系统性红斑狼疮患者血清可溶性细胞间粘附分子-1、L-选择素、细胞因子的变化及意义

目的探讨系统性红斑狼疮（SLE）患者血清可溶性细胞间粘附分子-1（sICAM-1）、L-选择素、白细胞介素（IL）-2、IL-6、IL-8和IL-10水平的变化及其致病意义。方法采自24例SLE患者的血清标本分别用酶联免疫吸附试验（ELISA）检测sICAM-1和L-选择素;用放射免疫检测法（RIA）检测IL-2、IL-6、IL-8和IL-10;另以20名健康志愿者作为对照。结果SLE患者血清sICAM-1、L-选择素、IL-6及IL-2/IL-10比值显著高于对照组（P〈0.05）,IL-2无明显变化,IL-8水平稍高于对照组,但差异无统计学意义（P〉0.05）。结论SLE患者sICAM-1、L-选择素和IL-6表达增加,而IL-10表达减少,提示免疫紊乱、促炎与抗炎细胞因子失平衡参与了SLE的发病过程。     

高密度脂蛋白抑制L-选择素对心血管的保护作用

目的　从炎症反应的角度探讨 HDL 保护冠心病的机制。方法　冠心病患者 30例 ,健康对照组 19例 ,分别测定两组血清中可溶性 L-选择素 (L- selectin)和 HDL。结果　 1冠心病组 HDL 水平 [(0 .74± 0 .33) mm ol/ L]较对照组 [(1.4 5± 0 .37) mm ol/ L]明显降低 (P<0 .0 5 ) ,而可溶性 L- selectin冠心病组 [(1.34± 0 .36 ) μg/ ml]较对照组 [(1.0 5± 0 .39)μg/ ml]明显升高 (P<0 .0 5 )。 2 4 9例受试者的可溶性 L - selectin和 HDL两者间呈明显负相关 (r=- 0 .88,P<0 .0 0 1)。结论　 1冠心病组 HDL较对照组低 ,符合 HDL有心血管保护作用的理论。可溶性 L - selectin在冠心病组较对照组高表明 L - selectin参与冠心病的发作。 2 HDL与可溶性 L - selectin间有明显负相关性 ,表明HDL 有可能通过抑制 L- selectin激活而起心血管保护作用的     

Adhesion molecule expression on peripheral blood mononuclear cells in rheumatoid arthritis: Positive correlation between the proportion of L-selectin and disease activity

Summary The expression of a series of adhesion molecules (the integrin family, the immunoglobulin superfamily, CD44 and the selection family) on peripheral blood mononuclear cells (PBMC) from RA patients was investigated by flow-cytometry. L-Selectin (CD62L) in the selectin family was more significantly expressed on PBMC from RA patients as compared to those from normal controls. Further, RA patients exhibited a slight but significant increase of VLA-2 (CDw49b), p150,95 (CD11c), and VNR- (CD61) in the integrin family. The enhanced expression of L-selectin was positively correlated with disease activity.An increase in the proportion of L-selectin⁺CD4⁺ cells in PBMC from patients with RA and its clinical significance is reported.     

非小细胞肺癌中CCR7和CD62L表达及与淋巴结转移的关系

目的探讨CC趋化因子受体7(CCR7)和L-选择素(CD62L)在非小细胞肺癌(NSCLC)组织中的表达及其与淋巴结转移的关系。方法采用免疫组化法检测80份NSCLC癌组织和20份癌旁正常肺组织标本中CCR7和CD62L表达,比较二者在淋巴结转移者与无淋巴结转移者中的阳性表达率。结果 NSCLC癌组织中CCR7和CD62L表达阳性率均明显高于癌旁正常肺组织(P均<0.05),且CCR7表达与CD62L表达有明显相关性(P<0.05)。有淋巴结转移者CCR7和CD62L表达阳性率均明显高于无淋巴结转移者(P均<0.05)。结论 NSCLC癌组织中CCR7和CD62L表达均上调,二者可能共同参与了NSCLC的淋巴结转移过程。     

火把花根片对EAE大鼠模型VCAM-1和L-选择素的影响

目的探讨火把花根片对实验性自身免疫性脑脊髓炎(EAE)大鼠模型的治疗作用以及对VCAM-1和L-选择素的影响。方法模型组采用豚鼠髓鞘蛋白匀浆和福氏完全佐剂诱发大鼠急性EAE模型;治疗组在模型组基础上予以火把花根(300mg·kg-1·d-1,每日2次),观察动物表现并评分,HE染色和Loyez氏髓鞘染色观察病理和髓鞘改变,免疫组化技术测定脑和脊髓的VCAM-1和L-选择素(L-selectin)水平。结果治疗组未出现临床症状,VCAM-1为(2.13±0.99),L-selectin为(1.88±0.64),与模型组比较差异有统计学意义(P<0.05);脑和脊髓小血管周围炎症细胞浸润明显减少,髓鞘结构完整。结论火把花根片对EAE有治疗作用,其作用机制与抑制VCAM-1及L-selectin表达有关。     

rhGH对老年多器官功能不全患者CD47、L-选择素及高级氧化蛋白产物表达的影响

目的观察重组人生长激素(rh GH)对老年多器官功能不全(MODSE)患者膜糖蛋白CD47、L-选择素及高级氧化蛋白产物(AOPPs)表达的影响。方法 66例MODSE患者随机均分为对照组(n=33,给予常规治疗)及治疗组(n=33,在常规治疗基础上加用rh GH)。所有患者均于治疗前及治疗后第3、14、28天取静脉血,流式细胞仪检测血清CD47阳性率,ELISA和分光光度计法检测L-选择素及AOPPs浓度,并观察两组患者APACHEⅢ评分的变化。结果与治疗前比较,对照组和治疗组的CD47阳性率增高,AOPPs浓度、L-选择素水平及APACHEⅢ评分降低,差异均有统计学意义(P<0.05)。与对照组比较,治疗组CD47阳性率增高(P<0.05),AOPPs浓度降低,L-选择素水平下降,APACHEⅢ评分降低,病死率降低,差异均有统计学意义(P<0.05)。治疗组内观察,与治疗后第3天比较,第14天CD47阳性率增高,AOPPs浓度降低,L-选择素水平下降,APACHEⅢ评分降低,差异均有统计学意义(P<0.05);与治疗后第14天比较,第28天CD47阳性率增高,AOPPs浓度降低,L-选择素水平下降,APACHEⅢ评分降低,差异均有统计学意义(P<0.05)。结论 rh GH可增强MODSE患者的免疫功能,减轻氧化应激及炎症反应,并可降低病死率。     

Loss of functional suppression by CD4+CD25+ regulatory T cells in patients with multiple sclerosis

CD4+CD25+ regulatory T cells contribute to the maintenance of peripheral tolerance by active suppression because their deletion causes spontaneous autoimmune diseases in mice. Human CD4+ regulatory T cells expressing high levels of CD25 are suppressive in vitro and mimic the activity of murine CD4+CD25+ regulatory T cells. Multiple sclerosis (MS) is an inflammatory disease thought to be mediated by T cells recognizing myelin protein peptides. We hypothesized that altered functions of CD4+CD25hi regulatory T cells play a role in the breakdown of immunologic self-tolerance in patients with MS. Here, we report a significant decrease in the effector function of CD4+CD25hi regulatory T cells from peripheral blood of patients with MS as compared with healthy donors. Differences were also apparent in single cell cloning experiments in which the cloning frequency of CD4+CD25hi T cells was significantly reduced in patients as compared with normal controls. These data are the first to demonstrate alterations of CD4+CD25hi regulatory T cell function in patients with MS.     

促炎与抗炎细胞因子在肾综合征出血热发病中的作用

目的了解肾综合征出血热患者促炎与抗炎细胞因子的变化在其发病中的作用。方法将35例患者分为轻症组19例,重症组16例,按病期采血,分别用ELISA和放射免疫法检测细胞内黏附分子(ICAM)-1、E-选择素、L-选择素、转化生长因子(TGF)β-1、IFN-γ、TNF-α、IL-1β、IL-2、IL-4、IL-10等细胞因子,并同期检测PLT和肾功能。结果从发热期至多尿期,血清TNF-α、IL-1β、IFN-γ、IL-2、E-选择素、L-选择素和ICAM-1水平均高于对照组(P＜0．05或P＜0．01),而IL-4、TGF-β1则显著降低,血清IL-10增幅比IFN-γ低,以致IFN-γ/IL-10比值显著增高;TNF-α、IFN-β与BUN呈一致性变化趋势,而与PLT变化趋势相反。结论肾综合征出血热发病过程中存在促炎与抗炎细胞因子的失衡,这种失控性炎症反应是引起毛细血管渗漏和多器官功能障碍综合征的主要机制。合理补液、适量使用免疫调节剂,尽快恢复促炎与抗炎的平衡,可望改善本病的预后。     

Polymorphonuclear Leukocytes Released from the Bone Marrow Preferentially Sequester in Lung Microvessels

Objective : A hallmark of the systemic response to an inflammatory stimulus is the release of polymorphonuclear leukocytes (PMNs) from the bone marrow. This study was designed to measure the release of PMNs from the bone marrow and to determine their sequestration in the lung after an intravenous injection of either endotoxin (n = 5) or saline (n = 5). Methods and Results : The thymidine analogue 5′-bromo-2-deoxyuridine (BrdU) was used to pulse label dividing PMNs in the bone marrow of rabbits (n = 13), and immunohistochemistry and morphometry were used to detect the release of BrdU-labeled PMNs into the circulation and to determine their sequestration in the lung. Endotoxin treatment caused a drop in the circulating PMN counts (3.3 ± 0.08 at baseline to 0.12 ± 0.02 × 10⁹/L at 1 hour after endotoxin), which was followed by a neutrophilia at 8 hours (6.3 ± 1.1 × 10⁹/L, p < 0.01), an increase in circulating band cells (0.12 ± 0.01 at baseline to 2.18 ± 0.4 × 1⁹/L at 8 hours, p < 0.001), and an increase in the percentage of BrdU-labeled PMNs (0.01% ± 0.004% at baseline to 26.1% ± 3.2% at 8 hours, p < 0.001). Endotoxemia caused an arteriovenous difference in BrdU-labeled PMNs across the lung (35.9% ± 2.9% versus 26.1% ± 3.1%, mixed venous versus arterial, p < 0.02). Morphometric studies showed that endotoxin caused sequestration of PMNs in the lung (2.2 ± 0.4 versus 1.0 ± 0.2 × 10¹⁰, endotoxin versus saline, p < 0.03) with preferential retention of BrdU-labeled PMNs (0.79 ± 0.21 versus 0.039 ± 0.016 × 10¹⁰, endotoxin versus saline, p < 0.05). The percentage of BrdU-labeled PMNs in the alveolocapillary walls was higher than in circulating blood (64.01% ± 4.3% versus 26.1% ± 3.2%, p < 0.01) in the endotoxin group. In vitro filtration of cells through 5-mm pore size filters showed that circulating BrdU-labeled PMNs, 8 hours after endotoxin, were preferentially retained in the filters (p < 0.01). Conclusions : We conclude that endotoxemia stimulates the bone marrow to release mature and immature PMNs. Compared to PMNs released from the bone marrow during normal turnover, these PMNs are less deformable and preferentially sequester in the lung microvessels.     

高渗氯化钠羟乙基淀粉40注射液对失血性休克大鼠肠缺血-再灌注损伤中L-选择素的表达和中性粒细胞浸润的影响

目的:观察高渗氯化钠羟乙基淀粉40注射液(HSH)对失血性休克/内毒素二次打击大鼠复苏时是否能抑制L-选择素的表达和减少肠组织中性粒细胞的浸润,从而减轻肠缺血-再灌注损伤.方法:SD大鼠54只,采用失血性休克/内毒素二次打击模型.动物随机分为对照组(C组)、乳酸林格氏液复苏组(RL组)、高渗氯化钠羟乙基淀粉40注射液(HSH组).比较中性粒细胞L-选择素的表达及肠组织髓过氧化物酶(MPO)活性;肠标本进行病理学检查.结果:休克复苏后中性粒细胞L-选择素检测,各时相点HSH组明显低于RL组(P＜0.01);肠组织MPO活性测定,HSH组稍高于C组,无统计显著性,但HSH组明显低于RL组(P＜0.01);病理学检查,HSH组肠组织较RL组损伤轻.结论:HSH可以抑制中性粒细胞L-选择素的表达,从而降低肠组织中性粒细胞浸润,减轻肠组织缺血-再灌注损伤.