Platelet-binding immunoglobulins in pregnancy-induced hypertension I. Platelet-associated IgM on fetal platelets: evidence of a fetal autoimmune reaction?

Pregnancy-induced hypertension (PIH) can be complicated by maternal or fetal thrombocytopenia, or both. In order to investigate possible immunologic causes of these thrombocytopenias, platelet-associated IgG (PAIgG) and IgM (PAIgM) were measured in mothers with PIH and in their infants and compared with those from patients with autoimmune thrombocytopenic purpura (ATP), a known immunodestructive platelet disorder. Many PIH patients (33.3%) and most ATP patients (68.1%) had elevated levels of maternal PAIgG. In both diseases, the amount of PAIgG was directly proportional with the degree of thrombocytopenia (r = 0.446 in PIH and R = 0.668 for ATP). But in neither disease did the degree of maternal thrombocytopenia correlate with the degree of neonatal thrombocytopenia (r = 0.153 for PIH and R = 0.175 for ATP). Umbilical cord samples from PIH patients contained PAIgG (53.3%) and PAIgM (53.8%), whereas the umbilical cord samples from ATP patients had elevated amounts of PAIgG but not PAIgM. PAIgM in the umbilical cord blood could not be accounted for by IgM rheumatoid factors, IgM-containing immune complexes, or non-specific adsorption because of elevated total IgM levels. The umbilical cord blood PAIgM was probably not of maternal origin because it was observed even when the maternal blood contained no PAIgM and maternal IgM is not normally transported transplacentally. Therefore, the PAIgM appears to be of fetal origin. These results suggest that both maternal and fetal immunologic mechanisms may be involved in PIH-induced thrombocytopenia; if so, this is one of the first reported examples of a possible fetal autoimmune response.     

烧伤后红细胞免疫的变化及意义

对近年来烧伤后红细胞免疫的研究作一综述。     

中西医结合冲击治疗免疫性不孕的临床研究

目的：探讨中西医结合冲击治疗对女性免疫性不孕症病人的治疗效果。方法：应用酶联免疫吸附法（ELISA）对560例病人血清和宫颈粘液中的抗精子抗体（AsAb）、抗子宫内膜抗体（IAEmAb）、抗卵巢抗体（AOVAb、抗人绒毛膜促性腺激素抗体（AhCGAb）进行检测，采用中药，维生素E、维生素C对所有抗体阳性者进行周期性治疗，2个周期为1疗程。结果：560例病人血清中共检测中各种抗体641例例次，宫颈粘液中共检出各抗体596例次。治疗1疗程，AsAb、AEmAb、AOVAb、AhCGAb在血清的转阴率分别为87．4％、85．4％、74．0％、86．5％，在宫颈粘液中的转阴率分别为93．7％、95．0％、87．0％，94．2％，在宫内颈粘液中的转阴率分别为90．1％、94．0％、94．7％、100．0％，抗体转阴后妊娠率高达58．2％，结论：中西医结合冲击治疗对免疫性不孕抗体转阴所需时间短，转阴率和转阴后妊娠率高，对AsAb、AEmAb、AOVAb与AhCGAb等所致的免疫性不孕均有显著疗效。     

腹腔镜手术对HIV感染者免疫功能的影响

目的:检测HIV(+)者腹腔镜手术前后主要细胞和体液免疫指标的变化并与HIV(-)者对照,探讨微创手术对HIV感染者主要免疫功能的影响。方法:将42例胆囊疾病患者分为2组:观察组(HIV+)22例,对照组(HIV-)20例。用同样方法施行腹腔镜胆囊切除术(laparoscopic cholecystectomy,LC)。于术前1d,术后3、7d(POD3,7)检测血常规、白蛋白,CD3、CD4、CD8及其百分比和CD4/CD8;IgG、IgM、IgA,补体C3和C4,CRP。HIV(+)者检测HIV-RNA。常规统计学方法处理所得数据。结果:白细胞总数HIV(-)组>HIV(+)组(POD3,7)(P<0.05)。淋巴和中性粒细胞无显著变化(P>0.05)。白蛋白2组手术前后>35g/L。IgA手术前后HIV(+)>HIV(-)(P<0.05)。IgG、IgGM、C3和C42组手术前后均无显著变化,均在正常范围。CD4HIV(+)者术前1天至术后1月<50copy/ml。组间比较:CD4手术前后HIV(+)0.05)。CD4/CD8手术前后HIV(+)0.05)。CRPHIV(+)组术前>POD3,7(P<0.05)。CRP HIV(-)组术前相似文献   

CD80mAb协同imDC诱导同种异体大鼠胰十二指肠移植免疫耐受

目的 观察共刺激分子阻断剂CD80单克隆抗体（CD80mAb）在协同未成熟树突细胞（imDC）诱导同种异体大鼠胰十二指肠移植免疫耐受中的作用。方法 建立糖尿病大鼠胰十二指肠移植动物模型；4E5杂交瘤细胞株BABIMC小鼠腹腔注射，抽取腹水，分离纯化后获得CD80mAb；分离供体大鼠骨髓来源DC细胞前体，经GM—CSF、IL-4体外刺激后。再加入IL-10共培养，鉴定为imDC；移植前7d，将2×10^6imDC经静脉途径注射至受体体内，同时分别给予生理盐水1ml、CD80mAb5mg连续14d。结果 四组受体大鼠移植后中位生存时间分别为12．7d、32．4d、50．2d、92．0d，实验组存活时间明显延长；组织学观察发现移植后7dCD80mAb＋imDC组移植物形态尚完整，淋巴细胞浸润减少；混合淋巴细胞反应证实移植后7dCD80mAb＋imDC组供受体间呈低反应性。结论 共刺激分子阻断剂CD80mAb能够协同imDC诱导受体T细胞对移植物的免疫耐受，降低宿主对移植物的急、慢性排斥反应，延长移植物的存活时间。     

Immunological responses to pneumococcal vaccine in frail older people

Advanced age has been associated with a wide range of defects in both the innate and adaptive immune systems including diminished specific antibody responses that increase the risk of invasive pneumococcal disease (IPD) and limit the effectiveness of vaccines. However, the elderly are a heterogeneous group and measures of overall frailty may be a better indicator of disease susceptibility (or vaccine response) than chronological age alone.     

Massive Immune Hemolysis Caused by Anti-D After Dual Kidney Transplantation

Massive immune hemolysis due to passenger lymphocyte-derived anti-D has not been reported in renal transplantation. A 50-year-old (B-positive) male received a dual deceased-donor kidney transplant (B-negative) for diabetic renal failure. Two weeks post-transplant, the patient developed severe hemolytic anemia. The donor anti-D titer was 1:8. The recipient anti-D titer (zero pre-transplant) increased from 1:4 to 1:16 over 4 days. Rapid hemolysis caused severe anemia, minimum Hb = 4.2 g/dL, while selectively lysing the patient's autologous red cells during this time. The hemolytic anemia did not impair the allografts and subsided without monoclonal B-cell pharmacotherapy or apheresis. The anti-D titer decreased to barely detectable levels at four months and had cleared when checked 2 years post-transplant. Transfusion support subsided after two months. If complications of anemia can be avoided, the deleterious effects of hemolysis may be well tolerated by renal allografts using antigen negative transfusion alone.     

ITP患者T细胞对巨核细胞生成作用的影响

本文应用改良的血浆凝块技术和共培养系统研究特发性血小板减少性紫癜(ITP)患者T细胞在体外对异体骨髓巨核细胞生成作用的影响,以探讨ITP的发病机制。实验结果表明,从总体来看,ITP患者的T细胞当加到培养物中和靶细胞共培养时,对巨核系祖细胞集落形成单位(CFU-MK)的集落效应无明显的影响。其中三例PAIgG升高患者的T细胞对CFU-MK有不同程度的抑制作用。以上结果提示ITP的发病机制相当复杂。除体液免疫机制外,也有细胞免疫机制参与,T细胞或其亚群对巨核系祖细胞生成抑制在ITP的发病机制中可能起着一定的作用。