宫内感染乙型肝炎病毒儿童白细胞介素12转录研究

目的探讨外周血单个核细胞白细胞介素12(IL-12)P40转录变化和宫内感染乙型肝炎病毒(HBV)免疫失败的关系.方法采用体外细胞培养和半定量RT-PCR技术对25例宫内感染免疫失败儿童、8例宫内感染有效儿童及19名正常免疫儿童外周血单个核细胞在丝裂原(植物血凝素和细菌酯多糖)、酵母重组乙型肝炎表面抗原(HBsAg)及无刺激物时IL-12 P40 mRNA转录水平进行检测.结果IL-12 P40 mRNA丝裂原刺激时转录在免疫失败组高于免疫有效儿童(P=0.042),自发转录和血清丙氨酸转氨酶水平呈显著正相关(r=0.389,P=0.004).在小剂量HBsAg刺激时,对照组、有效组和免疫失败组转录差异不明显.和小剂量HBsAg刺激时比较,大剂量HBsAg刺激时对照组表现为转录显著增加(P=0.039),有效组和免疫失败组变化不明显.结论宫内感染HBV儿童对特异性抗原刺激IL-12反应低下可能是导致免疫失败的机制之一,对非特异性刺激反应增强可能与免疫失败儿童的肝细胞损伤有关.     

Graves眼病Th1/Th2相关细胞因子群谱的特征

目的　探讨Graves眼病 (Graves’ophthalmopathy ,GO)发生的免疫机制 ,明确GO的Th1/Th2 相关细胞因子群谱的特征。方法　用逆转录聚合酶链反应 (RT PCR)检测IFN γ、TNF α、IL 2、IL 4、IL 6、IL 10等 6种细胞因子的mRNA转录。结果　与正常对照组相比 ,Graves病恶性突眼组与非突眼组细胞因子的基因转录检出率明显增高 (P <0 .0 1) ;Graves病非突眼组Th2 类细胞因子IL 4和IL 6的基因转录检出率明显高于Th1类细胞因子IFN γ ,TNF α和IL 2的基因转录检出率 (P <0 .0 1) ;而恶性突眼组Th1和Th2 之间细胞因子的基因转录检出率差异无显著性 (P >0 .0 5 )。结论　Graves病恶性突眼者细胞因子的基因转录模式呈典型的Th0 ,细胞免疫和体液免疫共同参与了突眼的发生 ,而非突眼者细胞因子表达向Th2 方向漂移 ,以体液免疫应答为主。     

免疫刺激DNA序列对粉尘螨诱导的Th1和Th2细胞因子的调节作用

目的　研究免疫刺激DNA序列 (ISS)对螨性过敏性哮喘患者外周血单个核细胞 (PBMC)经粉尘螨变应原 (Df)诱导的Th1和Th2细胞因子的调节效应。方法　分离螨性过敏性哮喘患者及正常人PBMC ,加入ISS和Df刺激培养 ;以酶联免疫吸附试验检测培养上清中IFN γ、IL 12及IL 5含量 ;用荧光免疫酶标法检测患者血清中Df特异性IgE ,并作统计相关性分析。 结果　无论正常人还是患者PBMC加入ISS和Df刺激培养后 ,其上清中IL 12、IFN γ的含量较Df和对照序列刺激组明显增高 ,而IL 5却明显降低。正常对照组PBMC经ISS及Df刺激后产生的IFN γ、IL 12水平明显高于患者组 ,而IL 5则相反。患者组PBMC经ISS及Df刺激后产生的IL 12与IFN γ呈明显正相关。结论　ISS对正常人及螨性变态反应患者PBMC具有显著增强尘螨变应原诱导的Th1细胞因子表达 ,并抑制Th2细胞因子产生的作用 ,在尘螨变态反应疾病的治疗中具有潜在的临床价值。     

从基因水平对新型佐剂在旋毛虫疫苗中免疫调节作用的探讨

目的　从细胞因子的基因转录水平探讨两种新型佐剂霍乱毒素 B亚单位(CT B)和皂素(Saponin)在旋毛虫疫苗中的免疫调节作用。　方法　36只NIH小鼠随机分为CT B佐剂免疫组、Saponin佐剂免疫组和对照组。将CT B和Saponin分别与旋毛虫肌幼虫可溶性抗原混匀后,以口服或皮下注射途径免疫小鼠,隔周1次。第3次免疫后 1 周,经口感染旋毛虫感染期肌幼虫。感染后第8 d,采用RT PCR技术分析各组小鼠脾细胞在体外旋毛虫肌幼虫抗原刺激下,转录细胞因子 IFN γ、IL 2、IL 4及 IL 5 mRNA的水平。　结果　各组小鼠的脾细胞在体外抗原诱导下均未能转录 IL 2和 IFN γmRNA,但均有不同程度的 IL 4和 IL 5特异扩增,两免疫组的 IL 4 及 IL 5 mRNA转录水平明显高于对照组。结论　 Th2细胞及其分泌的细胞因子在机体抗旋毛虫的保护性免疫中发挥着重要作用;从佐剂角度提高旋毛虫疫苗的保护性是可行的。     

大鼠支气管哮喘模型γδT细胞Th1/Th2免疫应答模式的研究

目的　探讨γδT细胞在哮喘的免疫应答模式 ,认识γδT细胞亚群在哮喘发病机制中的作用。方法　Wistar大鼠 2 0只 ,随机分为健康对照组与哮喘组 (用鸡卵清蛋白致敏和刺激大鼠 ,制作哮喘模型 ) ,每组 10只。收集外周血单个核细胞 (PBMC)和支气管肺泡灌洗液 (BALF) ,用补体攻击法结合洗淘法选择性培养扩增γδT细胞 ,并用流式细胞术鉴定培养体系中的γδT细胞及其纯度 ,用原位杂交法测γδT细胞白细胞介素 (IL) 4mRNA和干扰素 (IFN)γmRNA的表达 ,用ELISA检测培养上清液中IL 4和IFN γ的浓度。结果　哮喘组大鼠PBMC和BALF中 ,γδT细胞培养上清液中IL 4浓度显著高于健康对照组 (P <0 0 1) ,IFN γ浓度低于健康对照组 (P <0 0 1) ;γδT细胞IL 4mRNA表达阳性率高于健康对照组 (P <0 0 1) ,IFN γmRNA表达阳性率低于健康对照组 (P <0 0 1)。结论γδT细胞或者γδT细胞亚群存在Th1/Th2模式 ,在大鼠哮喘模型呈Th2优势应答 ,γδT细胞参与了哮喘的发病过程。     

阿苯达唑治疗泡球蚴病患者血清中Th1/Th2型细胞因子的变化及临床意义

目的　为探讨泡球蚴病患者经阿苯达唑治疗后 ,机体免疫应答的状态和对病程转归影响。方法　 35例泡球蚴病患者经阿苯达唑治疗 1 2月前后 ,血清中sIL - 2R ,IFN -γ ,IL - 4IL - 5 ,IL - 6 ,TNFα,及特异性IgG ,IgE抗体进行检测。 结果　在治疗 1 2月后 ,Th1型细胞因子sIL - 2R ,IFN -γ无改变 (P >0 0 5) ,Th2型细胞因子IL - 4显著性下降 (P <0 0 1 ) ,IL - 5在患者中检出率明显降低 (P <0 0 1 ) ,TNFα和IgE水平较治疗前显著性下降 (P <0 0 1 )。 结论　泡球蚴病患者治疗后 ,Th2型细胞因子反应减弱 ,机体的保护性免疫应答有所恢复     

慢性移植物抗宿主病狼疮小鼠模型肾组织细胞凋亡及Th1/Th2细胞因子的研究

目的研究慢性移植物抗宿主病(cGVHD)狼疮样小鼠模型。肾组织细胞凋亡及Th1／Th2细胞因子的改变方法20只B6D2F1代杂交鼠，随机分为模型组(10只)及对照组(10只)，12周后处死采用原位末端标记法(TUNEL)染包观察肾组织细胞凋亡；免疫组织化学、Western blot和反转录-聚合酶链反应(RT-PCR)技术检测Fas、FasL基因转录及蛋白表达情况。结果TUNEL法结果显示模型组肾组织细胞凋亡较对照组增多。免疫组织化学提示：各组均有Fas、FasL表达，正常对照组有极少量Fas表达．表达部位在肾小球系膜细胞；FasL表达部位在近端肾小管上皮细胞。聚合酶链反应(PCR)结果：模型组较正常对照组Fas mRNA表达增高。模型组较正常对照组FasL mRNA表达差异无显著性。正常对照组干扰素(IFN)-γ和白细胞介素(IL)-4阳性细胞极少；模型组肾组织血管周围浸润的炎性细胞中可见IFN-γ和IL-4阳性细胞，且IL-4阳性细胞明显高于IFN-γ，提示Th2细胞表达占优势。模型组比正常对照绀INFγ／和IL-4阳性细胞明显升高，RT-PCR结果显示：模型组IFN-γ与正常对照组比较差异无显著性：模型组IL-γ较正常对照组显著升高。结论cGVHD狼疮样小鼠模样小鼠模织细胞凋亡异常及Th1/Th2细胞因子失衡，在狼疮肾炎(LN)的发病中起重要作用。     

尿毒症血液透析患者血清瘦素和Th1/Th2型细胞因子平衡的临床研究

目的 观察尿毒症血液透析(HD)患者血清瘦素、Th1/Th2型细胞因子水平的改变及其相互关系,探讨其在HD患者免疫功能异常中的作用.方法 选择终末期尿毒症行HD患者35例及健康对照者20例,双抗体夹心酶联免疫吸附法(ABC-ELISA)测定血清白细胞介素(IL)-2、干扰素(IFN)-γ、IL-4和IL-10水平,放射免疫分析法(RIA)测定两组血清瘦素水平.直线相关分析它们之间的相关性.结果 HD患者血清瘦素水平较对照组明显升高(P<0.01),与男性患者相比,女性患者升高尤为显著(P<0.01).HD患者血清Th1型细胞因子IL-2、IFN-γ水平明显升高,与对照组比较差异均有统计学意义(P<0.01);Th2型细胞因子IL4、IL-10水平较对照组降低,但差异无统计学意义(P>0.05),Th1/Th2比值升高.直线相关分析表明HD患者血清瘦素水平与IL-2(r=0.43,P<0.01)、IFN-γ(r=0.51,P<0.01)呈显著正相关,与IL-4(r=-0.39,P<0.01)、IL-10(r=-0.32,P<0.05)呈负相关.结论 HD患者存在高瘦素血症及以Th1型细胞因子占优势的Th1/Th2细胞因子平衡失调;患者血清细胞因子水平改变与瘦素水平相关.     

自身免疫性甲状腺疾病患者甲状腺内Th1/Th2细胞失衡研究

目的　探讨甲状腺中Th1/Th2 细胞失衡在自身免疫性甲状腺疾病 (AITD)发病中的作用。方法　选取 13例Graves病 (GD)患者、12例桥本甲状腺炎 (HT)患者 ,并以 8例非毒性结节性甲状腺肿患者作为对照进行研究。采用免疫组化染色方法检测这些患者甲状腺内单个核细胞 (ITMC)的γ 干扰素(IFN γ)和白介素 4(IL 4)细胞因子抗原表达 (分别代表Th1,Th2 分泌的细胞因子 ) ,并与外周血甲状腺刺激性抗体 (TSAb)、甲状腺球蛋白抗体 (TGAb)、甲状腺微粒体抗体 (TMAb)等免疫学指标进行相关分析。结果　 ( 1)GD、HT患者ITMC的IL 4、IFN γ阳性表达明显高于对照组 (均P <0 .0 1) ;GD患者ITMC的IL 4阳性表达明显高于IFN γ阳性表达 ;而HT患者ITMC的IFN γ阳性表达则明显高于IL 4阳性表达(均P <0 .0 5 ) ;( 2 )GD患者ITMC的IL 4阳性表达与TSAb显著正相关 (r =0 .67,P <0 .0 1) ,ITMC的IFN γ阳性表达与TSAb无相关性 ;HT患者ITMC的IFN γ阳性表达与TGAb、TMAb均呈显著正相关(分别为r =0 .65 ,r =0 .5 9,均P <0 .0 5 ) ,但ITMC的IL 4阳性表达与TGAb、TMAb均无相关性。结论　GD患者Th1/Th2 细胞平衡失衡偏向以Th2 占优势的免疫应答 ,而HT患者Th1/Th2 平衡失衡偏向以Th1占优势的免疫应答。     

日本血吸虫不同免疫原对小鼠Th1/Th2免疫偏移的影响

目的　观察单、双性日本血吸虫感染小鼠后Th1/Th2细胞因子水平的动态变化 ,探讨日本血吸虫不同免疫原对Th1/Th2免疫偏移的影响及与虫卵肉芽肿形成的相关性。方法　用ELISA夹心法检测单、双性日本血吸虫感染小鼠及单性感染 8w双性再感染 0～ 12w ,小鼠脾淋巴细胞培养上清Th1细胞因子IL - 2、IFN -γ和Th2细胞因子IL - 4表达水平。结果　单性感染小鼠 6～ 12w在脾淋巴细胞培养上清中可测出一定量的IL - 2和IFN -γ ,但无明显动态变化 ,而IL - 4未能测出 ;双性感染小鼠IL - 2和IFN -γ在感染后 4～ 6w开始上升 ,8w达高峰 ,随后下降 ,IL - 4则在感染后 8w时迅速上升且随着感染时间延长而明显升高 ,单性感染 8w双性再感染 4w时 ,小鼠脾淋巴细胞培养上清IL - 2、IFN -γ和IL - 4表达水平即迅速升高且在双性再感染 8～ 12w逐渐增强。结论　日本血吸虫不同免疫原对Th1/Th2免疫偏移的影响作用不同 ,Th1优势应答可能主要由虫体抗原诱导 ,Th2优势应答可能主要由虫卵抗原 (SEA)所诱导 ,后者是诱导宿主产生免疫病理反应的主要因素     

Long-term course of type I-simulating type II-diabetes mellitus

In only few cases of primarily non- insulin-dependent diabetes mellitus after many years an absolute insulin dependency can develop. Within 5000 patients of a diabetic outpatient clinic in 2 years this happened in 21 patients. These patients offered a C-peptide-secretion after stimulation which was typical for an insulin dependent diabetes. The investigation of HLA-frequencies showed a marked increase of the DR 3 und DR 4 loci. These results demonstrate that obviously the genetically as type I characterized diabetes may appear clinically in the picture of type II-diabetes for many years. This must be taken in consideration in therapeutic or epidemiologic questions.     

Multiplicity in type V adenylylcyclase: type V-a and type V-b

Type V mammalian adenylylcyclase cDNA was originally isolated from two animal species, the dog and rat. The amino acid sequences from the two species are highly homologous, but completely different in the putative N-terminal, cytoplasmic region. Northern blot analysis using oligonucleotide probes unique to either of the two clones has revealed that the two forms of type V adenylylcyclase mRNA, canine form (= type V-a) and rat form (= type V-b), are co-expressed as splicing variants in both species. Genomic Southern blot analysis has suggested that the two forms are the products of a single gene. When overexpressed, however, deletion of the N-terminal domain did not alter any biochemical properties. Thus multiple splicing variants with unique N-terminal amino acid sequences of type V adenylylcyclase can be generated from a single gene, however, biochemical properties of these variants may not be different.     

New mutation type in pseudohypoparathyroidism type Ia

Context The GNAS gene encodes the α‐subunit of the stimulatory G proteins, which play a crucial role in intracellular signal transduction of peptide and neurotransmitter receptors. Heterozygous inactivating maternally inherited mutations of GNAS (including translation initiation mutations, amino acid substitutions, nonsense mutations, splice site mutations and small insertions or deletions) lead to a phenotype in which Albright hereditary osteodystrophy is associated with pseudohypoparathyroidism type Ia. Objective We sought to identify the molecular defect in a patient who was thought to have PHP‐Ia. Methods and results The GNAS gene of a 5‐year‐old boy with brachydactily, mental retardation, pseudohypoparathyroidism and congenital hypothyroidism was investigated. We found a heterozygous inversion of exon 2 and part of intron 1 of de novo origin. Molecular studies of cDNA from blood RNA demonstrated that both the normal and the mutant variants were stable and that new splice‐sites were generated. Conclusion This report demonstrates the first evidence for an inversion at the GNAS gene responsible of pseudohypoparathyroidism type Ia.     

Diagnosis and management of type I and type V hyperlipoproteinemia

Both type I and type V hyperlipoproteinemia are characterized by severe hypertriglyceridemia due to an increase in chylomicrons. Type I hyperlipoproteinemia is caused by a decisive abnormality of the lipoprotein lipase (LPL)- apolipoprotein C-II system, whereas the cause of type V hyperlipoproteinemia is more complicated and more closely related to acquired environmental factors. Since the relationship of hypertriglyceridemia with atherosclerosis is not as clear as that of hypercholesterolemia, and since type I and V hyperlipoproteinemia are relatively rare, few guidelines for their diagnosis and treatment have been established; however, type I and V hyperlipoproteinemia are clinically important as underlying disorders of acute pancreatitis, and appropriate management is necessary to prevent or treat such complications. Against such a background, here we propose guidelines primarily concerning the diagnosis and management of type I and V hyperlipoproteinemia in Japanese.     

Progression of proteinuria in type 1 and type 2 diabetes

A longitudinal study evaluating the time course of the transition from normal to microalbuminuria, and then on to macroalbuminuria, was made over a mean period of 7 years in a cohort of 52 patients with Type 1 diabetes and 61 patients with Type 2 diabetes. Transient episodes of micro- and macroalbuminuria were often observed before the ultimate development of persistent Albustix-positive proteinuria. The transition from normal to microalbuminuria and from micro- to macroalbuminuria was characterized by rises in renal albumin clearance accompanied by lesser rises in total proteinuria. Seven patients with Type 1 and 12 with Type 2 diabetes showed evidence of progression, the interval for the transition from normal to macroalbuminuria varying from 3 to 5 years. In Type 1 diabetic patients, the development of micro- and macroalbuminuria was associated with a decline in renal function and a rise in systolic blood pressure without a significant change in blood glucose control. In Type 2 diabetic patients, the development of microalbuminuria was associated with a small decline in renal function but no change in blood pressure or blood glucose control. It is concluded that the transition from normal to micro- and on to macroalbuminuria may be more rapid then previously reported and varies considerably among individuals.     

Unusual type of hypochromic anemia complicating billroth II type gastrectomy

Summary An unusual type of hypoferremic hypochromic anemia, after Billroth II type of gastric resection, is presented. The ferrokinetic studies indicate defective red blood cell re-utilization of iron. It is postulated that a small intestinal disease which complicated this type of surgery, like any other inflammatory reaction, was responsible for production of defective red cell reutilization of iron, and anemia. This defect was corrected after the second operative procedure—ie, Henley jejunal interposition.Supported in part by USPHS Grants CA 05462 and H 6374, and the Clinical Research Center, Thomas Jefferson University Hospital.The authors wish to thank Mr. William Burke and Miss Shirley Wilcher for their technical assistance, and Drs. Allan J. Erslev and Dhodanand Kowlessar for critical review of this paper.     

Platelet membrane fluidity in type IIA, type IIB and type IV hyperlipoproteinemia.

Fluorescence spectroscopy, a very sensitive index for measuring the biophysical properties of living cell systems, was used to examine the structural order of intact, resting, gel-filtered platelets from hyperlipidemic subjects (n = 48, 25-70 years) and normolipemic subjects (n = 34, 19-68 years). Fluorescence anisotropy (r[s]), which is inversely related to membrane fluidity, was estimated using 3 different fluorescent dyes, DPH, TMA-DPH, and 6-AS, known to label different regions of biological membranes. Increased membrane fluidity was observed in type IIB (n = 24, 36-62 yrs; r[s] = 0.0692 +/- 0.09) and type IV (n = 10, 33-57 yrs; r[s] = 0.058 +/- 0.006) hyperlipidemics in comparison to type IIA (n = 14, 25-70 yrs; r[s] = 0.086 +/- 0.019) and control subjects (n = 24, 28-68 yrs; r[s] = 0.079 +/- 0.012). The temperature dependency of r[s]-DPH values was significantly different (P less than 0.01) in platelets from type IIB and type IV patients compared to type IIA and control subjects of similar age. A significant positive correlation (P less than 0.005) between membrane fluidity and age was found only in healthy control subjects (n = 34, 19-68 yrs). Despite significant (P less than 0.01) differences in plasma lipid concentrations in hyperlipidemic patients and controls, significant ex vivo relations between membrane fluidity and lipoprotein concentrations, free fatty acid distribution, and increased age were found only in healthy control subjects. Plasma levels of thromboxane as well as serum selenium concentrations did not significantly differ between hypercholesterolemic, hypertriglyceridemic, and control subjects.