Intravenous immunoglobulin therapy for aspirin-heparinoid-resistant antiphospholipid syndrome

We encountered a woman who had a history of repeated fetal losses and positive tests for lupus anticoagulant, phosphatidylserine-dependent antiprothrombin (aPS/PT) IgG, IgM and kininogen-dependent antiphosphatidylethanolamine (aPE) IgG, IgM. Her previous pregnancy had ended in intrauterine fetal death at 24 weeks of gestation despite a therapy of low-dose aspirin, prednisolone and danaparoid. During the present pregnancy, she was treated with repeated intravenous infusions of immunoglobulin (IVIg) together with low-dose aspirin, prednisolone and heparin. When thrombocytopenia developed, she delivered a female baby weighing 2,152 g at 34 weeks of gestation by cesarean section. Titers of aPS/PT IgM and aPE IgM were reduced or maintained at low levels by repeated IVIg therapies. The IVIg therapy might be effective for aspirin-heparinoid-resistant antiphospholipid syndrome.     

Peripheral nerve pathology at fixed stage in spinal muscular atrophy with respiratory distress type 1

Spinal muscular atrophy with respiratory distress type 1 (SMARD1) is characterized by severe respiratory failure due to diaphragmatic paralysis and distal muscular weakness in early infancy. After an initial decline in respiratory state and motor function until 1–2 years of age, residual capabilities reach a plateau.We report the peripheral neuropathological findings of a patient with SMARD1 at 1 year and 1 month of age, when his muscle strength and respiratory symptoms had deteriorated and then stabilized for several months. Peripheral nerve biopsy revealed severely progressed axonal degeneration. This finding suggests the rapid progression of peripheral axonal neuropathy in SMARD1 that leads to its characteristic clinical course of respiratory failure and paralysis in the early infantile period.     

水痘-带状疱疹病毒膜抗原荧光抗体试验的建立与评价

目的  建立用于检测血清中水痘-带状疱疹病毒（varicella-zoster virus,VZV)特异性抗体的膜抗原荧光抗体（fluorescent antibody to membrane antigen,FAMA）试验并对其进行验证和评价。方法  用VZV感染细胞作为抗原制备抗原载玻片,以异硫氰酸荧光素标记的羊抗人IgG为二抗建立FAMA试验。对试验的灵敏度、特异性和重复性进行验证。用FAMA试验和市售ELISA试剂盒对200份血浆样品中的抗VZV抗体进行检测。采用Spearman秩相关检验对两种方法的检测结果进行比较。结果 FAMA试验的灵敏度为0.04 IU/ml,与常见的人疱疹病毒（单纯疱疹病毒1和2型、人巨细胞病毒）没有交叉反应且重复性良好。经FAMA试验检测,200份血浆样品的抗体阳性率为93.5%,抗体几何平均效价为1:18.1,检测结果与市售ELISA试剂盒的符合率为90.0%。两种方法的检测结果具有相关性,Spearman秩相关系数为0.49,P<0.000 1。结论  建立的方法具有良好的灵敏度、特异性和重复性,可用于血清中抗VZV抗体的检测。     

卡介菌多糖核酸注射液对部队肺结核患者免疫球蛋白和C3、C4的影响

 目的 观察卡介菌多糖核酸注射液对部队肺结核患者抗结核治疗前后免疫球蛋白IgA、IgG、IgM和补体C3、C4的影响,评价该药治疗肺结核的免疫调节作用.方法 肺结核患者随机分为治疗组和免疫治疗组.两组都使用短程标准抗结核方案2HRZF/4HR,免疫治疗组联合使用卡介菌多糖核酸注射液,治疗前和治疗开始后第1、2个月检查IgA、IgG、IgM和C3、C4,并与20例健康人血清作对照组.结果　和健康对照组比较,两组肺结核患者治疗前IgG、IgM和C3有不同程度下降(P＜0.05),而C4下降不明显(P＞0.05),治疗前两组肺结核患者上述指标间差异无显著性(P＞0.05);免疫治疗组采用卡介菌多糖核酸注射液后IgM、IgG和C3、C4明显增高,显著高于治疗组(P＜0.05),而IgA变化不明显(P＞0.05).卡介菌多糖核酸治疗组患者疗效好于对照组(P＜0.05).结论 卡介菌多糖核酸注射液具有调节肺结核患者机体免疫功能作用,可辅助提高抗结核药物对肺结核疗效.     

EV71感染手足口病患儿血清炎性细胞因子及免疫球蛋白水平的变化及意义

目的 观察肠道病毒71型（EV71）感染手足口病（HFMD）患儿血清细胞因子及免疫球蛋白水平变化,探讨炎症及免疫学机制在手足口病发病中的意义。方法 选择2015年6月~2016年8月收治的65例EV71感染HFMD患儿为观察组,65例健康儿童为对照组。酶联免疫吸附试验法（ELISA法）检测血清中IL-6、IL-8、TNF-α水平,免疫散射比浊法检测血清IgA、IgG、IgM水平。结果 与对照组相比,观察组血清IL-6、1L-8及TNF-α水平显著升高（t值分别为7.94、6.87、9.56,P<0.01）,血清免疫球蛋白IgA、IgG及IgM水平也有上升,差异有统计学意义（t值分别为6.71、7.96、8.39,P<0.01）。结论 炎性细胞因子和免疫失衡在手足口病中的发生、发展中发挥重要作用,观察IL-6、IL-8、TNF-α、IgA、IgG及IgM水平的动态变化对判定HFMD病情和疾病防治具有一定的临床应用价值。     

人免疫球蛋白和重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白治疗中毒性表皮坏死松解症的对比研究

目的:评价静脉注射人免疫球蛋白（IVIG）及重组人Ⅱ型肿瘤坏死因子受体-抗体融合蛋白（rhTNFR：Fc）治疗中毒性表皮坏死松解症（TEN）的疗效。方法:收集2013—2019年武汉市第一医院使用IVIG及rhTNFR：Fc治疗的TEN患者资料。IVIG组11例,男3例,女8例,年龄25 ~ 72岁,中位TEN疾病严重...     

Inhibitory effects of Juglans mandshurica leaf on allergic dermatitis-like skin lesions-induced by 2,4-dinitrochlorobenzene in mice

Allergic dermatitis among common skin diseases is a chronic and recurrent inflammatory skin disorder caused by genetic, environmental, allergens as well as microbial factors. Allergic dermatitis patients clinically present skin erythematous plaques, eruption, elevated serum immunoglobulin E (IgE) and T helper cell type 2 (Th2) cytokine levels. The leaf of walnut tree Juglans mandshurica Maxim (JM) is consumed food and traditional phytomedicine in Asia, China, Siberia and Korea. JM has been reported to have various pharmacological activities, such as anti-tumor, anti-oxidative, and anti-bacterial effects. However, no study of the inhibitory effects of JM on allergic dermatitis has been reported. Here, we demonstrated the effect of JM against 2,4-dinitrochlorobenzene-induced allergic dermatitis-like skin lesions. 0.5% JM or 1% dexamethasone (positive control) applied to the dorsal skin inhibited development of allergic dermatitis-like skin lesions and scratching behavior. Moreover, the Th2-mediated inflammatory cytokines IgE, tumor necrosis factor-α, interleukin (IL)-1, and IL-13, were significantly reduced by JM treatment. Thus JM can inhibit development of allergic dermatitis-like skin lesions in mice by regulating immune mediators, and may be an effective alternative therapy for allergic dermatitis.     

Immunoglobulin-induced hemolysis,splenomegaly and inflammation in patients with antibody deficiencies

IgG replacement for primary antibody deficiencies is a safe treatment administered to prevent recurrent infections and reduce mortality. Recently, several reports described acute hemolytic episodes following IgG administration due to a passive transfer of blood group alloantibodies, including anti-A, anti-B, as well as anti-Rh antibodies. Here, we reviewed and discussed the consequences of passively transferred RBCs antibodies. The chronic passive transfer of alloantibodies might also cause a subclinical condition due to a compensated extravascular chronic hemolysis with poorly understood consequences. This phenomenon might possibly represent an unrecognized cause of splenomegaly and might contribute to inflammation in patients with primary antibody deficiencies.     

Stability of BK polyomavirus IgG seroreactivity and its correlation with preceding viremia

BackgroundRecently we showed that the level of BK polyomavirus (BKPyV) IgG seroreactivity in kidney donors predicted viremia and BKPyV-associated nephropathy in kidney transplant recipients (KTRs). This observation could be explained by assuming a direct association between BKPyV seroreactivity and the amount of persistent infectious virus in the renal allograft.ObjectivesSince the renal BKPyV reservoir is probably sowed by viremia during primary BKPyV infection, we systematically analysed the dynamics of BKPyV IgG seroreactivity in relation to preceding BKPyV viremia in KTRs and healthy individuals.Study designA cohort of 85 KTRs consisting of BKPyV viremic and nonviremic subjects was analysed for BKPyV IgG seroreactivity at five fixed time points until one year after transplantation. A cohort of 87 healthy blood donors (HBDs) was used as controls.ResultsBaseline BKPyV seropositivity was high in both KTRs and HBDs, and the baseline mean BKPyV IgG level comparable. BKPyV IgG levels in nonviremic KTRs and HBDs remained stable during follow-up, while a considerable increase was observed in viremic KTRs (p = 0.015). The increase of BKPyV seroreactivity in viremic KTRs was associated with the duration and peak level of BKPyV viremia.ConclusionsBKPyV IgG seroreactivity was stable over time in immunocompetent subjects, which enables the use of this potential pretransplantation biomarker in kidney donors. The observed dose-dependent relationship of BKPyV IgG seroreactivity with preceding BKPyV replication is in agreement with the assumption that BKPyV seroreactivity reflects past BKPyV activity and correlates with the amount of latent BKPyV residing within a kidney allograft.