spasm.

We report the case of a woman with refractory celiac disease who developed abnormal spontaneous movements of the extremities and face consistent with myorhythmia. Investigation led to a diagnosis of encephalitis, confirmed by postmortem examination. The movements were likely caused by nonparaneoplastic encephalitis associated with refractory celiac disease. Etiologic and diagnostic considerations and treatment options are discussed.     

预防接种与自身免疫病的关系

感染与自身免疫性疾病之间的联系已引出一场争论 :疫苗是否也能激发自身免疫性疾病。有关这种风险有众多正反两方面的主张。在此复习感染诱导自身免疫病的相关机制 ,并对预防接种和自身免疫病之间的相对危险度进行评估。     

原发性胆汁性肝硬化-自身免疫性肝炎重叠综合征患者的临床分析

目的了解原发性胆汁性肝硬化(PBC)-自身免疫性肝炎(AIH)重叠综合征在PBC患者中的发生率及临床特点。方法对123例PBC患者的临床及病理资料进行回顾性的分析,根据国际自身免疫性肝炎小组修订的诊断标准,筛选出6例PBC-AIH重叠综合征患者,并分析其临床及病理特点。结果123例PBC患者中有6例按国际自身免疫性肝炎小组评分诊断标准积分≥10,PBC-AIH重叠综合征在PBC患者中的发生率为4.8%;6例患者中有4例伴发其他自身免疫性疾病;6例患者的实验室检查兼具有PBC(ALP、GGT、IgM升高)及AIH(ALT、AST、IgG升高)的特点,同时伴有多钟自身抗体阳性,病理表现上有不同程度的碎屑样坏死及胆小管受累。结论PBC-AIH重叠综合征并非罕见,应根据患者的临床表现及病理特征做出及时的诊断。     

Immunoadjuvant action of liposomes for entrapped Japanese Encephalitis virus E－glucoprotein

ＩｍｍｕｎｏａｄｊｕｖａｎｔａｃｔｉｏｎｏｆｌｉｐｏｓｏｍｅｓｆｏｒｅｎｔｒａｐｐｅｄＪａｐａｎｅｓｅＥｎｃｅｐｈａｌｉｔｉｓｖｉｒｕｓＥ－ｇｌｕｃｏｐｒｏｔｅｉｎ￥ＨｕＪｕｎ（胡军）；ＭａＷｅｎｙｕ（马文煜）；ＨｕａｎｇＱｉｎｇｓｈｅｎｇ（黄庆生）...     

Non–rabies Lyssavirus human encephalitis from fruit bats: Australian bat Lyssavirus (pteropid Lyssavirus) infection

A 39-year-old woman died of encephalitis a few weeks after being scratched by fruit bats. Autopsy disclosed meningoencephalomyelitis, and revealed neuronal intracytoplasmic inclusions which had similarities to Negri bodies of rabies. Laboratory investigations detected a Lyssavirus type previously identified only in fruit bats. This appears to be the first human case of encephalitis due to this Lyssavirus type.