白癜风患者血清中抗酪氨酸酶抗体及可溶性细胞间黏附分子1的检测

目的 探讨白癜风患者血清中抗酪氨酸酶IgG、IgM抗体滴度和可溶性细胞间黏附分子1(sICAM-1)水乎与疾病活动程度的关系和临床意义。方法 抗酪氨酸酶IgG、IgM抗体和sICAM-1检测采用酶联免疫吸附试验(ELISA)方法。结果 ①白癜风患者血清中抗酪氨酸酶IgG抗体平均滴度为0.316,显著高于正常人对照组0.082(P<0.001);白癜风患者血清中抗酪氨酸酶IgM抗体平均滴度为0.238,显著高于正常人对照组0.065(P<0.001)。②白癜风患者进展期血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期(P均<0.001),泛发型明显高于局限型(P均<0.001)。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgG抗体阳性及IgM抗体阳性均呈正相关(P均<0.001)。④白癜风患者血清sICAM-1平均水平为697.40ng/mL,显著高于正常人对照组602.40ng/ml(P<0.001);进展期高于稳定期(P<0.001);泛发型高于局限型(P<0.001);稳定期和局限型白癜风患者血清中sICAM-1水平与正常人对照组差异无统计学意义(P均>0.05)。结论 白癜风患者血清中抗酪氨酸酶IgG、IgM抗体和sICAM-1与疾病活动性和严重程度相关。     

血清可溶性黏附分子与系统性红斑狼疮患者活动性的关系

目的 探讨血清黏附分子中可溶性血管细胞黏附分子-1(sVCAM-1)和可溶性细胞间黏附分子-1(sICAM-1)水平与系统性红斑狼疮(SLE)活动性的关系。方法 sVCAM-1和sICAM-1检测采用酶联免疫吸附试验(ELISA)。结果 ①SLE患者血清sVCAM-1平均水平为2342.45ng/mL,显著高于正常对照组1239.68ng/mL(P<0.001);SLE患者血清sICAM-1平均水平为802.34ng/mL,显著高于正常对照组626.15ng/mL(P<0.001)。②SLE患者血清sVCAM-1水平和sICAM-1水平活动期均高于非活动期(P均<0.001),肾损组均高于非肾损组(P均<0.001)。③SLE组血清sVCAM-1和sICAM-1水平与SLE疾病活动指数(SLEDAI)、抗dsDNA抗体阳性呈正相关,与血清补体C3水平呈负相关。④糖皮质激素治疗后患者sVCAM-1水平和sICAM-1水平均低于治疗前(P均<0.001)。结论 sVCAM-1、sICAM-1可能参与SLE的发病,与SLE活动性相关。     

催乳素对系统性红斑狼疮患者单一核细胞产生IgG和抗dsDNA抗体的影响

目的 探讨催乳素(PRL)对系统性红斑狼疮(SLE)患者外周血单一核细胞(PBMC)产生抗体和自身抗体的影响。方法 体外培养SLE患者和正常人PBMC,用催乳素(PRL)和白介素2(IL-2)、白介素10(IL-10)和植物凝集素(PHA)刺激外周血淋巴细胞,采用³H-TdR掺入法测定淋巴细胞增殖情况,用ELISA测定PBMC分泌的IgG型抗体和抗dsDNA抗体。结果 ①10^-9mol/LPRL可刺激SLE患者的PBMC增殖。②10^-9mol/L的PRL分别可以刺激SLE患者PBMC分泌IgG型抗体和抗dsDNA抗体,且活动期患者显著高于静止期患者和正常人对照(P<0.01)。③PHA+PRL、IL-2+PRL刺激SLE患者PBMC分泌IgG型抗体和抗dsDNA抗体分别显著高于PRL组(P<0.01);抗IL-2抗体+PRL组低于PRL组,差异有显著性(P<0.01);IL-10+PRL组与PRL组间差异无显著性(P>0.05)。结论 PRL能够刺激体外培养的SLE患者PBMC分泌IgG型抗体和抗dsDNA抗体;PHA、IL-2与PRL有协同作用。     

芪加真武汤联合糖皮质激素体外对SLE患者外周血淋巴细胞凋亡及Fas、FasL表达的影响

目的 探讨中药芪加真武汤联合糖皮质激素对系统性红斑狼疮(SLE)患者外周血淋巴细胞(PBL)凋亡及Fas、FasL表达的影响。方法 采用血清药理学方法 ,制取芪加真武汤含药兔血清。运用流式细胞仪检测19例SLE患者外周血淋巴细胞在不同浓度的芪加真武汤的含药血清(20%、10%、5%)、地塞米松(0.001mol/L)及两者联合刺激下细胞凋亡和Fas、FasL表达的变化。结果 ①SLE患者PBL凋亡率明显高于正常组(P<0.001),Fas表达明显多于正常组(P<0.01),FasL表达与正常组差异不明显(P>0.05)。②10%、20%含药血清显著减少SLE患者PBL的凋亡率(P<0.01),显著降低Fas表达(P<0.01),升高FasL的阳性细胞率(P<0.05);③地塞米松可增高SLE患者PBL的凋亡率(P<0.05),但对Fas、FasL的表达无影响(P>0.05);④含药血清联合地塞米松显著减少PBL凋亡率(P<0.01),降低Fas表达(P<0.05),明显升高FasL的阳性细胞率(P<0.01)。结论 SLE患者PBL存在凋亡及凋亡相关蛋白表达的紊乱,中药芪加真武汤在体外可纠正其紊乱,缓解由地塞米松引起的PBL过度凋亡。     

梅毒患者病程中宿主的免疫学变化

目的 探讨梅毒螺旋体(TP)感染的不同病程与宿主免疫学变化的关系。方法 采用ELISA法分别检测一期和二期梅毒患者血清抗TP抗体的滴度(用活动指数AI表示)。MTT比色法测定一期和二期梅毒患者血清对脐带血淋巴细胞增殖反应的影响(用刺激指数SI表示)。ABC-ELLSA法分别检测一期和二期梅毒患者血清中细胞因子IL-2、IL-4含量。结果 二期梅毒患者抗TP抗体的活动指数(AI)显著高于一期梅毒(t=3.92,P<0.01)。一期和二期梅毒血清对脐带血淋巴细胞增殖反应的刺激指数SI显著低于无血清含PHA组(q₁=12.99,P₁<0.01。q₂=12.04,P₂<0.01),且二期梅毒血清SI亦显著低于一期梅毒(q=7.18,P<0.01)。一期梅毒血清中IL-2含量明显高于二期梅毒(t=3.50,P<0.05),IL-4含量与二期梅毒差异无显著性(t=1.31,P>0.05)。结论 抗TP抗体随着梅毒病程由一期向二期进展其滴度越来越高,但与体液免疫有关的细胞因子IL-4没有发生显著性变化;宿主感染梅毒螺旋体后,其细胞免疫功能受到明显抑制,且随着病程由一期向二期进展,其抑制现象越来越显著。     

系统性红斑狼疮患者血清肝细胞生长因子及基质金属蛋白酶9的研究

目的 探讨血清肝细胞生长因子(HGF)及基质金属蛋白酶9(MMP-9)的水平与系统性红斑狼疮(SLE)疾病活动程度的关系和意义,并对相关机理进行探讨.方法 ①双抗体夹心法检测血清HGF及MMP-9水平;②绘制ECV304细胞株生长曲线;③明确重组人肝细胞生长因子(rhHGF)的作用浓度;④流式细胞仪检测MMP-9水平.结果 患者血清HGF明显升高(P<0.001),MMP-9明显降低(P<0.001);经糖皮质激素治疗后HGF浓度下降(P<0.05),MMP-9浓度升高(P<0.05);活动期HGF高于非活动期(P<0.05),MMP-9低于非活动期(P<0.05);肾损组HGF高于非肾损组(P<0.001),MMP-9则低于非肾损组(P<0.05);关节炎组HGF高于非关节炎组(P<0.01),MMP-9水平两组之间差异无显著性(P>0.05);以HGF水平作为SLE的诊断指标,则ROC曲线下面积为0.707,灵敏度为66.7%;以MMP-9水平作为SLE的诊断指标,则ROC曲线下面积为0.984,灵敏度为97.2%;同时检测HGF及MMP-9水平,灵敏度为66.7%(24/36);rhHGF的作用浓度为8ng/mL;正常ECV304细胞株MMP-9的表达量为39.74%,rhHGF刺激后MMP-9的表达量为40.32%.结论 HGF及MMP-9可能参与SLE的发病机制,其水平可作为反映疾病活动程度、肾脏损害以及疾病进展与改善的指标,且血清MMP-9水平诊断准确性更高;rhHGF可促进ECV304细胞株MMP-9的表达.     

系统性红斑狼疮患者血清基质金属蛋白酶-9的检测

目的 检测系统性红斑狼疮(SLE)患者血清基质金属蛋白酶-9(MMP-9)和金属蛋白酶组织抑制物-1(TIMP-1)水平并探讨其临床意义。方法 MMP-9和TIMP-1检测采用ELISA方法。结果 ①SLE患者血清MMP-9平均中位数水平为65.00ng/mL显著低于正常人对照组267.50ng/mL(P<0.001)。②SLE患者中,血清MMP-9水平活动组低于非活动组(P<0.05),肾损组低于非肾损组(P<0.01),低补体C3血症者低于无低补体C3血症者(P<0.05),低血清白蛋白血症者低于非低白蛋白血症者(P<0.05),外周血白细胞计数降低者低于无白细胞降低者(P<0.01)。③糖皮质激素治疗后患者MMP-9水平高于治疗前(P<0.05)。④患者MMP-9水平与SLE疾病活动指数(SLEDAI)呈负相关(P<0.01),与C3(P<0.05)、白细胞(P<0.01)、白蛋白/球蛋白比值(P<0.05)呈正相关。⑤血清TIMP-1水平在SLE组与对照组、SLE各相关组之间差异均无显著性。结论 MMP-9可能参与SLE发病机制。     

系统性白念珠菌病患者血清中芽管抗体的检测

目的 探讨一种诊断深部白念珠菌病的新方法.方法 以间接免疫荧光法测定白念珠菌系统感染患者血清中芽管抗体的滴度,并与常规真菌检测结果及菌株磷脂酶活性相比较.结果 血清中芽管抗体检测与常规检测方法(镜检+培养)阳性率比较,有较好的一致性(P<0.001).磷脂酶活性测定结果显示,感染组患者分离株较定植组的磷脂酶活力差异有统计学意义(P<0.05);磷脂酶活性与芽管抗体滴度具有相关性,P<0.001.结论 检测白念珠菌芽管抗体在系统件白念珠菌感染诊断中具有一定的诊断意义.     

性病患者中输血传播病毒的检测及其传播途径

目的 探讨输血传播病毒(transfusion transmitted virus,TTV)在性病(STD)患者中的感染状况及经性传播的可能性。方法 调查性病患者的性行为相关因素及应用巢式聚合酶链反应(nested-PCR)检测237例STD患者和80例健康体检正常人的血清TTVDNA。结果 ①STD患者和正常人的血清TTVDNA阳性率分别为19.41%(46/237)和2.5%(2/80),前者TTVDNA的阳性率明显高于后者(P<0.005)。②STD患者男性与女性TTVDNA的阳性率分别为20.59%和17.82%,两者之间差异无显著性(P>0.05)。③不同STD病种患者中以梅毒、生殖器疱疹以及梅毒合并非淋球菌性尿道炎(NGU)和尖锐湿疣(CA)、生殖器疱疹合并NGU患者的TTVDNA的阳性率较高,分别为29.41%、30.43%、33.33%、42.86%、33.33%,而NGU患者的TTVDNA阳性率(10.87%)较低。④28对(56例)STD患者配偶TTVDNA阳性率为28.57%(16/56),11对(22例)正常人配偶TTVDNA的阳性率为4.55%(1/22),两者之间差异有显著性(P<0.05)。⑤TTVDNA阳性组和阴性组的STD患者嫖娼大于半年以上者的人数分别为21例和9例(P<0.005),性伴平均人数分别为17.12和7.86(P<0.001)。结论 STD患者中存在严重的TTV感染;嫖娼的时间越长,性伴数越多,感染TTV可能性越大,提示性传播可能是TTV感染途径之一。     

系统性红斑狼疮患者外周血单一核细胞CD80/CD86和CTLA-4mRNA的表达

目的 探讨CD80/CD86和CTLA-4在系统性红斑狼疮(SLE)发病机制中的作用及临床意义。方法 用逆转录-聚合酶链反应(RT-PCR)检测32例SLE患者外周血单一核细胞(PBMC)中CD80、CD86、CTLA-4mRNA的表达水平。结果 活动期SLE患者PBMC中CD86的阳性表达率为90.63%,正常人对照组为60%,两组差异有非常显著性(P<0.01)。CD86的mRNA表达的平均水平(0.6410±0.0174)亦明显高于正常人对照组(0.4510±0.0402),差异有非常显著性(P<0.001);活动期SLE患者PBMC中CTLA-4的阳性表达率为81.25%,其mRNA表达的平均水平为1.0020±0.0624,均明显高于正常人对照组,差异有显著性(P<0.01);活动期SLE患者PBMC中CD80的阳性表达率和CD80mRNA的表达水平与正常人对照组差异均无显著性(P>0.05)。结论 CD86和CTLA-4的异常表达可能在SLE疾病活动和发展过程中起重要作用。     

梅毒、红斑狼疮和皮肌炎患者抗磷脂抗体检测

目的：探讨抗磷脂抗体与梅毒、系统性红斑狼疮(SLE)和皮肌炎(DM)的关系。方法：应用酶联免疫吸附试验检测16例梅毒患者、32例SLE患者和11例皮肌炎患者血清中的抗磷脂抗体。结果：①梅毒患者抗磷脂抗体的吸光度（A值)[lgG型抗磷脂酰胆碱抗体(aPC)除外]和IgM型阳性率[抗磷脂酸抗体(aPA)除外]与正常人相比显著升高，IgG型抗磷脂抗体阳性率只有抗心磷脂抗体(aCL)和抗磷脂酸抗体(aPA)，与正常人相比显著升高；②SLE患者抗磷脂抗体的A值和阳性率[IgG型抗磷脂酰乙醇胺抗体(aPE)和IgM型抗磷脂酰肌醇抗体(aPI)除外1与正常人相比显著升高；③DM患者抗磷脂抗体的A值[IgG型抗磷脂酰乙醇胺抗体(aPE)除外1与正常人相比显著升高。④梅毒和SLE患者总阳性率与正常人相比显著升高。结论：自身免疫性疾病患者的抗磷脂抗体与感染时有所不同；抗磷脂抗体虽然存在于多种自身免疫性疾病中，但以SLE的阳性率最高。     

血清中抗酪氨酸酶抗体的检测与白癜风活动性的关系

目的：探讨白癜风患者血清中抗酪氦酸酶IgG、IgM抗体滴度与疾病活动程度的关系和意义。方法：抗酪氯酸酶IgG、IgM抗体检测采用酶联免疫吸附试验（ELISA）方法。结果：①白癜风患者血清抗酪氨酸酶IgG抗体、平均滴度为0．316，显著高于正常对照组0．082（P〈0．001）；抗酪氨酸酶IgM抗体平均滴度为0．238，显著高于正常对照组0．065（P〈0．001），②活动期白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期白癫风患者（均P〈0.001）；泛发型白癜风患者血清抗酪氨酸酶IgG、IgM抗体滴度明显高于局限型白癜风患者（均P〈0．001）。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IGg抗体性呈正相关（均P〈0．001）；抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgM抗体阳性呈正相关（均P〈0．001）。①糖皮质激素治疗后患者抗酪氨酸酶IgG、IgM抗体滴度均低于治疗前（均P〈0．001）。结论：白癜风患并血清抗酪氨酸酶IgG、IgM抗体与疾病活动性和严重程度相关。     

SLE患者血清抗磷脂抗体的分布及临床意义

目的:探讨抗磷脂抗体(APA)在SLE患者血清中的分布及临床意义。方法:应用酶联免疫吸附实验(ELISA)法检测64例正常人和56例SLE患者血清中6种APA。结果:SLE患者IgG型抗心磷脂抗体(aCL)、抗磷脂酰肌醇抗体(aPI)、抗磷脂酸抗体(aPA)、抗磷脂酰丝氨酸抗体(aPS)、抗磷脂酰胆碱抗体(aPC)的A值和阳性率均显著高于正常人;IgM型aCL、aPA、aPE、aPS、aPC的A值和阳性率均显著高于正常人。SLE时IgG型和IgM型APA的总阳性率分别为67.86%和69.65%。结论:正常人血清中存在低滴度的APA,SLE患者血清中APA的阳性率高于正常人。APA的检测对早期诊断SLE可能有一定意义。     

IgG and IgM antibody reactivity to antigens of Treponema pallidum after treatment of syphilis

The persistence or loss of IgG and IgM antibody specificities for individual polypeptides of Treponema pallidum after therapy for syphilis was examined by sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) and by the Western blot technique. Both IgG and IgM antibodies to as many as 12 treponemal antigens, including a major 47-kdalton molecule, were evident in plasma from patients with untreated primary syphilis. IgM reactivity declined rapidly and uniformly after therapy, whereas IgG persisted despite some diminution in intensity of staining. Faint-to-moderate IgM and strong IgG antibody reactivities to at least 22 treponemal antigens (12-85 kdaltons) were identified in plasma from patients with untreated secondary and early latent syphilis. Again, IgG antibody declined slightly in staining intensity after treatment but continued to show reactivity against all molecules detected initially. IgM antibody reactivity declined more rapidly and was lost entirely against some determinants, including the 14- and 12-kdalton molecules. Immunofluorescence titers of IgG and IgM antibodies to T. pallidum in sera from these patients generally correlated with results of Western blot analysis. Antibody to the 12-, 14-, and 47-kdalton molecules of T. pallidum may have potential diagnostic applications.     

Comparison of four different serological methods for detection of antibodies to Borrelia burgdorferi in erythema migrans.

Three different enzyme-linked immunosorbent assays (ELISA) and Western blot were compared in regard to the detection of antibodies to Borrelia burgdorferi in sera from 100 patients with erythema migrans and from 100 controls. For IgG detection, a commercial indirect ELISA kit with flagellum antigen (flagellum ELISA) was significantly more sensitive than the routinely-used indirect ELISA with sonicated whole-cell antigen (sonicate ELISA) (p = 0.008). The difference in positivity in the IgM test was of borderline significance (p = 0.058). An IgM antibody-capture ELISA with sonicated whole-cell antigen (capture ELISA) was significantly more sensitive than either the IgM sonicate ELISA (p less than 0.001) or IgM flagellum ELISA (p less than 0.001). With the Western blot pattern chosen as the criterion for positivity, IgM Western blot was at least equal to IgM capture ELISA in terms of the number of positive erythema migrans sera, but a frequent discrepancy between these two tests was noted as to positivity in individual sera. IgG Western blot was considered to be of less value for the diagnosis of current disease due to a high occurrence of positivity among controls.     

RPR持续阳性梅毒患者的传染性与细胞免疫的相关性研究

目的:检测RPR持续阳性经治梅毒患者外周血淋巴细胞亚群,探讨其传染性与细胞免疫的相关性。方法:应用流式细胞仪检测RPR持续阳性梅毒患者中38例IgM阳性和32例IgM阴性的患者外周血T细胞亚群及NK细胞,并以30例健康人作为对照组。结果:IgM阳性组外周血CD3、CD4和CD8细胞均高于对照组(P<0.05),而NK细胞低于对照组(P<0.001);IgM阴性组外周血CD3、CD4细胞低于对照组(P<0.05),而CD8细胞及NK细胞均高于对照组(P<0.05);两组之间外周血淋巴细胞亚群的检测结果相比,IgM阳性组CD3、CD4细胞高于IgM阴性组(P<0.001),NK细胞低于IgM阴性组(P<0.001),而CD8细胞相比差异无显著性(P>0.05)。结论:RPR持续阳性梅毒患者存在明显的细胞免疫不平衡和免疫抑制;NK细胞显著降低可能是RPR持续阳性且具传染性的主要原因。     

Quantitative determination of FTA abs IgM in different stages of syphilis before and after treatment

The titres of treponemal specific IgM and IgG antibodies were determined by monospecific immunofluorescence (FTA abs IgM/IgG) on 191 sera from 107 patients with treated or untreated syphilis, at various stages and from 10 neonates born from seropositive mothers. IgM antitreponemal antibody was found in all cases of untreated syphilis but two neurosyphilis. After treatment the antibody usually disappeared within one year. However it persisted in three patients treated two years ago or more. When sera from these patients were fractionated by density gradient ultracentrifugation and examined for antitreponemal antibodies of the IgM classe (FTA abs IgM 19S) they never showed detectable concentrations of IgM. False reactive results as false non reactivity due to competitive inhibition, observed with FTA abs IgM can be eliminated after separation of immunoglobulins.     

白癜风患者血清中抗酪氨酸酶抗体及可溶性细胞问黏附分子1的检测

目的探讨白癜风患者血清中抗酪氨酸酶IgG、IgM抗体滴度和可溶性细胞间黏附分子1（sICAM-1）水平与疾病活动程度的关系和临床意义。方法抗酪氨酸酶IgG、IgM抗体和sICAM-1检测采用酶联免疫吸附试验（ELISA）方法。结果①白癜风患者血清中抗酪氨酸酶IgG抗体平均滴度为0．316，显著高于正常人对照组0．082（P〈0．001）；白癜风患者血清中抗酪氨酸酶IgM抗体平均滴度为0．238，显著高于正常人对照组0．065（P〈0．001），②白癜风患者进展期血清抗酪氨酸酶IgG、IgM抗体滴度明显高于稳定期（P均〈0．001），泛发型明显高于局限型（P均〈0．001）。③抗酪氨酸酶IgG、IgM抗体滴度与抗黑素细胞IgG抗体阳性及IgM抗体阳性均呈币相关（P均〈0．001）。④白癜风患者血清sICAM-1平均水平为697．40ng／mL，显著高于正常人对照组602．40ng／ml（P〈0．001）；进展期高于稳定期（P〈0．001）；泛发型高于局限型（P〈0．001）：稳定期和局限型白癜风患者血清中sICAM-1水平与正常人对照组差异无统计学意义（P均〉0．05）。结论白癜风患者血清中抗酪氨酸酶IgG、IgM抗体和sICAM-1与疾病活动性和严重程度相关。     

Treponema-specific and antilipoidal 19S(IgM) antibodies in penicillin-treated and untreated rabbits after infection with Treponema pallidum

The titres of treponema-specific and antilipoidal 19S(IgG) antibodies were determined in rabbits infected intratesticularly with Treponema pallidum. One group of rabbits was treated with penicillin the other served as control. Using different serological tests it was shown that 19S(IgM) antibodies were still detectable eight months after infection at about the same titres in both groups. In contrast, 19S(IgM) antibody titres in patients with syphilis became undetectable within three to six months after penicillin treatment. It is suggested therefore that the rabbit is not a reliable model for studying the effect of penicillin in human T pallidum infections.     

Treponema-specific and antilipoidal 19S(IgM) antibodies in penicillin-treated and untreated rabbits after infection with Treponema pallidum.

The titres of treponema-specific and antilipoidal 19S(IgG) antibodies were determined in rabbits infected intratesticularly with Treponema pallidum. One group of rabbits was treated with penicillin the other served as control. Using different serological tests it was shown that 19S(IgM) antibodies were still detectable eight months after infection at about the same titres in both groups. In contrast, 19S(IgM) antibody titres in patients with syphilis became undetectable within three to six months after penicillin treatment. It is suggested therefore that the rabbit is not a reliable model for studying the effect of penicillin in human T pallidum infections.