再生障碍性贫血患者骨髓及外周血T、NK细胞膜分子和可溶性分子动态变化

目的研究T淋巴细胞及免疫分子在再生障碍性贫血（AA）致病中的作用及其与临床疗效的相关性。方法应用免疫荧光染色技术和流式细胞仪分析AA骨髓及外周血T淋巴细胞表型，ELISA测定骨髓和外周血白介素-2及其可溶性受体（IL-2，sIL-2R）、可溶性Fas配体（sFas-L）和Flt3配体（FL）的水平。结果（1）AA病人骨髓和外周血CD8+细胞百分率增加，CD4/CD8比例下降；骨髓血CD25+和HLA-DR+细胞百分率增多，急性AA增加尤为显著（P<0.01）；骨髓血中CD16+或CD56+细胞百分率也明显增多（P<0.05）。（2）所有AA患者骨髓及外周血IL-2含量均显著升高，绝大部分患者的sFas-L含量增加，FL水平升高尤为显著，高达正常水平的20倍。IL-2、sFas-L和FL的含量与临床疗效密切相关，经治疗有效的患者骨髓和外周血的IL-2、sFas-L和FL水平明显下降，但FL仍不能降至正常水平。结论T细胞的异常活化，多种免疫分子表达的异常升高，以及产生针对自身造血干/祖细胞的细胞毒效应，是AA造血功能衰竭的主要原因。     

再生障碍性贫血患者淋巴细胞表型变化

目的：研究再生障碍性贫血（AA）患者骨髓（BM）及外周血（PB）淋巴细胞及其活化相关分子的表达及临床意义。方法：采用单色和双色免疫荧光标记法，流式细胞仪分析AA患者的BM和PB中淋巴细胞膜分子的表达。结果：AA患者BM和BP中CD8^ 细胞增加，CD4／CD8比例下降，BM在CD25^ 细胞和HLA－DR^ 细胞增多，急性AA增加尤为显著（P＜0．01），BM中CD16^ 或CD56^ 细胞也明显增多（P＜0．05），双标记分析提示T细胞主要为CD8^ 细胞：急性AA患者CD8^ -CD25^ 细胞显著增多（P＜0．01），AA患者BM中淋巴细胞活化相关分子表达增多，尤其4－1BB^ ,CD95L^ 和CD40L＋细胞显著增多（P＜0．01），结论：AA患者BM中淋巴细胞活化相关膜分子增多，是AA免疫功能异常及最终导致造血功能衰竭的原因之一。     

再生障碍性贫血骨髓及外周血高水平Flt3配体的来源及意义

目的：研究再生障碍性贫血（AA）患者骨髓及外周血高水平FL（Flt3配体）的来源和影响因素。方法：采用常规ELISA法测定AA患者骨髓和外周血FL含量，应用单色和双色免疫荧光标记流式细胞仪分析FL的分泌细胞及其受体Flt3的表达，并观察AA患者淋巴细胞经PHA激发后环胞菌（CyA)对FL分泌的影响。结果：AA患者骨髓和外周血FL含量显著升高，为正常的25倍以上，外周血和骨髓浓度无区别；正常人CD3^ 细胞内贮存有大量FL，而AA患者CD3^ 细胞以膜型FL为主，胞内基本无FL存在；淋巴细胞经PHA活化后可分泌FL，CyA可抑制FL的分泌，结论：AA患者骨髓和外周血FL水平显著升高，主要由CD^＋细胞产生。     

卵巢癌患者化疗前后血清IL-2,SIL-2R,TNF-α检测的临床意义

目的:分析了34例卵巢癌患者化疗前后血清IL-2、SIL-2R和TNF-α水平的变化。方法:采用放 射免疫分析测定患者血清中IL-2、TNF-α含量和使用ELISA法检测SIL-2R含量,并与30名正常健康人作 比较。结果:化疗前IL-2活性明显低于正常人,TNF-α和SIL-2R水平明显高于正常人(P<0.01),化疗后 6个月复发者,IL-2、TNF-α、SIL-2R水平持续异常;未复发者IL-2、TNF-α、SIL-2R水平恢复正常。结 论:观察卵巢癌患者免疫功能的变化与患者的病情及预后密切相关。     

sFas、 sFasL及细胞因子在类风湿关节炎疾病中的意义

目的研究sFas,sFasL,细胞因子及抗单链DNA抗体与类风湿关节炎(rheumatoidarthritis,RA)致病的关系及意义。方法采用ELISA法检测32名RA患者的血清标本。结果RA患者血清sFas,sFasL,IL-6及IL-8的水平均高于正常对照组。活动期sFasL,IL-6及IL-8的水平显著高于非活动期(P∨0.01),而sFas的水平未见显著差异。在32例RA患者中,有8例sFas和sFasL的水平同时升高,9例抗单链DNA抗体和sFasL同时升高。结论IL-6和IL-8的水平与RA的炎症程度有关。高浓度的sFas和sFasL可抑制Ts细胞对TH细胞的负向调节。由Fas/FasL启动淋巴细胞凋亡产生的核抗原,可致机体产生抗单链DNA抗体。检测sFas,sFasL,IL-6及IL-8有助于对RA的诊断,并可为RA的免疫生物治疗提供依据。     

sFas、sFasL及细胞因子在类风湿关类疾病中的意义

目的：研究sFas、sFasL及细胞因子及抗单链DNA抗体与类风湿关节炎（rheumatoid arthritis,RA)致病的关系及意义。方法采用ELISA法32名RA患者的血清标本。结果RA患者血清sFas、sFasL,IL－6及IL－8的水平均高于正常对照组,活动期sFasL,IL-6及IL－8的水平显著高于非活动期（P＜0．01）,sFas的水平未见显著差异。在32例RA患者中,有8例sFas和sFasL的水平同时升高,9例抗单链DNA抗体和sFasL同时升高。结论IL－6和IL－8的水平与RA的炎症程度有关。高浓度的sFas和sFasL可抑制Ts细胞对TH铁负向调节。由Fas/FasL启动淋巴细胞凋亡产生的核抗原,可致机体产生抗单链DNA抗体。检测sFas,sFasL,IL-6及IL－8有助于对RA匠诊断,并可为RA的免疫生物治疗提供依据。     

NF-кB在Graves病免疫病理机制中的意义

目的:探讨Graves病（GD）患者外周血单个核细胞（PBMCs）NF-кB活性变化及其在GD免疫病理机制中的意义。方法:分别采集22例未经治疗的GD患者（未经治疗组）、20例经他巴唑治疗>1年的GD患者（治疗组）及25例健康志愿者（对照组）静脉血,采用凝胶电泳可动性移位分析（EMSA）检测PBMCs中NF-кB活性;采用放免法检测血清IL-1β、IL-6及TNF-α含量。 结果:未经治疗GD组患者PBMCs NF-кB活性显著高于治疗组及正常对照组（P<0.05）;未经治疗GD组患者血清IL-1β、IL-6、TNF-α水平明显高于治疗组和正常对照组（P<0.05）; 未经治疗GD组和治疗组NF-кB活性与IL-6水平均呈正相关。 结论:GD患者NF-кB活性明显升高,NF-кB活性增高可能在GD免疫病理机制中起重要作用。     

再生障碍性贫血患者免疫调节剂治疗前后TNF和IL-2水平变化及意义

为了探讨再生障碍性贫血(AA)的免疫发病机理及抗T淋巴细胞单克隆抗体(McAb-T)的免疫调节治疗作用,采用放射免疫分析法检测30例AA患者McAb-T治疗前后血清肿瘤坏死因子(TNF)和白细胞介素-2(IL-2)水平及其中10例AA外周血单个核细胞(PBMNC)体外诱生TNF和IL-2水平的变化。结果表明,治疗前AA患者血清TNF水平显著增高(p<0.01),PBMNC诱生的TNF和IL-2水平均明显高于正常对照(p<0.01)。治疗后血清TNF和PBMNC诱生的TNF和IL-2水平降低,与对照组比较无显著差异(p>0.05)。提示AA患者存在造血调控因子分泌异常,McAb-T对TNF和IL-2能发挥特异性的免疫调节作用。     

动脉粥样硬化性脑梗死患者血浆抗凝血酶Ⅲ的变化及其机制

 目的：探讨抗凝血酶Ⅲ（AT-Ⅲ）在动脉粥样硬化性脑梗死患者中的变化及其机制。方法：采用发色底物法检测55例动脉粥样硬化性脑梗死患者血浆中AT-Ⅲ活性,并与神经系统损伤程度、一般生化项目进行相关性分析;应用酶联免疫吸附法（ELISA）测定血浆肿瘤坏死因子（TNF-α）和白细胞介素6（IL-6）水平;酶免疫法（EIA）测定患者血浆中免疫复合物的含量;流式细胞术检测外周血单核细胞数量及表型,并与正常组55例体检者进行对照。采用ELISA法分析免疫复合物刺激外周血单核细胞后TNF-α和IL-6分泌的变化;Western blotting法观察TNF-α和IL-6对人脑血管内皮细胞AT-Ⅲ表达的影响。结果：动脉粥样硬化性脑梗死患者血浆中AT-Ⅲ活性明显降低（P<005）,且与神经系统功能损伤程度呈负相关（P<005）,与收缩压、舒张压、空腹血糖、胆固醇、甘油三酯、低密度脂蛋白、同型半胱氨酸呈负相关,与高密度脂蛋白呈正相关（P<005）;同时,患者血浆中TNF-α和IL-6水平明显升高（P<001）,伴随免疫复合物含量增多（P<001）;流式细胞术分析发现,患者外周血CD14+CD16+和CD14+CD32+单核细胞数量无明显变化（P>005）,而CD14+CD64+单核细胞数量显著增多（P<005）。经免疫复合物刺激后,外周血单核细胞TNF-α和IL-6分泌明显升高（P<001）,而TNF-α或IL-6与人脑血管内皮细胞共孵育后,均可下调其AT-Ⅲ蛋白表达水平（P<005或P<001）。结论：AT-Ⅲ在动脉粥样硬化性脑梗死患者血浆中明显降低,是脑梗死发病的危险因素之一,且与病情严重程度相关,其可能的机制是免疫复合物通过CD14+CD64+单核细胞介导促炎细胞因子的产生。升高AT-Ⅲ活性对缺血脑组织具有保护作用。     

原因不明习惯性流产患者主动免疫前后IL-4、IL-12变化的研究

目的:探讨原因不明习惯性流产（UHA）患者主动免疫治疗前后外周血IL-4和 IL-12mRNA水平的变化。方法:用半定量逆转录-聚合酶链反应（RT-PCR）技术,检测30例正常非孕妇女和30例UHA妇女的外周血单个核细胞内IL-4和IL-12mRNA表达水平的相对含量（％）。结果:①UHA组妇女外周血单个核细胞上IL-4mRNA的相对含量,明显低于正常非孕组妇女（P<0.01）。而IL-12　mRNA的相对含量明显高于正常非孕组妇女（P<0.05）。②主动免疫治疗后,UHA组妇女外周血单个核细胞上IL-4 mRNA的相对含量较治疗前明显升高（P<0.05）,而IL-12mRNA的相对含量较治疗前明显降低（P<0.01）。③主动免疫治疗后,UHA组妇女上述细胞因子mRNA的相对含量与正常非孕组妇女相比无显著差异。④主动免疫治疗后,妊娠成功者其外周血单个核细胞上IL-4　mRNA的相对含量较治疗前明显升高（P<0.05）,IL-12　mRNA的相对含量较治疗前明显降低（P<0.05）;而妊娠失效者IL-4和IL-12　mRN的相对含量与治疗前无显著差异。结论:IL-4和IL-12的表达异常与UHA的发生密切相关,主动免疫治疗可上调IL-4的表达及下调IL-12的表达,可能进一步诱导TH2分化和抑制TH1分化,从而促使TH1/TH2型细胞因子平衡向TH2为主的模式转换,并使妊娠获得成功。     

Variations in the serum concentrations of soluble Fas and soluble Fas ligand in Vietnamese patients infected with hepatitis B virus

Earlier studies of both chronic hepatitis B and C virus (HBV and HCV) patients have shown a strong correlation between the soluble membrane Fas (sFas) and Fas protein expression on hepatocytes. The serum concentrations of sFas and soluble Fas ligand (sFasL) was examined in both healthy and HBV-infected Vietnamese patients to determine their relationship with the outcome of HBV infection. Patients with chronic rather than acute HBV had significantly higher amounts of sFas and sFasL, whilst the highest concentrations of both molecules were detected in those with malignant forms of HBV infection. sFas and sFasL concentrations tended to increase with a profile that paralleled the progression from asymptomatic to acute through chronic to malignant states, most markedly in the case of sFas. The sFas:sFasL ratio highlighted the relative predominance of sFas in those with acute and chronic HBV compared with asymptomatic or severe forms. In patients with hepatocellular carcinoma (HCC) a significant correlation was also observed between sFasL and alpha-feto protein (AFP) levels. The results indicate that sFas and to a lesser extent sFasL levels are to some degree associated with clinical progression in HBV infection.     

Serum levels of soluble Fas ligand in patients with silicosis

Certain patients with silicosis have been reported to exhibit immunological abnormalities such as the appearance of antinuclear antibodies and the occurrence of autoimmune diseases. Fas ligand (FasL) is a type II membrane protein which induces apoptosis by binding to its membrane receptor, Fas. FasL is converted to a soluble form by a metalloproteinase-like enzyme. We have already found serum soluble Fas (sFas) levels in silicosis patients as well as in patients with systemic lupus erythematosus (SLE) to be significantly higher than those in healthy volunteers. To examine further the role of the Fas/FasL system in silica-induced immunological abnormalities, we investigated serum soluble FasL (sFasL) levels in silicosis patients with no clinical symptoms of autoimmune diseases, using ELISA for sFasL. Although the serum sFasL levels in patients with SLE were significantly higher than those in healthy volunteers and showed a slight positive correlation with serum sFas levels, those in silicosis patients exhibited no significant difference from those in healthy volunteers, and there was no correlation with serum sFas levels. However, sFasL levels were elevated in silicosis patients with slight dyspnoea or normal PCO2 among various clinical parameters of silicosis. It may be speculated that the immunological disturbances presented by the abnormalities of apoptosis-related molecules in silicosis patients do not occur with a similar degree of respiratory involvement. Further studies are required to clarify which kinds of factors are involved in silicosis patients who exhibit immunological abnormalities.     

Prognostic significance of soluble fas and soluble fas ligand in serum of patients with complete hydatidiform moles

Citation Soni S, Rath G, Deval R, Salhan S, Mishra AKumar, Saxena S. Prognostic significance of soluble Fas and soluble Fas ligand in serum of patients with complete hydatidiform moles. Am J Reprod Immunol 2011; 66: 230–236 Problem Despite of advances in diagnosis and staging, the prognosis of hydatidiform mole (HM) remains intricate. HM possesses the substantial risk of developing persistent trophoblastic disease (PTD), which is considerably high for complete hydatidiform moles (CHMs). Significance of serum soluble Fas (sFas) and soluble FasL (sFasL) has been observed in various malignancies; however, there is no report till date on HM. Method of study The serum levels of sFas and sFasL were measured using enzyme‐linked immunosorbent assay in 62 patients with CHMs and 64 healthy controls. The protein concentrations were also correlated with clinicopathological parameters, β‐hCG level, and clinical outcome. Results The serum sFas and sFasL levels in patients with CHM were significantly higher than those in control group (mean ± SD: 703.497 ± 491.759 versus 348.141 ± 175.24; P < 0.004 and 31.17 ± 18.758 versus 18.802 ± 6.775; P < 0.0001, respectively). Patients who progressed to PTD demonstrated higher sFas and sFasL concentrations than those who regressed spontaneously (794.211 ± 415.892 versus 446.69 ± 161.382; P < 0.046 and 37.55 ± 20.337 versus 22.763 ± 6.52; P < 0.011, respectively). Furthermore, significant associations were observed among sFas, sFasL, and β‐hCG levels (P < 0.0001 for all associations). Conclusion Production of sFas and sFasL may play a crucial role in progression of CHM and may serve both as prognostic tool and therapeutic target in improving the clinical outcome.     

Serum and follicular fluid levels of soluble Fas, soluble Fas ligand and apoptosis of luteinized granulosa cells in PCOS patients undergoing IVF

BACKGROUND: There are limited data about the levels of soluble apoptotic factors and their modulation with therapeutic regimens in IVF cycles. The aim of the current study was to determine follicular fluid, and serum levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) in PCOS patients undergoing IVF/ICSI cycles; also to investigate the effects of metformin on these factors and on apoptosis of luteinized granulosa cells. METHODS: We investigated the serum and follicular fluid levels of sFas and sFasL in patients with PCOS (n = 28) and compared them with those of the patients with infertility due to male factor (n = 12) undergoing IVF cycles. Effects of metformin therapy on these parameters and apoptosis of luteinized granulosa cells were also investigated among the patients with PCOS. RESULTS: Serum levels of sFas were significantly lower in the PCOS group compared to those in women with infertility due to male factor. Metformin therapy in PCOS patients preceding IVF cycles increased serum levels of sFas and decreased follicular fluid levels of sFasL compared to those on placebo. Follicular fluid from PCOS patients demonstrated luteinized granulosa cell DNA fragmentation in agarose gel, whereas a similar pattern was not observed among PCOS patients undergoing metformin therapy. CONCLUSION: Decreased serum levels of sFas and luteinized granulosa cell DNA fragmentation is observed in patients with PCOS undergoing IVF cycles. Metformin therapy preceding IVF demonstrates an antiapoptotic effect with increased serum levels of sFas, decreased follicular fluid levels of sFasL and prevention of luteinized granulosa cell DNA fragmentation.     

Presence of membrane and soluble forms of Fas ligand and of matrilysin (MMP-7) activity in normal and abnormal human semen

BACKGROUND: The aim of this study is to shed some light on the role of the Fas system in human semen, by investigating whether there is an association between the expression of the molecules regulating the Fas system [membrane-bound Fas ligand (mFasL), soluble Fas ligand (sFasL) and matrilysin, the metalloprotease cleaving mFasL to sFasL] and sperm parameters. METHODS: We investigated, by flow cytometric analysis, the presence of FasL on spermatozoa from normozoospermic and teratozoospermic subjects and, by western blot, the presence of sFasL and matrilysin in the seminal plasma of the same samples as well as on samples from azoospermic subjects. The enzymatic activity of matrilysin was examined by gel zymography. RESULTS: We observed that sperm cells expressed mFasL in 22% of normozoospermic men, whereas it was absent from spermatozoa from teratozoospermic patients. Higher levels of sFasL and augmented enzymatic activity of matrilysin were found in azoospermic samples. CONCLUSIONS: The presence of mFasL on sperm from normozoospermic men and its absence in pathological samples emphasize the role of the Fas system in human semen. Moreover, the presence of both sFasL and matrilysin in seminal plasma implies a fine regulation of the function of the Fas system and, consequently, of the apoptotic process in the human genital tract.     

Soluble Fas and soluble Fas L levels in patients with acute pancreatitis

The FasL-Fas system is an apoptosis induction system and plays an important role in homeostasis and biophylaxis. The present study was conducted to investigate soluble Fas (sFas), soluble Fas ligand (sFasL), and tumor necrosis factor alpha (TNF-alpha) in patients with acute pancreatitis. As acute pancreatitis became severe, the levels of sFas in the serum increased significantly, while those of sFasL decreased significantly. A significant inverse correlation was observed between the serum levels of sFas and those of sFasL. Also, a significant positive correlation was observed between the levels of TNF-alpha and sFas. A greater increase in serum sFas and decrease in serum sFasL levels was observed in patients with complicating multiple organ dysfunction syndrome (MODS) than in those without it. The results of the study suggest that the pathological aggravation of acute pancreatitis could be related to changes in the Fas-FasL system.     

Expression of FasL and Fas protein and their soluble form in patients with hypersensitivity pneumonitis

BACKGROUND: Hypersensitivity pneumonitis (HP) is characterized by a lymphocytic alveolitis and loosely formed granulomas in lung biopsy specimens. HP improves or disappears altogether after cessation of antigen exposure. The Fas-Fas ligand (FasL) system is one of the representative systems of apoptosis-signaling receptor molecules, and is involved in various inflammatory diseases. We hypothesized that the Fas-FasL system may be associated with this disorder. METHODS: We examined the expression of FasL and Fas proteins in lung tissues from patients with HP using immunohistochemistry. We also measured the soluble form of FasL (sFasL) and sFas levels in serum and bronchoalveolar lavage fluid (BALF) from patients with HP using enzyme-linked immunosorbent assay (ELISA). Furthermore, we also measured the cytotoxic activity of BALF sFasL in vitro. RESULTS: FasL was detected in infiltrating mononuclear cells, and Fas was detected in infiltrating mononuclear cells, alveolar macrophages, and epithelioid cells in HP, whereas FasL was not detected and Fas was detected in few alveolar macrophages in controls. The levels of sFasL and sFas in BALF, but not in serum, were significantly increased in HP compared with controls. BALF of HP that included high levels of sFasL had no cytotoxic activity for bronchiolar epithelial cells in vitro. CONCLUSIONS: In HP, there is an upregulation of FasL and Fas in lung tissues. Since there is no incidence of apoptosis and no cytotoxic activity for lung epithelial cells in BALF from patients with HP, the increased levels of BALF sFasL and sFas may reflect the activation and sequestration of inflammatory cells rather than apoptosis.     

Characterization of soluble FAS, FAS ligand and tumour necrosis factor-alpha in patients with chronic HCV infection.

BACKGROUND: There are limited reports on the role of the cell surface receptor Fas and its ligand molecule in mediating apoptosis during infection with the hepatitis C virus (HCV). OBJECTIVES: The aims of this study were (1) to assess the susceptibility of the Fas antigen expressed on peripheral blood mononuclear cells to Fas ligand-induced-death in patients with chronic HCV infection and (2) to investigate the correlation between the plasma levels of soluble Fas (sFas), soluble Fas ligand (sFasL), tumour necrosis factor-alpha (TNF-alpha), alanine amino transferase (ALT), and HCV viral load. STUDY DESIGN: The susceptibility of peripheral blood mononuclear cells from 17 subjects with chronic HCV infection to Fas ligand induced cell death was assessed using a water soluble tetrazolium assay. The plasma levels of associated markers such as sFas, sFasL, and TNF-alpha were quantified using immunoassays. ALT values were obtained from hospital records. Viral loads were quantified using a commercially available quantitative assay--the Amplicor Monitor (version 2.0). Controls for comparison included a group of healthy individuals and individuals infected with the human immunodeficiency virus 1. RESULTS: The percentage of cell death induced in hepatitis C virus infected individuals was lower than that seen in the healthy control group. Patients infected with HCV had higher average values of sFas and TNF-alpha as compared to both control groups. Plasma levels of sFas in patients with chronic HCV infection showed significant positive correlations to ALT and TNF-alpha levels. TNF-alpha levels also showed a significant positive correlation with ALT levels. CONCLUSIONS: PBMC in HCV infection exhibit decreased susceptibility to Fas ligand induced cell death. This may signify a means by which HCV escapes immune surveillance. This phenomenon merits further investigation. The strong correlations observed between plasma sFas, ALT and TNF-alpha suggest a potential role for these markers as an alternative to an invasive liver biopsy.     

Alteration of Fas and Fas ligand expression during human visceral leishmaniasis

Several studies in murine systems have suggested a role of apoptosis in the pathogenesis of leishmaniasis. However, the role of apoptosis in visceral leishmaniasis in man has not been explored. In this study, we show that patients with visceral leishmaniasis demonstrate significant dysregulation of Fas and Fas ligand. Levels of soluble Fas (sFas) and soluble Fas ligand (sFasL) were elevated in plasma of patients with active visceral leishmaniasis (VL) and individuals co-infected with VL-HIV-1 compared to healthy controls. The levels of sFas and sFasL were normalized 6 months after successful treatment. In VL patients, the expression of membrane bound Fas, and to a lower extent FasL, were up-regulated on Leishmania donovani-infected spleen cells, the site of parasite multiplication. Expression of Fas and FasL on peripheral blood mononuclear cells was within normal range, probably reflecting that the blood is not a normal site of L. donovani infection. Furthermore, this is suggested by the finding that in vitro infection of macrophages with L. donovani up-regulated Fas expression on the surface of infected cells and enhanced the levels of sFasL in supernatants from infected cultures. How this dysregulation may affect the pathogenesis of human visceral leishmaniasis is discussed.