慢性持续期支气管哮喘患者外周血中性粒细胞和单核细胞Toll样受体的表达及意义

目的 探讨慢性持续期支气管哮喘(简称哮喘)患者外周血中性粒细胞和CD14+成熟单核细胞TLR2、TLR4表达的变化及意义.方法 入选慢性持续期哮喘患者30例,健康对照组46名,应用流式细胞仪全血双色免疫荧光直标法检测中性粒细胞和单核细胞TLR2和TLR4的表达情况,结果以细胞的TLR相对平均荧光强度(rmfi)和TLR相对阳性细胞百分率(rpcp)表示.结果 哮喘组患者中性粒细胞TLR2表达的rmfi(1.48±0.19)和rpcp(M=1.34％,Q1 - Q3为0.65％～2.91％)均明显低于健康对照组[分别为1.99±0.53和14.13％(Q1 - Q3为2.61％～27.51％),P值均＜0.001];TLR4表达的rmfi(1.77±0.21)明显低于对照组(1.95±0.26),(P＜0.01),rpcp(8.16±5.03)％与对照组(9.58±6.40)％比较,差异无统计学意义(P＞0.05).哮喘组CD14+单核细胞中TLR2 rpcp(90.92±8.42)％和TLR4 rpcp(11.92±10.34)％明显高于健康对照组[分别为(78.52±18.79)％和(5.78±3.98)％,P值均＜0.01];TLR2 rmfi( 9.91±2.14)及TLR4 rmfi(2.60±0.74)与对照组[分别为(9.73±2.71)和(2.77±0.58)]差异无统计学意义(P值均＞0.05).结论 慢性持续期哮喘患者外周血中性粒细胞TLR2和TLR4的表达较健康人群明显下调,CD14+单核细胞TLR2及TLR4阳性细胞率显著高于健康人群,中性粒细胞和单核细胞TLRs表达的变化在哮喘病程中可能发挥不同的免疫作用.     

冠心病患者PTCA前后外周血CD11b、CD62P表达变化及意义

采用流式细胞仪检测23例健康体检者（对照组）及41例冠心病患者（观察组）,经皮冠状动脉腔内成形术（PTCA）术前72、2h、术后30min及24、72h外周血中性粒细胞和单核细胞表面CD11b、CD62P的表达。结果观察组患者外周血中性粒细胞和单核细胞CD11b平均荧光强度（MFI）和CD62P阳性细胞百分比较对照组明显升高。PTCA术后24hCD11b荧光强度和CD62P阳性细胞百分比较术前72、2h明显升高。血小板CD62P与中性粒细胞CD11b呈正相关（r=0．253）。认为PTCA术后中性粒细胞和单核细胞CD11b及血小板CD62P表达上调,且可作为反映PTCA后炎症反应和血栓形成状况的指标。     

嗜酸性粒细胞性支气管炎发病机制中过敏原作用的探讨

对26例嗜酸性粒细胞性支气管炎（EB）患者行吸入性过敏原皮内试验、诱导痰细胞学检查;免疫组化法检测12例EB患者气道黏膜及黏膜下层组织中淋巴细胞亚群CD3、CD4、CD8及髓过氧化物酶（MPO）阳性细胞;以10例哮喘和15例健康查体者的诱导痰细胞学为对照;以早期周围型肺癌和哮喘患者各10例的气道黏膜免疫组化为病理对照。结果23例EB患者对过敏原有阳性反应;EB和哮喘患者诱导痰中的细胞总数（TCC）、嗜酸性粒细胞计数（Eos）均显著高于健康查体者（P〈0．05）;EB患者的中性粒细胞计数（Neu）高于哮喘和健康查体者（P〈0．05）;EB和哮喘患者的CD3、CD4、CD8、MPO阳性细胞高于肺癌对照组（P〈0．05）;EB患者MPO阳性细胞高于哮喘患者（P〈0．05）;过敏原反应分级与TCC、Eos、Neu以及CD3、CD4、MPO阳性细胞呈正相关（P〈0．05）,与CD8无相关性（P〉0．05）。认为吸入性过敏原可能通过激活气道组织中的T淋巴细胞,造成嗜酸性粒细胞或伴有中性粒细胞浸润为主的慢性气道炎症。     

白细胞介素-8受体A型和B型在强直性脊柱炎中的表达及其意义探讨

目的 检测白细胞介素-8受体A型（CXCR1）和白细胞介素-8受体B型（CXCR2）在强直性脊柱炎（AS）患者外周血中性粒细胞、CD14^＋单核细胞和CD3^＋T细胞上的表达水平，探讨其与AS疾病活动的相关性和可能涉及的AS炎症发病机制。方法 研究对象包括30例活动期AS患者，30例活动期类风湿关节炎（RA）患者和30名健康对照者，应用流式细胞术（FCM）检测CXCR1、CXCR2分别在AS患者、RA患者和健康对照者外周血中性粒细胞、CD14^＋单核细胞和CD3^＋T细胞上平均荧光强度（MFI）的表达水平，并和AS患者的临床BASFI、BASDAI、红细胞沉降率（ESR）、血清C反应蛋白（CRP）等指标进行相关分析。结果 CXCR1在AS患者组外周血CD3^＋T细胞上MFI表达水平（41±24）分别较RA患者组（18±10）和健康对照组（19±7）高（P均〈0．01）。CXCR2在AS患者组外周血CD14^＋单核细胞MFI表达水平（210±54）较健康对照组（300±52）低（P〈0．01），与RA患者组（191±53）比较差异无统计学意义（P〉0．05）；CXCR2在AS患者外周血CD14^＋单核细胞上MFI表达下降与患者毕氏疾病功能指数（BASFI）（r=-0．394，P=0．031）、毕氏AS疾病活动指数（BASDAI）（rs=-0．378，P=0．040）、ESR（rs=-0．465，P=0.010）、CRP（rs=-0．648．P=0．000）存在着负相关关系。结论 CXCR1和CXCR2分别在AS患者外周血CD3^＋T细胞和CD14^＋单核细胞表达异常，提示它们可能参与了AS的发病过程。检测AS患者外周血CD14^＋单核细胞的MFI表达水平可能是评价AS疾病活动性有价值的潜在的生物学标志之一。     

e抗原阳性慢性乙型肝炎患者外周血树突状细胞Toll样受体3的表达及意义

目的探讨Toll样受体3（TLR3）的表达与HBV感染后宿主免疫清除障碍的关系。方法选取轻度CHB患者50例,健康对照者48名,其外周血用免疫磁珠细胞分选法获得纯化的CD14^＋单核细胞,用RPMI 1640培养基培养,并且用人粒细胞-巨噬细胞集落刺激因子和hIL-4诱导单核细胞成为未成熟的髓样树突状细胞（mDC）,加入聚肌胞刺激后获得成熟的mDC。分别在剌激后0、12、24、48h用流式细胞仪检测TLR3、CD86、HLA-DR和CD1a的表达,实时PCR检测TLR3的表达变化。结果健康对照组中mDC在刺激后24h,TLR3表达较0 h时上调显著（P〈0.05）,48h时TLR3的表达与0h相比差异无统计学意义（P〉0.05）;患者组在刺激后12、24h TLR3的表达与0h时相比,上调不明显,48h时TLR3的表达显著上调（P〈0.05）。实时PCR检测mDC上TLR3 mRNA结果发现,对照组TLR3 mRNA在刺激后12h的表达水平较0h显著上升（P〈0.05）,也显著高于患者组刺激后0、12、24h的表达水平;患者组刺激后48h的TLR3 mRNA表达水平较0h显著上升（P〈0.05）。与0h比较,健康对照组在刺激后12、24h和48h,CD86的表达水平显著高于患者组（P〈0.05）。患者组与对照组间CD1a和HLA-DR的表达差异无统计学意义。结论慢性HBV感染者mDC受聚肌胞刺激后TLR3表达异常,协同刺激因子CD86表达低下,可能造成宿主对HBV感染的免疫清除障碍,导致疾病慢性化。     

高血压病患者外周血单核细胞Toll样受体4的表达

目的 探讨Toll样受体4(TLR4)在高血压伴靶器官损害患者外周血白细胞上的表达及其表达差异在高血压发病中的意义.方法 采用流式细胞仪检测45例轻型高血压不伴靶器官损害患者、40例高血压伴靶器官损害患者及40名健康对照者外周血淋巴细胞、单核细胞和中性粒细胞上TLR4的表达.结果 3组外周血淋巴细胞和中性粒细胞TLR4的阳性率平均值低于6%;高血压不伴靶器官损害组单核细胞的TLR4阳性率为(48.2±14.3)%,高血压伴靶器官损害组(55.9±15.2)%,均显著高于健康对照组的阳性率[(40.8±13.6)%,P均＜0.01),高血压伴靶器官损害组的TLR4阳性率高于高血压不伴靶器官损害组(P＜0.05).结论 TLR4主要表达于外周血单核细胞,在高血压及伴靶器官损害患者其阳性率升高;TLR4及其介导的炎性反应与高血压的发生发展存在一定的相关性.     

Toll 样受体在新生儿败血症患者中的动态变化及临床意义

目的：观察Toll样受体（TLR2、TLR4）在新生儿败血症病程中的动态变化,探讨其在新生儿抗感染免疫中的作用。方法将60例不同胎龄（31～42周）新生儿分为败血症组和对照组。应用流式细胞仪检测败血症组感染后第1天、第7～10天和非感染组第1天的外周血单核细胞和粒细胞表面TLR2、TLR4蛋白表达;同时检测血CRP、WBC、血小板。结果感染后第1天,败血症组TLR2蛋白在粒细胞和单核细胞的表达水平及CRP均高于非感染组（ P均＜0．05）;第7～10天,TLR2在粒细胞的表达水平接近对照组,而在单核细胞中则持续高表达（ P＜0．05）。败血症组TLR4在粒细胞表面持续低表达,在单核细胞表达高于粒细胞（ P＜0．05）;第7～10天,TLR4在单核细胞表达水平明显下降,接近对照组,但与第1天比P＜0．05。两组治疗前后WBC、血小板均变化不明显。结论新生儿败血症患儿外周血单核细胞和中性粒细胞表面TLR2、TLR4蛋白表达异常增高,提示TLR信号传导途径参与了新生儿的抗感染免疫机制,与新生儿败血症的发生、发展密切相关。     

高血压病患者外周血单核细胞Toll样受体4的表达

目的探讨Toll样受体4(TLR4)在高血压伴靶器官损害患者外周血白细胞上的表达及其表达差异在高血压发病中的意义。方法采用流式细胞仪检测45例轻型高血压不伴靶器官损害患者、40例高血压伴靶器官损害患者及40名健康对照者外周血淋巴细胞、单核细胞和中性粒细胞上TLR4的表达。结果3组外周血淋巴细胞和中性粒细胞TLR4的阳性率平均值低于6%;高血压不伴靶器官损害组单核细胞的TLR4阳性率为(48.2±14.3)%,高血压伴靶器官损害组(55.9±15.2)%,均显著高于健康对照组的阳性率[(40.8±13.6)%,P均<0.01),高血压伴靶器官损害组的TLR4阳性率高于高血压不伴靶器官损害组(P<0.05)。结论TLR4主要表达于外周血单核细胞,在高血压及伴靶器官损害患者其阳性率升高;TLR4及其介导的炎性反应与高血压的发生发展存在一定的相关性。     

益生菌对肝硬化患者免疫功能的影响

肝硬化患者易发生多种感染，与免疫功能下降、肠道菌群紊乱有关。目的：观察口服微生态制剂对肝硬化患者细胞免疫功能、外周血单核细胞内毒素受体表达以及血清细胞因子和血浆内毒素水平的影响。方法：选取连续入院的肝硬化患者，予常规保肝治疗和口服微生态制剂4周，应用流式细胞术检测患者治疗前后外周血T细胞及其亚群和自然杀伤细胞、外周血单核细胞内毒素受体Toll样受体（TLR）4和CD14的表达。分别以酶联免疫吸附测定法和偶氮基质显色法检测细胞因子白细胞介素（IL）-1β、肿瘤坏死因子（TNF）-α、IL-10水平和血浆内毒素水平。结果：治疗前肝硬化患者外周血总T细胞（CD3）和CD4细胞数明显低于正常对照组（P〈0．05），微生态制剂治疗后CD3和CD4亚群显著升高（P〈0．05）。治疗前肝硬化患者外周血单核细胞内毒素受体TLR4和CD14的表达显著高于正常对照组（P〈0．01），微生态制剂治疗后CD14表达显著降低（P〈0．01），TLR4表达也呈下降的趋势，但差异无统计学意义。治疗前肝硬化患者血清IL-1β、TNF-α、IL-10水平显著高于正常对照组（P〈0．05），微生态制剂治疗后血清细胞因子和血浆内毒素水平均无明显改变。结论：肝硬化患者存在细胞免疫功能下降和慢性炎症状态，微生态制剂可改善患者免疫功能的紊乱。因此可将其作为一种慢性肝病的辅助治疗。     

外周血DNT细胞和T细胞亚群检测在乙型肝炎病毒感染者诊断中的意义

目的：探讨乙型肝炎病毒感染者外周血CD3＋CD4-CD8-T细胞（DNT）和T细胞亚群的变化及意义。方法使用流式细胞仪检测136例乙型肝炎病毒感染者,包括33例无症状携带者、28例急性乙型肝炎患者、28例轻度慢性乙型肝炎患者、25例中度慢性乙型肝炎患者、22例重度慢性乙型肝炎患者和39例健康人外周血DNT细胞及T细胞亚群。结果健康人群和急性乙型肝炎患者外周血DNT细胞比例分别为（4.82±3.43）%和（4.75±2.71）%,显著低于无症状携带者[（5.43±3.31）%,P〈0.05]和慢性乙型肝炎患者（P〈0.05）;轻度慢性乙型肝炎患者DNT细胞比例为（7.97±4.12）%,显著低于重度慢性乙型肝炎患者[（11.36±5.01）%,P〈0.05];中度慢性乙型肝炎患者DNT细胞比例为（8.41±4.93）%,也显著低于重度慢性乙型肝炎患者（P〈0.05）;健康人、急性乙型肝炎患者和无症状携带者之间 T 淋巴细胞亚群分布无明显差异,但随着慢性乙型肝炎患者病情加重,外周血 CD3＋、CD3＋CD4＋CD8-细胞比例降低（P〈0.05）,CD3＋CD4-CD8＋细胞比例升高（P〈0.05）。结论外周血DNT细胞比例的升高与乙型肝炎病毒感染者慢性化及慢性乙型肝炎患者的疾病进程有关。     

支气管哮喘儿童急性发作期诱导痰液T细胞亚群及自然杀伤T细胞的变化

目的 分析支气管哮喘(简称哮喘)儿童急性发作期及缓解期诱导痰液T细胞亚群及自然杀伤T细胞(NKT细胞)的变化,探讨T细胞及NKT细胞在儿童哮喘气道炎症中的作用.方法 选取18例哮喘急性发作、21例哮喘缓解期及12名正常儿童的痰液,采用流式细胞术比较各组儿童诱导痰液CD3、CD4、CD8、NKT(CD3~+ CD56~+)百分比及CD4/CD8比值.结果 哮喘急性发作组CD4细胞百分比[(43.75±13.5)%]明显高于缓解期组[(37.04±7.11)%]和正常对照组[(33.57±7.54)%](P＜0.05),CD8细胞百分比[(21.10±6.10)%]明显低于缓解期组[(28.67±5.32)%]和正常对照组[(28.31±9.46)%](P<0.05),CD4/CD8比值(2.14±0.94)高于缓解期组(1.33±0.35)和正常对照组(1.31±0.42)(P＜0.05),CD4、CD8细胞百分比及CD4/CD8缓解期组和正常对照组差异无统计学意义(P>0.05),急性发作组CD4/CD8比值与嗜酸粒细胞百分比呈正相关(r=0.559,P＜0.05).缓解期组CD4/CD8比值与嗜酸粒细胞无相关性(r=0.398,P>0.05).急性发作组CD3+ CD56+细胞百分比[(3.33±1.69)%]略高于缓解组[(3.09±1.23)%]及对照组[(2.94±0.87)%],但差异无统计学意义(P>0.05).CD3- CD56+细胞百分比在三组之间无统计学差异(P>0.05).结论 儿童哮喘急性发作期,气道内CD4细胞占优势,CD4/CD8细胞比例失衡,CD4细胞可能介导儿童哮喘气道炎症过程.     

乙型肝炎e抗原对外周血单核细胞Toll样受体2表达的影响

目的 探讨HBeAg对外周血单核细胞表面Toll样受体2(TLR2)表达的影响.方法 对68例慢性乙型肝炎(CHB)患者(其中HBeAg与HBV DNA刚性37例,HBeAg阴性、HBVDNA阳性14例,HBeAg与HBV DNA阴性17例)和16名健康人的外周血肝素抗凝,加入Pam3CSK4在37℃、5%CO2条件下刺激3 h,用特异性TLR2单克隆抗体标记,经流式细胞仪检测CD14+细胞表面TLR2表达的百分率;比较刺激前后各组之间的差异.定量检测HBV DNA和血清HBV标志物,分析TLR2表达水平与HBeAg、HBV DNA的关系.用HBeAg与健康人及HBeAg阴性CHB患者的抗凝血在37℃、5%CO2条件下共培养6 h,用流式细胞仪定量分析HBeAg刺激后CD14+细胞表面TLR2的表达水平. 结果 HBeAg阳性CHB患者外周血CD14+细胞TLR2的表达率为47.57%±21.40%,明显低于健康对照组(76.51%±7.46%)和HBeAg阴性组(HBV DNA阳性组为73.2%±14.2%、HBV DNA阴性组为75.2%±11.3%,P<0.05);TLR2的表达水平在HBeAg阴性的HBV DNA阳性或阴性CHB患者组与健康对照组的差异无统计学意义.HBeAg阳性CHB患者外周血单核细胞经Pam3CSK4刺激后,TLR2的表达率明显升高,大部分患者TLR2的表达水平能够达到健康人或HBeAg阴性患者未经配体刺激的水平.健康人或HBeAg阴性CHB患者的外周血与HBeAg共孵育6 h后,CD14+细胞表面TLR2表达水平较HBeAg刺激前明显下降(P<0.05).结论 HBeAg阳性的CHB患者外周血CD14+细胞TLR2的表达水平明显低于HBeAg阴性患者和健康人,HBeAg能够抑制CD14+细胞TLR2的表达,提示HBeAg能够引起CHB患者外周血单核细胞表面TLR2表达的下调,这可能是HBV持续感染的重要因素之一;CHB患者HBVDNA水平可能不影响单核细胞表面TLR2的表达;Pam3CSK4可以明显提高HBeAg阳性CHB患者单核细胞表面TLR2的表达水平,TLR2配体有可能成为CHB免疫治疗的一个潜在靶位.     

支气管哮喘患者血清对内皮穿越模型中单核细胞分化为树突状细胞的作用

目的 探讨支气管哮喘(简称哮喘)患者血清和正常血清对内皮穿越模型中单核细胞向树突状细胞(DC)分化和功能的作用及其机制.方法 在江苏省哮喘联盟数据库中选择2008年5月至2009年5月轻～中度哮喘患者12例,募集匹配的健康志愿者12名,常规分离血清和外周血单个核细胞,免疫磁珠法获得单核细胞.选择健康产妇5名,胰酶消化法获得人脐静脉内皮细胞(第2代),培养融合至内皮细胞单层.在内皮细胞上方加入单核细胞及哮喘血清(哮喘组)或正常血清(对照组),构建内皮穿越模型.硝酸银染色法观察单核细胞来源的树突状细胞(MDDC)迁移行为.于48 h收集MDDC,扫描电镜观察形态学特征,电泳迁移率实验检测核因子κB(NF-κB)活性,流式细胞术、ELISA和混合淋巴细胞反应分别检测其表型和功能.结果 (1)在内皮穿越模型中,单核细胞2 h后发生正向穿越,48 h后发生逆向穿越并分化为DC.(2)与穿越前单核细胞[CD14(81±6)%、人白细胞抗原DR(HLA-DR)(24±5)%、CD80(2.8±2.0)%、CD86(14±4)%、CD83(0.9±0.8)%]比较,对照组MDDC的CDi4[(20±5)%]显著下降(F=49.01,P＜0.05)、HLA-DR、CD80、CD86和CD83[(43±4)%、(17.9±3.5)%、(43±11)%和(6.7±1.8)%]均显著增高(均P＜0.05),但CD83仍较低,为未成熟DC.(3)与对照组比较,哮喘组MDDC的HLA-DR和CD86[(55±6)%和(59±12)%]相仿(F值分别为15.29和35.97,均P＞0.05)、CD80和CD83[(49.7±10.2)%和(30.2±6.8)%]显著增高(F值分别为34.01和20.68,均P＜0.05),为成熟DC.并且,哮喘组MDDC呈典型的树枝样突起,其NF-κB活性、白细胞介素-12 P70水平和T细胞增殖作用[(100±11)%、(568±43)ng/L和(2033±198)cpm]较对照组[(12±3)%、(220±35)ng/L和(952±64)cpm]显著增高(均P＜0.05).结论 哮喘血清可诱导内皮穿越模型中单核细胞向DC异常分化成熟,并与NF-κB过度激活有关.该模型为剖析哮喘免疫学发病机制和筛选新型抗哮喘药物建立了新的体外实验平台.

Abstract：

Objective To explore the effect of asthmatic and healthy serum on differentiation and function of monocyte-derived dendritic cells (MDDC) in a transendothelial trafficking model. Methods The sera and peripheral blood mononuclear cells (PBMC) were separated from 12 asthmatic patients and 12 healthy volunteers, and monocytes were selected from PBMC using magnetic beads. The trypsin-digested human umbilical vein endothelial cells (HUVEC) at passage 2 from 5 healthy lying-in women were used to construct the transendothelial trafficking model under asthmatic or healthy serum, wherein MDDC were identified by silver nitrate staining and scanning electron microscopy. Nuclear factor κB (NF-κB) activity was determined by electrophoretic mobility shift assay. Flow cytometry, ELISA and mixed leukocyte reaction were relevantly utilized to detect the phenotype, cytokine and T cell proliferation. Results ( 1 ) Monocytes traversed through HUVEC monolayer after 2 h, and reverse-transmigrated to develop into DC 48 h later. ( 2 ) The healthy serum stimulated monocytes into immature MDDC with lower CD14 [ ( 20 ±5)%] (F=49.01, P＜0.05), and higher HLA-DR, CD80, CD86 and CD83 [(43 ±4)%, (17.9 ±3.5)%, (43 ± 11)% and (6.7 ± 1.8)%, respectively] (F= 10.35 -40.17, all P＜0.05) than monocytes did before transmigration at 0 h [ CD14(81 ±6)%, HLA-DR (24 ±5)%, CD80(2. 8 ±2. 0)%,CD86( 14 ±4)% and CD83(0. 9 ±0. 8)%, respectively]. (3) The asthmatic serum stimulated monocytes into mature MDDC, characteristic of dendrites, with similar HLA-DR and CD86 [ ( 55 ± 6 ) % and ( 59 ±12)%] (F=15.29 and 35.97, all P ＞0.05), higher CD80 and CD83 [(49.7 ± 10.2)% and (30.2 ±6. 8) % ] ( F = 4. 01 and 20. 68, all P ＜ 0. 05), accompanied by increased levels of NF-κB activity, IL-12 p70 and T cell proliferation [ ( 100 ± 11 )%, (568 ±43) ng/L and (2033 ± 198) cpm, respectively] (F=49. 23 - 350. 84, all P ＜ 0. 05 ) relative to the healthy serum-stimulated immature MDDC [ ( 12 ± 3 ) %,(220 ± 35) ng/L and (952 ± 64) cpm, respectively ]. Conclusion The asthmatic serum induces mature MDDC in association with NF-κB overactivation in the transendothelial trafficking model, which provides a promising experimental platform for both investigation of immunological mechanisms in asthma and screening of novel anti-asthma drugs in vitro.     

Neutrophil hyperchemotaxis in Beh?et’s disease: a possible role for monocytes orchestrating bacterial-induced innate immune responses

Increased neutrophil chemotaxis and hyperresponsiveness to streptococci have been considered to play a role in Behçet’s disease (BD) pathogenesis. Our aim was to correlate TLR2 expression and chemotactic responses stimulated by bacterial lipoteichoic acid (LTA) in BD neutrophils. Thus, we assessed expressions of TLR2 and the correlate receptors CD14, CD114 (G-CSF receptor), CD116 (GM-CSF receptor) and also TLR4 on circulating neutrophils and monocytes of patients with active BD. Serum concentration of soluble CD14 (sCD14) was also measured. Neutrophil chemotactic responses from BD patients and healthy controls under LTA stimulation were assessed. Disease activity was evaluated by Behçet’s Disease Current Activity Form (BDCAF). Receptor expressions were measured by flow cytometry, neutrophil chemotaxis was assessed in a Boyden chamber and sCD14 was measured by enzyme-linked immunosorbent assay. TLR2 expression was higher only on BD monocytes compared with healthy controls (39.9?±?13.1 vs. 33.6?±?5.3, p?=?0.019). Expressions of all other receptors were similar in BD and control group. Of particular interest, TLR2 expression on neutrophils was similar in both groups and, when stimulated with LTA, BD neutrophils showed chemotactic responses similar to the controls. Neutrophils exhibited increased chemotaxis only when incubated with BD plasma. Serum sCD14 concentration was higher in BD patients than in controls (1,920.8?±?563.6 vs. 1,623.2?±?391.3 ng/ml, p?=?0.008), and it was positively correlated with both CD14 expression on circulating monocytes membrane (p?=?0.035) and BDCAF scores (p?=?0.025). In conclusion, isolated BD neutrophils do not overexpress TLR2 neither overreact to LTA. However, because TLR2 expression was higher on BD monocytes, sCD14 from monocyte origin correlated with disease activity and neutrophil hyperchemotaxis occurred on strict dependence of plasmatic soluble factors, we suggest a possible role for bacterial stimulation of monocytes via TLR2 producing neutrophil-stimulating pro-inflammatory factors in BD.     

原发性胆汁性肝硬化患者外周血单个核细胞Toll样受体表达与调节性T细胞相关性分析

目的 探讨原发性胆汁性肝硬化(PBC)患者外周血单个核细胞(PBMC)Toll样受体2、4、9(TLR2,TLR4,TLR9)表达及PBMC中CD4+ CD25+调节性T细胞(Tregs)特点和影响因素.方法 采用流式细胞术检测PBC患者(52例)和健康对照者(22例)外周血PBMC中TLR2、4、9阳性细胞及Tregs比例,比较其在PBC患者和健康对照者中的差别并分析TLR与Tregs相关性.结果 PBC患者Tregs比例低于健康对照者[(1.53+1.33)vs(4.42±1.43),P＜0.0001],TLR4阳性细胞比例高于健康对照者[(36.95±3.53)vs(32.84±8.06),P=0.003];PBC患者Tregs比例与TLR9阳性细胞比例呈负相关(R2 =0.115,P=0.016),健康对照者Tregs比例与TLR2,4和TLR2,4,9联合表达阳性细胞比例呈负相关(R2=0.326,P=0.007;R2 =0.226,P=0.034).结论 PBC患者外周血PBMC中Tregs比例降低,TLR4表达升高,可能受肝硬化失代偿期腹腔感染的影响.     

初发系统性红斑狼疮患者外周血CD4+调节性T细胞CD73表达

目的 研究CD73在初发活动性系统性红斑狼疮(SLE)患者外周血CD4+调节性T细胞的表达情况,探讨其在SLE发病中的作用.方法 采用流式细胞术检测29例初发未经治疗的活动期SLE患者(SLE组)和22例健康人(健康对照组)外周血CD4+CD25+CD73+T细胞百分率及CD4+CD73+、CD4+CDhi25、CD4+CD25+T细胞中叉头状转录因子3(FOXP3)蛋白表达,同时对CD73表达水平与SLE活动指标进行相关性分析.结果 SLE组患者外周血CD4+ CD25+ CD73+T细胞百分率低于健康对照组[(1.25±1. 32)%vs(2.35±1.09)%,P＜0.01].SLE组和健康正常对照组,CD73在C4+ CDhi25T细胞的表达水平[(29.05±12.53)%、(43.35±10.09)%]高于CD4+ CD25+T细胞[(17.48±6.92)%、(29.98±10.39)%,P＜0.001];FOXP3蛋白在CD4+ CD73+ T细胞[(65.36±14.40)%、(63.80±14.05)%]、CD4+ CDhi25 T细胞的表达水平[(67.30±13.04)%、(56.30±9.21)%]明显高于CD4+ CD25+ T细胞[(45.70±12.74)%、(43.98±5.17)%,P＜0.001],在CD4+ CD73-T细胞几乎不表达,而在CD4+ CD73+ T细胞、CD4+ CDhi25 T细胞中的表达差异无统计学意义(P值均大于0.05).CD73在CD4+ CD25+ T细胞的表达水平与SLE疾病活动指数、ESR、C反应蛋白、抗补体C1q、抗核小体抗体均无相关性(P＞0.05).结论 CD73可作为调节性T细胞新的表面标记,其在调节性T细胞中的异常表达可能参与SLE的发病机制.     

系统性红斑狼疮患者外周血CD4+CXCR5+滤泡辅助性T细胞样细胞的变化及糖皮质激素对其的影响

目的 研究系统性红斑狼疮(SLE)患者外周血CD4+CXCR5+T细胞占CD4+T细胞百分率以及糖皮质激素对其的影响,探讨其在SLE发病机制中的作用.方法 采用流式细胞术检测45例活动期、20例缓解期SLE患者及20名健康对照外周血中CD4+CXCR5+T细胞占CD4+T细胞的百分率,比较其在各组中的差异及糖皮质激素治疗对其的影响,同时检测各组中CD19+B细胞上CXCR5的表达.2组间比较用独立样本t检验,3组间比较采用多变量方差分析,与临床指标之间的相关性分析采用非参数的Spearman相关分析,治疗前后的差异用重复测量的方差分析.结果 ①SLE患者外周血CD4+CXCR5+T细胞占CD4+T细胞的比例高于健康对照组[(16±7)%与(12±3)%,P＜0.01],其中活动组[(18±7)%]高于健康对照组(P＜0.05),而缓解组[(11±4)%]和健康对照组之间差异无统计学意义(P＜0.05);狼疮肾炎组高于非狼疮肾炎组,但差异无统计学意义[(18±7)%与(14±7)%,P=0.05].②CD4+CXCR5+T细胞百分率与SLE疾病活动指数(SLEDAI)、抗核抗体滴度和红细胞沉降率(ESR)呈正相关,与补体C3呈负相关(P均＜0.05),与C反应蛋白、病程、免疫球蛋白无相关性(P＞0.05).抗双链DNA抗体升高组与正常组之间、抗sm抗体、抗SSMSSB抗体阴性组和阳性组之间差异无统计学意义(P均＞0.05).③活动期SLE患者CD19+B细胞上CXCR5的表达比例低于健康对照组[(85±11)%与(94±3)%,P＜0.05].④10例初发、未接受治疗的活动期患者在接受地塞米松(20 mg/d)治疗后第1、3、7天外周血中CD4+CXCR5+T细胞百分率均低于治疗前(P均＜0.05).治疗前后CD19+CXCR5+B细胞的百分率无变化(P均＞0.05).结论 外周血CD4+CXCR5+滤泡辅助性T细胞样细胞的异常町能参与SLE的发病.

Abstract：

Objective To investigate the frequencies of CD4+CXCR5+T cells in the CD4+T cells of peripheral blood of patients with systemic lupus erythematosus (SLE) and the effect of glucocorticoid on it.Methods Frequencies of CD4+CXCR5+T cell were analyzed by flow cytometry in 45 active,20 inactive SLE patients and 20 healthy controls.Differences between groups and the effect of glucocorticoid were analyzed.Meanwhile, the expression of CXCR5 on CDI9+B cells was analyzed. Independent sample t test was used for statistical analysis between twogroups, ANOVA was applied for data analysis between 3 groups,,nonparameterical Spearman's analysis was used for correlation analysis and repeated measurement ANOVA were used to compare the parameters before and after treatment. Results The percentage of CD4+CXCR5+ in CD4+T cells was increased in patients with SLE compared with healthy controls[(16±7)% vs (12±3)%, P＜0.01].It was increased in patients with active SLE [(18±7)%] compared with healthy controls (P＜0.05) but there was no significant difference between inactive SLE[(11±4)%] and healthy controls(P＞0.05). The percentage in patients with LN was higher than that in patients without LN, but without significant difference[(18±7)%vs (14±7)%, P=0.05 ]. The percentage of CD4+CXCR5+T cells was positively correlated with SLEDAI,the titer of ANA and level of ESR but negatively correlated with the level of C3 (P<0.05 for each).No correlation was found between duration and the levels of CRP and immunoglobulin.. The percentage in patients with high anti-dsDNA group was also higher than that of the low group, but no differences were found between anti-Sm antibody positive and negative groups neither between anti-SSA/SSB antibody positive and negative groups(P＞0.05 for each).The expression level of CXCR5 on CD19+B cells in active SLE patients was lower than that of healthy controls[(85±11)% vs (94±3)%, P＜0.05 ]. The percentages of CD4+CXCR5+T cells in 10 untreated active SLE patients were decreased at day 1,day 3 and day 7 after being treated with dexamethasone (20mg/d) when compared with those before the treatment (P＜0.05 for each), but the percentages of CD19+CXCR5+B cells had no significant change (P＞0.05 for each).Conclusion These results demonstrate that the abnormality of CD4+CXCR5+T cells may play an important role in the pathogenesis of SLE.     

阿托伐他汀对C反应蛋白诱导的CD14+单核细胞Toll样受体4表达影响的实验研究

目的 观察阿托伐他汀对C反应蛋白(CRP)诱导的外周血CD14+单核细胞Toll样受体4(TLR4)表达,以及TLR4信号传导下游炎症因子肿瘤坏死因子α(TNFα)、白细胞介素-6(IL-6)和基质金属蛋白酶-9(MMP-9)的影响,探讨阿托伐他汀的抗炎机制.方法 不同浓度(0、5、25、50、100 μg/ml)和不同作用时间(0、6、12、24、48 h)的C反应蛋白(CRP)刺激正常人外周血CD14+单核细胞.给予CRP 50 μg/ml预先干预CD14+单核细胞2 h后,再用不同浓度的阿托伐他汀(1.0、2.5、5.0、7.5、10.0 μmol/L)进行干预.应用流式细胞仪检测细胞表面TLR4蛋白的表达,并应用定量PCR方法检测TLR4 mRNA和髓样分化蛋白2(myeloid differentiation protein,MD2)mRNA的表达,ELISA法检测刺激前后细胞上清液TNFα、IL-6和MMP-9的蛋白水平.结果 (1)CRP 0 μg/ml组TLR4蛋白表达量为19.59%,CRP 5 μg/ml组的TLR4蛋白表达为29.33%,差异有统计学意义(P<0.01),并随着CRP浓度的增加,TLR4蛋白表达量逐渐增加.以CRP 0 h组为空白对照,CRP 6 h组的TLR4蛋白表达量为25.75%,差异有统计学意义(P<0.01),并随着时间的增加,TLR4表达量逐渐增加.(2)以CRP 50 μg/ml组为对照组,CRP 50 μg/ml和阿托伐他汀1.0 μmol/L组、2.5 μmol/L组、5.0 μmol/L组、7.5 μmol/L组、10.0 μmol/L组,TLR4蛋白表达分别为(68.17±1.71)%、(52.43±1.38)%、(27.72±4.55)%、(17.46±3.20)%、(9.99±2.81)%.(3)以CRP 50 μg/ml组为标准,CRP 50 μg/ml〖JP〗和阿托伐他汀1.0 μmol/L组、2.5 μmol/L组、5.0 μmol/L组、7.5 μmol/L组、10.0 μmol/L组,TLR4 mRNA分别为对照组的82.72%、67.34%、48.16%、30.88%、13.85%.MD2 mRNA分别为对照组的81.78%、71.04%、47.85%、27.06%、18.30%.随着阿托伐他汀浓度增加,TLR4和MD2的mRNA含量减少.(4)当单核细胞未受CRP和阿托伐他汀刺激时,分泌TNFα、IL-6和MMP-9的基础值分别为(16.3±5.8)pg/ml、(31.1±9.5)pg/ml 和(155.0±47.2)ng/ml.CRP 50 μg/ml组,单核细胞分泌TNFα、IL-6和MMP-9分别为(106.9±7.5)pg/ml、(566.9±10.0)pg/ml和(416.9±37.1)ng/ml,与空白对照组比较,差异均有统计学意义,P均<0.01.而CRP和阿托伐他汀2.5 μmol/L组,单核细胞分泌TNFα、IL-6和MMP-9分别为(81.1±5.4)pg/ml、(433.9±18.1)pg/ml和(310.5±16.3)ng/ml,与CRP 50 μg/ml组比较差异均有统计学意义,P均<0.01.结论 CRP可剂量依赖性和时间依赖性地增加CD14+单核细胞TLR4和MD2的表达,阿托伐他汀通过抑制CRP诱导单核细胞TLR4信号转导途径,降低炎症因子TNFα、IL-6和MMP-9的分泌,是其抗炎作用的机制之一.

Abstract：

Objective To investigate the effects of atorvastatin on C-reactive protein (CRP)induced Toll-Like receptor 4(TLR4)expression on CD14+ monocyte, and the production of proinflammatory cytokines tumor necrosis factor α (TNFα), interleukin-6 (IL-6), matrix metalloproteinases-9 (MMP-9), and to study the anti-inflammatory mechanisms of statins. Methods The monocytes were isolated from blood of healthy volunteers by the Ficoll density gradient and stimulated by CRP with different doses (5, 25, 50, 100 μg/ml)and different exposure time (6, 12, 24, 48 h). Cells were also incubated with atorvastatin of different doses (1.0, 2.5, 5.0, 7.5, 10.0 μmol/L)in the presence of CRP 50 μg/ml. The protein expression of TLR4 was measured by flow cytometry, mRNA expression of TLR4 and of myeloid differentiation protein (MD2)was detected by quantitative PCR. TNFα, IL-6, MMP-9 concentrations in supernatants of cultured medium were measured by ELISA.Results (1)Compared with the un-stimulated control group, enhanced TLR4 protein expression was already detected at a concentration of 5 μg/ml of CRP and increased in a dose-dependent manner (32.22±2.80)%, (49.94±5.58)%, (74.82±3.24)% and (90.82±2.88)% at 5, 25, 50 and 100 μg/ml CRP. (2)TLR4 protein expression on 50 μg/ml CRP stimulated cells also increased in a time-dependent manner (29.80±2.70)%, (47.44±4.41)%, (81.71±2.92)% and (50.57±3.34)% after 6 h, 12 h, 24 h, 48 h.(3)When monocytes were incubated with CRP 50 μg/ml and atorvastatin (1.0, 2.5, 5.0, 7.5, 10.0 μmol/L), protein expression [(68.17±1.71)%, (52.43±1.38)%, (27.72±4.55)%, (17.46±3.20)%, (9.99±2.81)%］and mRNA expression (82.72%, 67.34%, 48.16%, 30.88%, 13.85%)of TLR4 as well as mRNA expression of MD2 (81.78%, 71.04%, 47.85%, 27.06%, 18.30%)were reduced in a dose-dependent manner. (4)Level of TNFα, IL-6 and MMP-9 in supernatants was significantly reduced by atorvastatin (2.5 μmol/L)compared with control group(P<0.01). When monocyte incubated with CRP 50 μg/ml and atorvastatin 10.0 μmol/L, the level of TNFα, IL-6, MMP-9 decreased to (25.8±2.5)pg/ml, (128.2±14.7)pg/ml, (65.2±12.3)ng/ml, respectively.Conclusion CRP increased the protein expression of TLR4 on CD14+ monocyte in a dose-dependent and time-dependent manner. Atorvastatin can inhibit the signal transduction of TLR4 and reduce proinflammatory cytokines release induced by CRP on CD14+ monocyte, and this might be one of the anti-inflammatory mechanisms of atorvastatin.     

高迁移率族蛋白1及Toll样受体4在类风湿关节炎患者血清和外周血单个核细胞中的表达及意义

目的 通过研究高迁移率族蛋白(HMGB)1及Toll样受体(TLR)4在类风湿关节炎(RA)外周血单个核细胞(PBMC)和血清中的表达,探讨HMGB1的作用及其与疾病活动的关系.方法 选取活动期RA患者38例和非活动期RA患者36例及健康对照组26名.采用反转录-聚合酶链反应(RT-PCR)方法检测PBMC中HMGB1 mRNA的表达,酶联免疫吸附试验(ELISA)检测血清中HMGBI蛋白的表达.采用流式细胞术分析PBMC上TLR4的表达.结果 ①活动期RA组PBMC中HMGB1 mRNA相对表达量和血清中HMGB1蛋白水平均高于健康对照组和非活动期RA患者[分别为2.63与0.71.0.93和(10.2±1.2)与(7.5+1.8),(8.3±1.8)ng/ml,P＜0.01.②活动期RA患者CD14+单核细胞和CD3+淋巴细胞上TLR4蛋白相对表达量高于非活动期和健康对照组(P＜0.05或P＜0.01),非活动期患者高于健康对照组(P＜0.05或P＜0.01).③血清中HMGB1蛋白水平与红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、关节压痛数、肿胀数及关节X线分期均呈正相关,亦与TLR4蛋白相对表达量呈正相关.结论 RA患者PBMC具有合成和分泌HMGB1蛋白的功能,并部分通过与TLR4结合激活炎症反应,加重骨质破坏.     

免疫性血小板减少性紫癜35例患者外周血免疫细胞亚群的检测及其临床意义

目的 探讨免疫细胞亚群的变化在免疫性血小板减少性紫癜(ITP)发病机制中的作用及其临床意义.方法 应用流式细胞术检测35例ITP患者治疗前、后及20例正常对照者免疫细胞亚群各指标的变化,包括CD3+、CD4+、CD8+、CD56+、CD19+淋巴细胞及CD4+/CD8+比值.结果 ITP患者CD3+ T淋巴细胞百分比(61.58±6.45)%、CD4+ T淋巴细胞百分比(28.38±4.89)%、CD4+/CD8+比值(0.99±0.22)较对照组[(67.85±4.68)%、(38.00±3.37)%、1.54±0.13]均减低(P值均＜0.05),治疗后3项指标[(69.41±5.03)%、(38.17±3.18)%、1.60±0.15]均升高至正常水平;CD8+ T淋巴细胞百分比(29.20±4.50)%及CD19+ B淋巴细胞百分比(17.74±4.14)%较对照组[(24.82±2.93)%、(12.09±3.51)%]升高(P值均＜0.05),治疗后2项指标[(24.06±3.02)%、(10.90±3.55)%]均降至正常水平;ITP患者CD56+细胞百分比治疗前(15.80±2.85)%、治疗后(15.16±2.77)%与对照组(16.36±2.75)%差异无统计学意义(P＞0.05).结论 免疫细胞亚群紊乱参与了ITP的发病,对其检测可作为ITP的辅助诊断,在指导治疗方面可能有一定的意义.

Abstract：

Objective To explore the clinical significance of immunocyte subsets before and after immunosuppressive therapy in the peripheral blood of patients with immune thrombocytopenic purpura (ITP).MethodsThe percentages of immunocyte subsets in the peripheral blood of 35 patients with ITP and 20 healthy controls were detected by flow cytometry,including CD3+,CD4+,CD8+,CD56+,CD19+ lymphocytes and CD4+/CD8+.Results The percentages of CD3+ T lymphocyte (61.58 ± 6.45 ) %,CD4+ T lymphocyte (28.38 ±4.89)% and the ratio of CD4+/CD8+ 0.99 0.22 in patients with ITP were lower than those in healthy controls[( 67.85 ± 4.68 ) %,( 38.00 ± 3.37 ) %,1.54 ± 0.13,all P ＜ 0.05].After immunosuppressive therapy,the percentages of CD3+ T lymphocyte ( 69.41 ± 5.03 ) %,CD4+ T lymphocyte (38.17 ±3.18)% and the ratio of CD4+/CD8+ 1.60 ±0.15 recovered to control levels.The percentages of CD8+ T lymphocyte (29.20 ±4.50)% and CD19+B lymphocyte ( 17.74 ±4.14)% were higher than those in healthy controls[( 24.82 ± 2.93 ) % and ( 12.09 ± 3.51 ) %,all P ＜ 0.05].After the immunosuppressive therapy,the percentages of CD8+ T lymphocyte ( 24.06 ± 3.02 ) % and CD19+ B lymphocyte ( 10.90 ± 3.55 ) %recovered to control levels.There were no significant difference of the percentage of CD56+ lymphocyte among ITP patients ( 15.80 ± 2.85 )%,ITP patients after immunosuppressive therapy ( 15.16 ± 2.77 )% and healthy controls ( 16.36 ± 2.75 ) %.ConclusionThe aberrant immunocyte subsets are involved in the pathogenesis of ITP,and detection of immunocyte subsets might be helpful for the diagnosis and determination of therapeutic outcome of ITP.