肾移植术后受者人巨细胞病毒感染与其它机会感染…

应用聚合酶链反应技术检测６５例肾移植受者尿中人巨细胞病毒－ＤＮＡ，配合捕获ＥＬＩＳＡ法及间间接ＥＬＩＳＡ法检测ＨＣＭＶ－ＩｇＭ及ＩｇＧ，诊断ＨＣＭＶ感染，感染率为６０％ ，应用临床及实验室方法诊断其它病原体所致的机会感染，结果表明，ＨＣＭＶ感染组机会感染率明显高于ＨＣＭＶ未感组。     

巨细胞病毒感染在2型糖尿病发病中作用的研究

目的从定量水平上深入研究人类巨细胞病毒(HCMV)感染在2型糖尿病发病中的作用。方法采用定量PCR技术测量29例2型糖尿病患者和23例对照组血清中HCMV DNA含量,并与外周血T细胞亚群、血糖(BG)、胰岛素(Ins)和C肽(C-P)水平进行分析。结果 2型糖尿病患者HCMV DNA含量[(1.81±1.67)×108拷贝/ml]明显高于对照组[(5.50±4.30)×107拷贝/ml]。HCMVDNA阳性患者CD8百分率(29.53％±2.00％)显著高于对照组(27.13％±4.12％),CD4/CD8比值(1.24±0.05)显著低于对照组(1.41±0.10)。HCMV DNA阳性患者与阴性患者比较,空腹C-P明显降低,而BG和Ins差异无显著意义。结论2型糖尿病患者HCMV感染的活化,可影响细胞免疫,在2型糖尿病发病中的作用值得进一步研究。     

石家庄地区异常孕产史育龄妇女巨细胞病毒与弓虫感染研究报告

为了解有异常孕产史妇女（异常组），宫内人巨细胞病毒（ＨＣＭＶ）和弓形虫（ＴＯＸ）的感染，本文采用ＰＣＲ分别对１４５例异常组妇女的宫颈分泌物进行了ＨＣＭＶ１０８例和ＴＯＸ３７例的检测，同时对２７例无异常孕产史妇女（对照组）检测了ＨＣＭＶ和ＴＯＸ结果为异常组ＨＣＭＶ和ＴＯＸ的阳性率分别为４４．４４％和３２．４％，对照组为３．７％和０％，经统计学分析两组间有显著性差异（Ｐ〈０．０１），结果表明有异常孕产     

白血病患儿巨细胞病毒感染的PCR与抗原检测方法比较

目的 对不同种类标本应用ＰＣＲ检测巨细胞病毒（ｃｙｔｏｍｅｇａｌｏｖｉｒｕｓ,ＣＭＶ）ＤＮＡ,并与外周血白细胞ＣＭＶ抗体检测比较,以了解ＰＣＲ方法在诊断白血病患儿活动性ＣＭＶ感染时的意义。方法 实验组为３１例白血病患儿,对照组为３１例免疫功能正常儿童,两组儿童的年龄、性别无差异。应用ＰＣＲ方法检测血清、尿液和脑脊液ＣＭＶ ＤＮＡ,间接免疫荧光方法检测外周血白细胞ＣＭＶ抗原,ＥＬＩＳＡ方法检测血清抗     

巨细胞病毒感染时免疫功能的变化及其意义

目的　探讨巨细胞病毒感染时免疫变化及其意义。方法　以 2 0名CMV IgM(Cytomegalovirus immunoglobulinM)阳性的病儿为观察对象 ,另设对照组 30例。ELISA法检测柯萨奇B组病毒抗原 (CVB Ag)、IgM抗体 (CVB IgM)、巨细胞病毒IgM抗体 (CMV IgM)、EB病毒IgM抗体 (EBV IgM) ,单克隆抗体标记间接ABC免疫法检测外周血T细胞亚群。结果　CMV感染组的LAK细胞、NK细胞活性均明显降低 (P <0 .0 1)。合并其它感染原的CMV混合感染组CD3含量减少 ,CD8含量增加 (P <0 .0 5 ) ,CD4 CD8数值明显降低 (P <0 .0 1)。病毒混合感染并合并支原体感染组CD3含量减少 (P <0 .0 5 )、CD4 CD8数值、IgA含量明显降低 (P <0 .0 1)。结论　巨细胞病毒感染影响了T细胞亚群的平衡 ,在合并其他感染时天然免疫细胞功能下降和T细胞亚群紊乱更明显     

聚合酶链反应技术在诊断孕妇人巨细胞病毒感染中的应用

人巨细胞病毒 (humancytomegalovirus,HCMV)是引起宫内感染的常见病原体之一。孕妇感染HCMV后 ,可通过胎盘垂直传播 ,引起流产、早产、死胎、胎儿畸形或新生儿先天性感染。为了早期、快速地诊断HCMV感染 ,为临床治疗或终止妊娠提供依据 ,降低畸胎或缺陷患儿的出生 ,达到优生优育的目的 ,已经建立了许多用于诊断HCMV感染的技术 ,如血清学法、病毒培养法、病毒血症检测法、抗原血症检测法及聚合酶链反应法 (polymerasechainreaction ,PCR)等。其中 ,PCR是一种DNA体外引物定向酶促扩增技术 ,具有简便、敏感和特异的优点。目前 ,采用…     

免疫球蛋白防治肾移植后T淋巴细胞降低肺部感染

背景：肾移植后T淋巴细胞降低就容易发生感染,肺部是主要靶器官,因此如何控制肺部感染,尤其是重症肺炎,成为改善肾移植患者预后关键所在。 目的：探讨在肾移植后未发生肺部感染之前,根据监测到T淋巴细胞水平降低,予用免疫球蛋白预防肺部感染的作用。 方法：纳入肾移植后半年内患者30例,随机分成治疗组和对照组各15例,所有患者均采用原有的免疫抑制剂。治疗组加用免疫球蛋白0.2 g/(kg•d),2次/d,临床观察肺部感染发生率,移植肾功能和T淋巴细胞水平。 结果与结论：免疫球蛋白治疗组普通肺炎和重症肺炎发生及死亡率明显低于对照组(P < 0.05),CD4⁺T淋巴细胞水平和CD4⁺/CD8⁺T淋巴细胞比值明显上升(P < 0.01),动态观察两组7,14,21 d CD4⁺T淋巴细胞的亚群数目明显高于对照组(P  < 0.01),而肾功能无变化。结果提示,免疫球蛋白能提高肾移植后患者T淋巴细胞水平,恢复机体免疫功能,增强抗感染能力,从而减少肺部感染的发生。     

采用PCR技术对绒毛和羊水巨细胞病毒感染研究的比较分析

本文采用ＰＣＲ方法检测了早孕及孕中期羊水人巨细胞病毒的感染情况，孕早期１０１例绒毛的ＨＣＭＶ感染８７例，５４例羊水标本经ＰＣＲ检测发现ＨＣＭＶ阳性２４例，进一步分析三个孕期的ＨＣＭＶ感染表明ＨＣＭＶ可以经胎盘传播给胎儿，同时胎盘有一定的屏幕作用，而且母体胎儿自身也有相当的保护能力。此研究结果证实ＰＣＲ方法检测先天性ＨＣＭＶ感染敏感，快速，并具有特异性。     

巨细胞病毒感染患儿细胞免疫应答反应及临床意义

目的:探讨巨细胞病毒(CMV)感染患儿细胞免疫应答反应及临床意义.方法:选择2015年6月至2019年5月在本院确诊的97例CMV感染患儿,根据其有无临床症状分为症状组和无症状组,选择同期健康体检婴儿48例为对照组.采用RT-PCR反应检测所有患儿尿液标本中CMV DNA载量;采用ELISA法检测所有纳入研究对象IL-...     

Human Dendritic Cell Subsets for Vaccination

TProtective immunity results from the interplay of antigen (Ag)-nonspecific innate immunity and Ag-specific adaptive immunity. The cells and molecules of the innate system employ non-clonal recognition pathways such as lectins and TLRs. B and T lymphocytes of the adaptive immune system employ clonal receptors recognizing Ag or peptides in a highly specific manner. An essential link between innate and adaptive immunity is provided by dendritic cells (DCs). As a component of the innate immunc system, DC organize and transfer information from the outside world to the cells of the adaptive immune system. DC can induce such contrasting states as active immune responsiveness or immunological tolerance. Recent years have brought a wealth of information regarding DC biology and pathophysiology that shows the complexity of this cell system. Thus, presentation of antigen by immature (non-activated) DCs leads to tolerance, whereas mature, antigen-loaded DCs are geared towards the launching of antigen-specific immunity. Furthermore, DCs are composed of multiple subsets with distinct functions at the interface of the innate and adaptive immunity. Our increased understanding of DC pathophysiologywill permit their rational manipulation for therapy such as vaccination to improve immunity.     

褪黑素对带状疱疹后遗神经痛大鼠T细胞亚群及IL-2、TNF-α表达的影响

目的 分析褪黑素分泌减少对带状疱疹后遗神经痛(PHN)大鼠T细胞亚群及IL-2、TNF-α表达的影响.方法 雄性SD大鼠40只,根据随机数字表分为4组,每组10只,分别为空白对照组,该组大鼠不造模亦不采取任何治疗措施;假手术组,该组大鼠仅暴露松果体;非治疗组,该组大鼠去松果体并接种HSV-1病毒;治疗组,该组大鼠去除松果体+接种HSV-1病毒+腹腔注射外源性褪黑素120mg/(kg.d).接种病毒前以及接种后1、14、30d对各组大鼠进行机械痛觉评分(MPRS)并记录非治疗组与治疗组组大鼠PHN发病情况;采用ELISA法检测接种病毒前、接种后1、14、30d各组大鼠外周血褪黑素水平改变;采用流式细胞技术于接种病毒后30d检测各组大鼠外周血T细胞亚群水平改变.结果 接种病毒后14d以及30d,各组大鼠褪黑素水平表现为非治疗组显著低于治疗组和空白组,差异有统计学意义(P＜0.05).接种病毒30d,CD3+,CD4+细胞数以及CD4+/CD8+均表现非治疗组显著低于治疗组和空白组,差异有统计学意义(P均＜0.05);CD8+细胞数表现为非治疗组显著高于治疗组和空白组,差异有统计学意义(P均＜0.05).接种病毒30d,IL-2、TNF-α水平均表现为非治疗组显著低于治疗组和空白组,差异有统计学意义(P均＜0.05).结论 褪黑素减少会导致带状疱疹后遗神经痛大鼠T细胞亚群失衡,影响机体免疫功能的发挥,同时会降低多种细胞因子的水平,降低免疫炎症反应;外源褪黑素能显著改善上述改变,提示褪黑素可能存在对PHN的免疫治疗作用.     

T Lymphocytes Subsets in Experimental Iron Overload

Several abnormalities of the immune system have been reported in association with clinical and experimental iron overload. To dissect further such abnormalities, changes in lymphocyte subsets were evaluated in iron-loaded male Sprague-Dawley rats. The iron-loading protocol consisted of a total dose of iron-dextran (1.5 mg/Kg body weight) divided in daily intramuscular injections over twenty consecutive days. At days 0, 20, and 50 after initiation of iron injections lymphocyte subsets in blood, spleen and mesenteric lymph nodes were estimated by indirect immunofluorescence using monoclonal antibodies recognizing T cells (W3.13), the subset of helper T cells in (W3.25), and the subset of cytotoxic T cells (OX.8). By day 20, there was no change in the number of W3.25+ T cells in the blood of iron-loaded animals as compared to the controls, but the OX.8 + T cells were significantly elevated. At this time, the ratio W3.25 ⁺/OX.8⁺ cells was significantly decreased (0.5 in experimental rats vs 2.0 in controls). Similar results were obtained at day 50. In the spleen, there was a decrease in the proportion of W3.25 ⁺T cells and an increase in OX.8⁺ T cells at day 20. However, these values returned to normal by day 50. A negative correlation between W3.25 ⁺/OX.8⁺ ratio and serum ferritin was observed in blood and spleen during iron administration. These changes were associated with abnormalities in lymphocyte proliferative response. No changes in W3.25 ⁺/OX.8⁺ ratio were observed in mesenteric lymph nodes. These results demonstrate that iron overload alters the distribution of T lymphocytes in various compartments of the immune system.     

Immunotherapy Against Invasive Fungal Diseases in Stem Cell Transplant Recipients

Despite the availability of new antifungal compounds, morbidity and mortality of invasive fungal disease in allogeneic hematopoietic stem cell recipients are still unacceptably high. Over the past decade, one could witness an exciting improvement of the understanding of the molecular pathogenesis and of the complexity of host antifungal immune responses. This, in turn, provides critical information to augment host immunity against fungal pathogens. Strategies for enhancing the immune system include the administration of effector and regulatory cells (e.g., granulocytes, antigen-specific T cells, dendritic cells) as well as the administration of recombinant cytokines, interferons and growth factors (e.g., interferon-γ, keratinocyte growth factor, granulocyte- and granulocyte-macrophage colony stimulating factor). One has to recognize at the same time, however, that data of in vitro assays and animal models cannot necessarily be transferred into the clinical setting. In addition, meaningful clinical trials in allogeneic stem cell recipients suffering from invasive fungal disease require sufficiently large and homogenous cohorts of patients and can only be performed in international collaboration, but may ultimately improve the outcome of allogeneic transplant recipients with invasive fungal disease.     

Graves病患者外周血T细胞亚群和共刺激分子的表达及其意义

为研究Graves病患者外周血T细胞亚群及共刺激分子的表达 ,并探讨其在Graves免疫病理机制中的作用 ,本文采用免疫荧光标记和流式细胞仪术检测了 19例Graves病患者和 11例正常人外周血T细胞亚群及共刺激分子 (CD2 8、B7、CD40、CD40L、 4 1BB、OX40 )的表达。结果表明 ,19例初诊Graves病患者外周血T细胞亚群呈现异常改变 ,表现为CD3+ 和CD4+T细胞显著下降 (P <0 0 5 ,P <0 0 1) ,CD4+ /CD8+ T细胞比值倒置 (P <0 0 1) ,共刺激分子CD2 8在T细胞中的表达水平明显下降 (P <0 0 1) ,T细胞亚群CD4+ CD2 8+ 、CD8+ CD2 8+ 细胞数量均减少 (P <0 0 5 ,P <0 0 1) ,而 4 1BB分子表达显著地升高 (P <0 0 5 )。随防 10例治疗后缓解患者 ,T细胞亚群失衡明显改善 ,共刺激分子CD2 8的表达水平上调 (P <0 0 1) ,而4 1BB分子的表达明显下降 (P <0 0 1) ,T细胞亚群CD4+ CD2 8+ 、CD8+ CD2 8+ 细胞数量均增加 (P <0 0 1) ,甲状腺自身抗体甲状腺球蛋白抗体 (TGAb )和甲状腺微粒体抗体 (TMAb )的表达水平均下降 (P <0 0 1,P <0 0 1)。从而表明 ,T细胞亚群的异常及共刺激分子CD2 8、 4 1BB的表达改变与Graves病的免疫病理机制相关。     

Use of Leflunomide for Treatment of Cytomegalovirus Infection in Recipients of Allogeneic Stem Cell Transplant

Cytomegalovirus (CMV) reactivations are common after allogeneic stem cell transplants, and pre-emptive therapy has been found to be effective. However, in India, treatment options are limited because of high cost and toxicity of ganciclovir and unavailability of cidofovir and foscarnet. Leflunomide is a cheap and easily available anti-rheumatoid arthritis drug that has been shown to have anti-CMV properties both in vitro and in vivo. It also has been used effectively for CMV reactivation after renal transplants. In this retrospective analysis, we analyzed 70 allogeneic stem cell transplants that were conducted between April 2015 and February 2017. There were 49 episodes of CMV reactivations in 43 patients in this period. Leflunomide was used in 24 episodes. It was effective in CMV clearance in 9 of the 24 episodes (38%). When the CMV copy number was <2 × 10³ copies/mL, leflunomide was effective in 9 of 17 (53%) episodes, but when the copy number was >2 × 10³, leflunomide was ineffective in all of the 7 episodes. This difference was statistically significant (P= .022 by Fisher exact test), suggesting that leflunomide may be more effective in clearance of CMV when copy numbers are low.     

支原体肺炎患儿免疫球蛋白、T淋巴细胞亚群细胞因子检测的临床意义

目的:观察支原体肺炎(MPP)患儿外周血免疫球蛋白、T淋巴细胞亚群以及细胞因子的含量变化,并探讨其在MPP发病机制中的作用。方法:采用流式细胞技术检测43例MPP患儿和30例正常对照组儿童外周血T淋巴细胞亚群CD3+、CD4+、CD8+,并用速率散射比浊法检测血清IgG、IgA和IgM含量,采用ELISA检测血清干扰素-γ(IFN-γ)、白介素(IL-2、IL-4和IL-6)水平。结果:MPP患儿外周血CD3+、CD4+T细胞百分率分别为61.45±6.75和33.52±5.81,较正常对照组68.28±7.34和38.71±6.29显著降低(P<0.05),CD8+T细胞和CD4+/CD8+比值较对照组无显著差别(P>0.05);MPP患儿血清免疫球蛋白与正常对照组比较,IgG和IgA均无明显差异,IgM较对照组增高(P<0.05);MPP患儿IFN-γ、IL-4、IL-6血清水平以及IFN-γ/IL-4比值较正常对照组明显增高(P<0.05),而IL-2水平低于正常对照组(P<0.05)。结论:MPP患儿存在免疫功能减低,免疫调节紊乱,辅助性T细胞亚群(Thl/Th2)失衡,并以Thl型细胞介导的免疫反应占相对优势状态。     

Human Circulating T Follicular Helper Cell Subsets in Health and Disease

T follicular helper (Tfh) cells are specialized to provide help to B cells and to induce durable antibody response. Our knowledge on the biology of Tfh cells and their contribution to disease has significantly increased in the past decade. In particular, recent discoveries of functionally distinct subsets within circulating Tfh (cTfh) cells in human blood have provided clues to assess the ongoing Tfh responses in healthy subjects after vaccinations and in patients with autoimmune diseases. The immune pathways associated with Tfh cell differentiation in humans are also getting revealed. In this review, I will first summarize the subsets within human cTfh cells, and discuss their alterations in patients with autoimmune diseases. Then I will discuss the mechanisms associated with the aberrant Tfh responses in human autoimmune diseases.