血清sIL－2R水平与晚期胃癌治疗及预后相关研究

通过ｓＩＬ－２Ｒ单克隆抗体建立了双夹心ＥＬＩｓＡ法检测了１６１例晚期胃癌（Ⅲ～Ⅳ期）在手术前后、化疗及术后复发或转移时，机体血清中ｓＩＬ－２Ｒ变化。结果表明：晚期胃癌患者血清中ｓＩＬ－２Ｒ水平显著高于正常人（ｎ＝４０），且ｓＩＬ－２Ｒ升高尤以术后复发或远处转移时明显，晚期癌较早期（Ⅰ～Ⅱ期）升高更显著，ｓＩＬ－２Ｒ＜１０００Ｕ／ｍｌ时，患者３年生存率显著高于＞１０００Ｕ／ｍｌ者；化疗有效时，其水平下降，反之无效者，ｓＩＬ－２Ｒ水平则无明显改变，甚至升高。这些结果提示ｓＩＬ－２Ｒ监测对于判断胃癌进展及临床疗效和评估其预后有重要临床价值。     

活动性肺结核患者血清sIL－2R与抗PPD抗体的相关性

应用ＥＬＩＳＡ检测了正常人和肺结核患者的血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）和抗ＰＰＤ抗体水平。结果表明，活动性肺结核患者的血清ｓＩＬ－２Ｒ和抗ＰＰＤ抗体呈正相关（γ＝０．４３３，Ｐ＜０．００１），而且两者的水平明显高于正常对照组；抗ＰＰＤ抗体阳性的活动性肺结核患者血清中ｓＩＬ－２Ｒ浓度明显高于抗体阴性患者，提示血清ｓＩＬ－２Ｒ浓度测定可以反映肺结核患者细胞免疫功能状态。     

活动性肺结核患者血清sIL－2R与抗PPD抗体的相关性

应用ＥＬＩＳＡ检测了正常人和肺结核患者的血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）和抗ＰＰＤ抗体水平。结果表明，活动性肺结核患者的血清ｓＩＬ－２Ｒ和抗ＰＰＤ抗体呈正相关（γ＝０．４３３，Ｐ＜０．００１），而且两者的水平明显高于正常对照组；抗ＰＰＤ抗体阳性的活动性肺结核患者血清中ｓＩＬ－２Ｒ浓度明显高于抗体阴性患者，提示血清ｓＩＬ－２Ｒ浓度测定可以反映肺结核患者细胞免疫功能状态。     

慢性肾炎患者血清sIL—2R和IL—8的变化及意义

本研究用ＥＬＩＳＡ双抗体夹心法对慢性肾炎肾功能不全各期患者血清ｓＩＬ－２Ｒ和ＩＬ－８水平进行了测定。结果显示：（１）肾功能不全代偿期ｓＩＬ－２Ｒ水平显著高于健康人，提示此期存在Ｔ细胞异常活化。（２）氮质血症期ｓＩＬ－２Ｒ水平显著高于健康人和代偿期，与Ｓｃｒ呈显著正相关提示血清ｓＩＬ－２Ｒ水平可作为肾小球肾炎恶化的重要指标。     

伤寒患者血清TNF,IL—2,sIL—2R水平的研究

为了解肿瘤坏死因子（ＴＮＦ）、白细胞介素２（ＩＬ－２）和可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）在伤寒发病中的作用，以双抗体夹心法检测２７例伤寒患者及１６例正常人血清ＴＮＦ、ＩＬ－２和ｓＩＬ－２Ｒ水平。结果发现，伤寒患者血清ＴＮＦ水平和ｓＩＬ－２Ｒ水平均明显高于正常人水平（Ｐ＜０．０１）。而血清ＩＬ－２水平显著低于正常对照（Ｐ＜０．０１）。对１５例伤寒患者各病期血清ＴＮＦ、ＩＬ－２和ｓＩＬ－２Ｒ水平动态观察发现伤寒患者血清ＴＮＦ、ｓＩＬ－２Ｒ水平动态变化与患者体温、病期、病情变化具有密切关系。伴肝功能损伤和有诸如消化道出血、肺炎、急性肾衰等并发症及复发性伤寒的患者其血清ＴＮＦ、ｓＩＬ－２Ｒ水平明显高于无肝功能损伤及无并发症的患者。结果提示，临床检测伤寒患者血清ＴＮＦ、ｓＩＬ－２Ｒ除可协助诊断外，对于患者病情、病期、预后的判断及治疗效果的观察均具有重要意义，因此可作为临床观察伤寒病情及判断预后的监测指标。血清ＩＬ－２检测对于伤寒的诊断有一定帮助，但作为判断临床病情、病期及预后的指标意义不大     

精神分裂症患者血清sIL－2R的测定及临床意义

精神分裂症患者血清ｓＩＬ－２Ｒ的测定及临床意义汪广剑，范庆祝，徐乐平，邵亚琴，薛蕴莊解放军第１０２医院常州２１３００３多种免疫性疾病表现为血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）异常，现将４０例精神分裂症患者血清ｓＩＬ－２Ｒ水平报道如下：１材料和方...     

甲状腺疾病患者血清可溶性白细胞介素2受体测定的临床意义

某些甲状腺疾病时血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平及其与游离甲状腺素（ＦＴ＿４）、游离三碘甲腺原氨酸（ＦＴ＿３）和促甲状腺素（ＴＳＨ）水平的相关性比较。结果发现甲状腺机能亢进症（甲亢）未治疗组（Ａ）及甲亢未治疗伴突眼组（Ｄ）血清ｓＩＬ－２Ｒ明显升高；甲状腺机能减退症（甲减）经治疗甲状腺功能灭常组（Ｇ）ｓＩＬ－２Ｒ明显高于甲减未治疗组（Ｆ）；１０例毒性弥漫性甲状腺肿（Ｇｒａｖｅｓ病）患者经抗甲状腺药物治疗后ｓＩＬ－２Ｒ明显降低；Ｇｒａｖｅｓ病及甲减患者血清ｓＩＬ－２Ｒ均与ＦＴ＿３呈正相关。提示除自身免疫外，甲状腺素水平也是甲状腺疾病患者血清ｓＩＬ－２Ｒ水平的重要调节因素。     

多发性硬化患者血清sIL-6R 水平观察

为探讨可溶性白细胞介素－６受体（ｓＩＬ－６Ｒ）在多发性硬化（ＭＳ）发生、发展中的作用，采用双抗体夹心ＥＬＩＳＡ方法，对２８例ＭＳ患者和２５例正常对照组血清ｓＩＬ－６Ｒ水平进行了测定。结果显示缓解－复发型和进展型ＭＳ患者血清ｓＩＬ－６Ｒ水平明显高于正常对照组和良性型组（Ｐ＜０．０５，Ｐ＜０．０１）；而良性型ＭＳ患者血清ｓＩＬ－６Ｒ水平与正常对照组相比，未见明显改变。缓解－复发型ＭＳ患者血清ｓＩＬ－６Ｒ水平随着病情的好转而下降。ｓＩＬ－６Ｒ水平与ＭＳ患者头颅ＭＲＩ上的病灶大小和部位无明显相关性（ｒ１＝０．１２４，Ｐ＞０．０５；ｒ２＝０．０９１，Ｐ＞０．０５）。推测ｓＩＬ－６Ｒ水平的高低可作为判断ＭＳ患者病情变化的指标之一。     

可溶性白细胞介素2受体与肿瘤的研究进展

本文对近年来可溶性白细胞介素－受体（ｓＩＬ－２Ｒ）在肿瘤方面的应用进行了总结。ｓＩＬ－２Ｒ与血液、淋巴系统恶性疾病的临床分期、病情变化、疗效判断及预后有关，ｓＩＬ－２Ｒ在实体瘤患者的血清或胸、腹水中的含量与血液、淋巴系统恶性疾病一样，也明显高子正常人。ｓＩＬ－２Ｒ与一些实体瘤的鉴别诊断、分期、疗效及预后的判断有一定关系，但还需深入研究。     

细胞因子水平与晚期胃癌患者治疗及预后相关研究

本文报道了２４９例晚期胃癌（Ⅲ～Ⅳ期）患者外周血单个核细胞（ＰＢＭＣ）产生ＩＬ－２水平及ＩＬ－２Ｒ表达，外周血清中ｓＩＬ－２Ｒ浓度与ＰＢＭＣ被ＰＨＡ－Ｐ诱生后产生ＩＦＮ－γ活性；并探讨了姑息性手术、化疗和中药治疗对晚期胃癌患者细胞免疫调节因子水平的影响。结果发现：晚期胃癌患者外周血ＰＢＭＣ产生ＩＬ－２及ＩＦＮ－γ能力及ＩＬ－２Ｒ表达均显著低于早期胃癌患者和正常对照组水平（Ｐ＜０．０１）；ｓＩＬ－２Ｒ水平前者明显低于后二者（Ｐ＜０．０１）。姑息手术治疗尽管对晚期胃癌患者的ＩＬ－２、ＩＬ－２Ｒ和ＩＦＮ－γ水平无显著影响，但可降低其ｓＩＬ－２Ｒ水平；而扶正抗癌冲剂则可是显著提高患者术后ＩＬ－２及ＩＦＮ－γ水平和ＩＬ－２Ｒ表达，同时降低ｓＩＬ－２Ｒ水平（Ｐ＜０．０１）；化疗有效晚期患者，则可导致其ｓＩＬ－２Ｒ水平下降，无效者则ｓＩＬ－２Ｒ水平无改变或继续升高。三年随访发现，晚期胃癌患者，术前ＩＬ－２产生水平高于１００Ｕ／ｍｌ，同时ｓＩＬ－２Ｒ水平低于１０００Ｕ／ｍｌ者，其三年生存率高。因而，这项研究对晚期胃癌治疗疗效判断及预后评价有指导意义。     

Evaluation of soluble IL-6 receptor concentration in serum and epithelial lining fluid from patients with interstitial lung diseases.

We measured soluble IL-6 receptor (sIL-6R) levels in serum and bronchoalveolar lavage fluids (BALF) from patients with interstitial pneumonia of unknown etiology (IP) (n = 17), sarcoidosis (n = 8) and normal control subjects (n = 10), to investigate its role in pulmonary diseases. Soluble IL-6R was determined by an ELISA. The volume of epithelial lining fluid (ELF) in BALF was estimated using an urea method. We found that levels of sIL-6R in serum, BALF, and ELF from patients with IP or sarcoidosis were significantly higher than those from normal subjects. Furthermore, levels of sIL-6R in BALF or ELF were significantly correlated with those of albumin, indicating that sIL-6R, together with albumin, may enter ELF as a result of the increased permeability caused by pulmonary inflammation. Thus most of the sIL-6R in ELF would be from serum, and relatively small amounts of it might be produced locally. However, sIL-6R levels in ELF, but neither serum nor BALF, were significantly correlated with levels of C-reactive protein in patients with IP. These results suggest that both systemic and local production of sIL-6R are increased, and raised sIL-6R is involved in the modulation of systemic and local inflammatory responses in patients with IP and sarcoidosis.     

The significance of soluble IL-2 receptors in rheumatoid arthritis with interstitial pneumonia]

Interstitial pneumonia is well known as one of the complications of rheumatoid arthritis (RA). While interleukin-2 (IL-2) regulates the immune response through IL-2 receptor (IL-2R), the exact role of the soluble form of IL-2R (sIL-2R), recognized as a part of the alpha chain or IL-2R, is still obscure. So, the immunological significance of sIL-2R in serum and in bronchoalveolar lavage fluid (BALF) of those of RA patients with or without interstitial pneumonia was studied. The sIL-2R was measured with an ELISA kit (T-Cell Science Ltd). The levels of sIL-2R in the sera of RA patients without interstitial pneumonia were significantly higher than those of normal controls. Furthermore, the levels of sIL-2R showed a statistically significant correlation with ESR and Lansbary's index. The levels of sIL-2R of RA patients with interstitial pneumonia were higher than in those without interstitial pneumonia although the evaluation of class and stage of arthritis in those RA patients with or without interstitial pneumonia revealed no significant difference. A high sIL-2R/albumin ratio in BALF of RA patients with interstitial pneumonia was shown in comparison with those of normal control. These data indicate that the estimation of sIL-2R in RA patients could be useful in estimating the disease activity and that high levels of sIL-2R reflect the active immune response in the lungs of RA patients with interstitial pneumonia.     

血清基质金属蛋白酶-9 在肺结核鉴别诊断中的价值分析

目的:分析血清基质金属蛋白酶-9(MMP 9)在肺结核鉴别诊断中的价值。方法:选取肺结核、肺炎、肺癌患者及健康志愿者各60 例分别作为肺结核组、肺炎组、肺癌组和对照组,对受试者血清MMP-9 水平检测分析。结果:对照组、肺结核组、肺炎组、肺癌组研究对象的血清MMP-9 水平分别为(1 976.36±907.44)ng/ ml、(4 350.45±2 574.75)ng/ ml、(2 135.68±1 263.56)ng/ ml 和(2 590.38±1 532.84)ng/ ml,差异有统计学意义(F =25.000,P<0.001),其中,肺结核组患者的血清MMP-9水平显著高于其他三组(P<0.001),肺癌组患者的血清MMP-9 水平显著高于对照组,差异有统计学意义(P<0.05)。血清MMP-9 在肺结核与健康人+肺炎+肺癌、健康人、肺炎、肺癌、肺炎+肺癌鉴别诊断中的受试者工作特征曲线下面积(AUC)分别为0.739、0.769、0.751、0.699、0.725(P 均<0.05)。结论:肺结核患者表现为血清MMP-9 水平显著升高,且幅度高于肺癌或肺炎患者,血清MMP-9 有助于肺结核鉴别诊断和筛查,但应注意适当提高诊断的灵敏度。     

Clinical significance of serum soluble IL-2R levels in patients with adult T cell leukaemia (ATL) and HTLV-1 carriers

The levels of soluble IL-2Ralpha (sIL-2Ralpha) in serum were measured in HTLV-1 carriers and ATL patients in order to evaluate their possible correlation with clinical status. Mean sIL-2R levels in ATL patients were found to be 9704 U/ml for the acute/lymphoma type, 1961 U/ml for the chronic type and 788 U/ml for the smouldering type. The level for asymptomatic HTLV-1 carriers was 475 U/ml, and 165 U/ml for healthy young adult HTLV-1- controls. The serial measurement of sIL-2R in ATL patients, healthy HTLV-1 carriers, and HTLV-1 carriers with diseases other than ATL showed a good correlation between serum levels of sIL-2R and the pathophysiological status of disease. Furthermore, an increase in the sIL-2Ralpha level in serum indicated the exacerbation of HTLV-1 infection and autoimmune diseases. The measurement of sIL-2Ralpha levels is therefore a very useful parameter for determining disease status.     

肾移植受者血清TNF-α、IL-6和sIL-2R水平变化及临床意义

目的:探讨肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和可溶性白细胞介素-2受体(sIL-2R)在肾移植术后急性排斥反应中的变化。方法:采用固相酶标记化学发光免疫分析技术动态监测36例患者肾移植前后血清TNF-α、IL-6和sIL-2R水平,并结合临床资料作全面分析。结果:肾移植受者术后第1天血清TNF-α、IL-6和sIL-2R均明显升高,其中移植稳定组血清IL-6和sIL-2R第1天出现峰值后开始下降,而TNF-α则在术后5天达峰值后开始下降,至第10天均接近术前水平。急性排斥组血清TNF-α、IL-6和sIL-2R水平与肾功能稳定组比较,差异有显著性(P<0.05),抗排斥治疗有效后迅速下降。而环孢素A中毒组与稳定组比较,差异无显著性(P<0.05)。结论:肾移植术后受者血清TNF-α、IL-6和sIL-2R水平的检测,可在一定程度上反映肾移植受者的免疫反应状态,并为急性排斥反应的监测和诊断提供客观依据。     

Effects of symptomatic severity on elevation of plasma soluble interleukin-2 receptor in bipolar mania

BACKGROUND: Circulating soluble interleukin-2 receptors (sIL-2Rs) and soluble interleukin-6 receptors (sIL-6Rs) are stable immune measures. Elevated plasma sIL-2R levels are present in patients with schizophrenia, major depression, and bipolar mania, but not with minor psychiatric disorders. The increased plasma sIL-2R levels are state-dependent in bipolar mania. However, altered production of plasma sIL-6R and the effects of clinical characteristics on plasma sIL-6R and sIL-2R levels in bipolar disorder remains uncertain. METHODS: Plasma sIL-2R and sIL-6R levels were measured in 31 Taiwanese bipolar manic (DSM-IV) patients with Young Mania Rating Scale (YMRS) scores of > or =26 as well as during the subsequent remission (YMRS< or =12), and equal numbers of age- and gender-matched healthy controls. The relationships of clinical variables such as age, age of onset, smoking, medication status, coexisting psychotic features, number of prior episodes, duration of illness, presence of depression before or following the manic episode, and manic severity to plasma sIL-2R and sIL-6R levels in acute mania along with remission were examined. RESULTS: Plasma sIL-2R but not sIL-6R levels were significantly higher in acute mania than in subsequent remission (P<0.05) and controls (P<0.0005). In acute mania, the plasma sIL-2R levels were significantly correlated to YMRS scores (r=0.34, P<0.05). The remaining clinical variables had no effect on plasma sIL-2R and sIL-6R levels in acute mania or remission. There was a significantly positive relationship between the reduction of plasma sIL-2R levels from the acute to follow-up measurements (DeltasIL-2R) and symptomatic improvement of acute mania (DeltaYMRS) (r=0.61, P<0.001). Limitations: Our sample included medicated and unmedicated patients in acute mania. The psychotropic medication may have divergent effects on the plasma sIL-2R levels in acute mania and subsequent remission. CONCLUSIONS: Elevation of plasma sIL-2R but not sIL-6R levels in bipolar mania supports the idea that the immunomodulatory mechanism may vary in different psychotic disorders. In contrast to being a trait marker in schizophrenia and depressive disorder, plasma sIL-2R levels may be considered a biological indicator of manic severity in a group of bipolar affective patients.     

Serum interleukin-2-receptor in coeliac disease: response to treatment and gluten challenge.

Concentrations of the soluble interleukin-2 receptor (sIL-2R) in the serum of 33 patients with coeliac disease were measured by ELISA. The levels of sIL-2R were significantly raised in 15 patients with untreated coeliac disease compared with treated patients and age- and sex-matched symptomatic and non-symptomatic control groups. Longitudinal studies in individual coeliac patients showed that serum sIL-2R fell following commencement of a gluten-free diet. Gluten challenge of 16 treated coeliac patients for 1 week resulted in a significant increase in serum sIL-2R, which returned to prechallenge levels within 4 weeks of recommencement of a gluten-free diet. We suggest that serum sIL-2R levels in patients with coeliac disease reflect specific immunological activation in response to gluten ingestion. Measurement of serum sIL-2R may therefore be useful in the assessment of response to treatment in patients with coeliac disease.     

乙型病毒性肝炎患者血清IL-2、slL-2R、IL-13及PDGF测定的意义

目的：探讨乙型肝炎患者血清IL-2、sIL-2R、IL-13及PDGF水平的变化及测定的临床意义。方法：150例乙型肝炎患者分为3组（急性肝炎组20例、慢性肝炎组90例和重型肝炎组40例）;设健康人45名作为对照组。前2项血清标志物均采用放射免疫分析;后2项血清指标则采用酶联免疫吸附试验测定。将测定结果进行统计分析。结果：本文测定数值显示,血清IL-2水平急性肝炎患者组水平与对照组比较略有降低,但无统计学意义（P〉0.05）;慢性肝炎和重型肝炎2组患者该指标水平则均显著低于对照组（P均〈0.05）。sIL-2R水平显示急性、慢性及重型肝炎3组患者均非常显著地高于对照组（P均〈0.01）,且发现其递增规律与肝炎病情的严重程度呈明显的平行关系。IL-13水平测定结果也显示3组患者均显著高于对照组（P均〈0.05）。PDGF测定值显示,急性肝炎组水平显著高于对照组（P〈0.05）,慢性肝炎和重型肝炎2组水平则较对照组升高更为显著（P均〈0.01）。其水平的递增关系也与病情的严重程度相一致。结论：本文患者4项血清指标水平的变化与乙型肝炎的发病及病情进展有关;其测定有助于了解本病的发生机制和预后评估。