T-Cell Immunoregulatory Functions in Rheumatoid Arthritis Patients

We have studied the immunoregulatory function of T8+ (suppressor/cytotoxic) and Leu3a+ (inducer/helper) T cells from rheumatoid arthritis (RA) patients by measuring the effect of these T-cell subpopulations on the generation of immunoglobulin-secreting cells by normal allogeneic B cells after stimulation with pokeweed mitogen (PWM) in vitro. When T8+ or Leu3a+ cells from blood or synovial tissue from nine patients were substituted for T8+ or Leu3a+ cells, respectively, from normal blood mononuclear cells (MNC), RA T8+ cells showed an increased suppressor activity, whereas RA Leu3a+ cells were, except for one patient, weak augmentors. Unreplaced normal MNC and MNC replaced with allogeneic normal T-cell subpopulations responded equally to PWM. When T8+ plus Leu3a+ cells from the same patient replaced normal T cells, high B-cell responses were detected. Normal T8+ plus Leu3a+ cells generally supported the response to a lower degree. Substitution with two allogeneic T-cell subpopulations did not result in a B-cell response to PWM. Thus, whereas RA T8+ seemed to be strong suppressors and RA Leu3a+ cells weak augmentors by themselves, together they are possibly able to generate a B-cell stimulatory potential that might be of pathogenetic significance in the patients.     

Human T-Cell Hybrids Secreting Lymphokines: Effect of Different Parent Cell Clones of the Human T-Cell Acute Lymphoblastoid Leukaemia Line CCRF-CEM

We have cloned a number of cell lines from the human T-lymphocyte acute lymphoblastoid leukaemia (ALL) line CCFR-CEM, and attempted to construct functionally active human T-lymphocyte hybrids with them. Functional hybrids were generated using only one particular clone, 3H6. The activities found in the supernatants of two of these hybrids, DB1G7 and DB2D10, are described. Supernatant from DB1G7 was found to suppress strongly the migration of normal human peripheral blood mononuclear cells, while that from DB2D10 was shown to inhibit the proliferative response of human T lymphocytes to both phytohaemagglutinin and concanavalin A. There was no cross-reactivity between the two supernatants, confirming the usefulness of the human T-lymphocyte hybrid technique in dissecting human T-lymphocyte function. The successful use of 3H6 is contrasted with the failure of another clone, 2H2, to permit the production of functional hybrids. Problems relating to the use of CCRF-CEM and its clones as parent cell lines in the production of human T-lymphocyte hybrids are discussed.     

Immune Dysregulation in Patients with Severe Acute Pancreatitis

To investigate patients with severe acute pancreatitis (SAP) by dynamic levels of pro-/anti-inflammatory cytokines and endotoxin (ET) in plasma and the relationship between immunity and infection, organ dysfunction. Seventy-two patients with SAP were recruited. The ET, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), interleukin-10 (IL-10), and interleukin-4 (IL-4) were determined on admission and days 3, 7, and 14. For comparison, patients were analyzed through infection group versus non-infection group, multiple organ dysfunction syndrome (MODS) group versus non-MODS group. There were sixteen patients with secondary infection, twenty-two with MODS, and nine deaths. The infection group had higher levels of ET than the non-infection group on days 3 and 7. The dynamic cytokine levels of patients in the MODS group were unanimous with those outcomes in the infection group. The levels of cytokines in the infection group were different from the non-infection group, with more levels of TNF-α, IL-6 on days 3 and 7 and less on days 14, and more levels of IL-10, IL-4 on days7 and 14. The levels of TNF-α, IL-6 in the MODS group were different from the non-MODS group, with more levels on days 3 and 7, and less levels on days 14. Immune dysregulation may play an important role in infection and organ dysfunction for patients with SAP.     

重症急性胰腺炎患者肠内营养的时机选择

目的 观察不同时期肠内营养在重症急性胰腺炎患者肠道屏障功能中的作用。方法 2014年1月~2017年7月在我院就诊的110例重症急性胰腺炎患者,按数字随机表法分为两组,每组55例。EEN组为入院24~72 h给予早期肠内营养,EN组入院3~7 d给予肠内营养。观察治疗前、治疗14 d后实验室指标如白细胞计数、血淀粉酶、C-反应蛋白、肿瘤坏死因子的变化;肠黏膜功能指标D-乳酸、血清二胺氧化酶、尿乳果糖/甘露醇值、内毒素的变化;记录肠鸣音恢复时间、肛门排气排便时间及并发症发生率。结果 EEN组患者治疗14 d后较EN组实验室指标、肠黏膜功能指标降低,差异有统计学意义（P＜0.05）;EEN组肠鸣音恢复时间、肛门排气排便时间短于EN 组,差异有统计学意义（P＜0.05）; EEN组并发症发生率低于EN组,无患者退出及死亡。结论 入院后24~72 h内行肠内营养,有益于受损区域肠上皮细胞的恢复,维护肠黏膜屏障的完整性,降低感染发生率。     

Leukaemic T Cells from Patients with Chronic Lymphocytic Leukaemia of T-Cell Origin Respond to Staphylococcus aureus Enterotoxin Superantigens

We investigated the in vitro responsiveness of peripheral blood lymphocytes from two patients with T-cell chronic lymphocytic leukaemia (T-CLL) to Staphylococcus aureus enterotoxin (SE) superantigens. T-cell receptor (TcR) αβ(Vβ 7.1)-expressing CD4⁺ leukaemic T cells from patient HE (white blood cell count 480,000/μl) proliferated in response to SEA and, only at 1000-fold higher concentrations, to SEB, SED, and SEE. CD4⁺ CD8⁺ TcRαβ (Vβ 12.1)-expressing leukaemic T cells from patient KO (white blood cell count 120,000/μl) were activated by SEB but not by the other tested SEs. In both instances, the activation of leukaemic T cells by SE was dependent on the presence of HLA-DR⁺ cells. Southern blot analysis of TcRβ gene rearrangement confirmed that the proliferating cells were derived from the leukaemic T-cell clone and not from contaminating normal T cells. These data indicate that leukaemic T cells from patients with T-CLL exert a clonally variable responsiveness to SE superantigens. We conclude that recognition of specific antigen and subsequent signal transduction can be initiated via the TcR of leukaemic T-CLL cells.     

非典型肺炎病人动态血液分析

目的 :动态检测非典型肺炎 (SARS)病人血液分析结果 ,为SARS病人的诊断、治疗和预防提供帮助。方法 :对本院收治 10 3例SARS病人分别在入院后不同时间段和随访时作血液分析。结果 :SARS病人血液分析结果呈动态变化。入院时 3 1.1%的患者白细胞数减少 ,第 7～ 2 1天升高 ,超过正常值 ,出院时和随访时均正常 ;入院时 3 8.8%患者淋巴细胞数减少 ,第 7～ 2 1天淋巴细胞分类计数低于正常 ;入院时 8.7%患者血小板减少 ,但从住院第 2～ 12天有明显上升 (P <0 .0 5 )。结论 :SARS病人血液分析结果可以协助诊断和疗效判断。     

T-Cell Functions in Nude Mice: Proliferation of Spleen Cells from Athymic Mice in the One-way Xenogeneic Mixed Leucocyte Reaction

Spleen cells from nude mice proliferate in vitro when stimulated with xenogeneic (human) lymphoid cells rendered unresponsive by addition of digitalis glycosides. In digitalis-sensitive species, such as humans, DNA, RNA, carbohydrate, and protein synthesis is completely blocked by addition of low concentrations of glycoside, whereas no impairment is found in digitalis-resistant species such as mouse. Since T cells have been implicated to be the cells responding in the mixed leucocyte reaction, this finding may suggest the occasional existence of "T-like" cells in the spleens of nude mice.     

Mannose Binding Lectin Acute Phase Activity in Patients with Severe Infection

Mannose Binding Lectin (MBL) is a liver derived, circulating plasma protein that plays a pivotal role in innate immunity. MBL functions as a pathogen recognition molecule, opsonising organisms and initiating the complement cascade. MBL deficiency arising from mutations and promoter polymorphisms in the MBL2 gene is common and has been associated with risk, severity, and frequency of infection in a number of clinical settings. With MBL therapy on the horizon, the usefulness of replacement MBL therapy has been challenged by the notion, that as an acute phase protein, MBL levels may rise under stress to sufficient levels, in individuals who are usually deficient. This report demonstrates that in patients with sepsis and septic shock, the majority of patients do not display an MBL acute phase response: 41.4% of individuals maintained consistent MBL levels throughout hospital stay, 31.3% of individuals demonstrated a positive acute phase response, and a negative acute phase response was observed in 27.3% of individuals studied. Importantly, a positive acute phase response was generally observed in individuals with wild-type MBL2 genes. When a positive acute phase response was observed in individuals with coding mutation, these individuals demonstrated a normal MBL level on admission to hospital. Furthermore, no individual, regardless of genotype who was MBL deficient at admission was able to demonstrate a positive acute phase response into the normal MBL range. These findings indicate MBL demonstrates a variable acute phase response in the clinical setting of sepsis and septic shock.     

Characterization of T-Lymphocyte Colony-Forming Cells in the Mouse

T-cell colony-forming cells (CFC), the cells from which T-lymphocyte colonies are initiated when cells are grown in semisolid medium, have been studied. CFC have previously been shown to be more frequent in populations of rather mature thymic cells and peripheral lymphocytes than in populations of immature cortical thymocytes. We have here evaluated whether CFC in spleen and lymph nodes are confined either to newly emigrated thymocytes or to older recirculating T cells, h is shown that CFC in spleen have the same Lyt phenotype as thymic and lymph node CFC, namely Lyt-1⁺ 2⁺, and that the peripheral complement of CFC is rather slowly built up after birth or after total body irradiation and bone marrow reconstitution. Results obtained after fluorescence-activated cell sorting, hydrocortisone injection, or thymectomy indicate that CFC are present in a broad variety of peripheral T-cell populations in accordance with age and thus that T-cell colonies can be used to lest the proliferate capacity of the 'average' peripheral T cells of the Lyt-1⁺2⁺ phenotype.     

Effect of Cocaine Administration on Concanavalin A-Stimulated T-Lymphocyte Proliferation in Rats

There is a high prevalence of cocaine abuse among Americans. There is an increasing concern over the rise of infectious diseases among individuals in this drug abuse population. This concern may be due, at least in part, to a direct effect of cocaine on the immune system. The present study investigated the effects of cocaine administration on optimal mitogen-induced proliferation in rats. Following cocaine administration, splenic lymphocytes were isolated and T-lymphocytes incubated with concanavalin A. When T-lymphocytes were isolated 30 minutes following cocaine administration, a significant enhancement of optimal mitogen-stimulated proliferation was observed at 0.1 mg/Kg cocaine. Enhancement of proliferation was seen 20 hours following cocaine administration at 0.1, 1.0 and 10 mg/Kg. However, these results were not statistically significant. Cocaine administered once daily for seven days had no effect on mitogen-induced proliferation. These results suggest that cocaine administration has a limited effect on optimal mitogen-stimulated proliferation.     

非典型肺炎病人免疫功能分析

目的 :动态监测非典型肺炎 (SARS)病人免疫功能 ,为临床诊疗提供帮助。方法 :采用回顾性及随访研究方法 ,对本院收治 10 3例SARS病人分别在入院初期、中期、高峰期、恢复期和随访时作C反应蛋白 (CRP)、免疫球蛋白、补体、纤维蛋白原 (Fib)、血沉 (ESR)、和CD4、CD8等免疫功能检查 ,并进行描述性分析及方差分析。结果 :从发病初期至恢复期CRP、Fib、ESR均有程度不同的升高 ,以CRP异常率最高。总蛋白、白蛋白、白蛋白 /球蛋白比值在疾病过程呈下降趋势。在SARS疾病过程中和随访时存在免疫球蛋白变化、补体消耗和CD4、CD8细胞减少。结论 :SARS病人免疫功能可能低于正常人。其免疫功能的检测有利于协助诊断和疗效判断     

Dendritic Cells in Bone Marrow at Diagnosis and after Chemotherapy in Adult Patients with Acute Myeloid Leukaemia

Dendritic cells (DCs) develop in the bone marrow from haematopoietic progenitor cells. Two subsets, plasmacytoid DCs (pDCs) and myeloid DCs (mDCs), have been identified. Little is known regarding DC levels in bone marrow of patients with acute myeloid leukaemia (AML) before and after chemotherapy. We investigated relative pDC and mDC levels in bone marrow from 37 hospital controls and 60 patients with AML [at diagnosis, complete remission (CR) and follow‐up] using four‐colour flow cytometry. The pDC immunophenotype was characterized as lin‐/HLA‐DR+/CD123 +  and mDC as lin‐/HLA‐DR+/CD11c+. In 69% of patients with AML, no DCs were detected at diagnosis. At CR, mDC levels were the same in patients with AML and hospital controls while pDC levels were slightly lower. There was no association between minimal residual disease or survival rates and DC levels. Patients with low mDC levels at CR were more likely to suffer from complicated infections, although the difference was not statistically significant. Altogether, there was a profound decrease in DC levels in patients with AML at diagnosis. DC levels increased at CR and were higher than in hospital controls after post‐remission therapy, suggesting that DCs recover after repeated chemotherapy. There may be an association between mDC levels and infectious complications.     

动态监测SARS患者SARS病毒IgG抗体及其意义

目的 :动态监测SARS患者SARS病毒IgG抗体并探讨其意义。方法 :采用间接酶联免疫吸附法检测早期、恢复期SARS患者以及出院后第一次和第二次SARS随访者 ,一线未患SARS医护人员 ,健康体检者血清中SARS病毒IgG抗体。结果 :SARS不同时期和不同人群IgG抗体阳性数有显著性差异 (P <0 .0 0 1)。在疾病早期 ,IgG抗体阳性率 84.6% ,恢复期以后均为 10 0 % ;一线未患SARS医务人员阳性率 3 9.4% ,健康体检者无阳性。结论 :SARS病毒IgG抗体产生较早 ,可用于流行病学调查和血清学诊断     

Accessory Function of Endothelial Cells in Anti-CD3-Induced T-Cell Proliferation: Synergism with Monocytes

Monoclonal antibodies to CD3 can induce proliferation of resting T cells. In vitro this effect is dependent on the presence of monocytes. They serve as accessory cells providing a co-stimulatory signal after cross-linking of the antibody-coated TcR/CD3 complex by the Fc receptor on the monocytes. We have studied whether endothelial cells can replace monocytes with regard to this function. Highly purified T-cell preparations were cultured in the presence of anti-CD3 antibody, purified monocytes, and human umbilical vein endothelial cells. Anti-CD3 and endothelial cells alone were unable to support T-cell proliferation, due to lack of FcR expression. Addition, however, of as few as 1000 FcR+ monocytes (0.8% of the number of T cells present) to a coculture of T cells and endothelial cells (EC) in the presence of soluble anti-CD3 resulted in a strong proliferation of T cells. When anti-CD3 was presented in an immobilized form (coated to the culture well or to Sepharose beads), or when phytohaemagglutinin was added to the culture as a cross-linking agent, EC could support T-cell proliferation in the absence of any monocytes. We conclude that EC by themselves cannot support the proliferation of pure T cells induced by soluble anti-CD3, but are potent generators of the co-stimulatory signal(s). They provide a suitable starting material to further define this co-stimulatory activity.     

支气管哮喘病人T淋巴细胞亚群测定

本文应用抗人T淋巴细胞亚群单克隆抗体测定了90例哮喘儿童及32例正常对照儿童外周血T淋巴细胞亚群,结果表明哮喘病人无明显成熟T淋巴细胞、T_H亚群和T_s亚群异常。提示病人B淋巴细胞过度产生IgE可能是在更精细的水平上受T淋巴细胞所调节。     

重症急性胰腺炎手术干预的时机与预后分析

目的 探讨重症急性胰腺炎手术干预最佳时机.方法 1980～2006年经治的168例重症急性胰腺炎,按治疗方法和手术时间不同分为A、B、C三个组,回顾性分析治疗效果.结果 1980～1990为A组(57例),治疗简单,以早期(72h)手术为主,手术率80.7%,病死率66.7%;1991～1996年为B组(31例),以"个体化治疗方案"并适当延期(13～19d,平均16d)手术清创为主,手术率45.2%,病死率29%;1997～2006年为C组(80例),以综合治疗及延期(13～30d,平均21.5d)手术引流为主,手术率32.5%,病死率11.6%.结论 重症急性胰腺炎的关健问题是坏死组织感染,深入认识其病生变化及疾病过程,合理安排综合治疗,正确选择手术时机,可提高疗效,改善预后.     

严重急性呼吸综合征(SARS)患者血清白介素-8测定及其评价

为观察SARS患者血清白介素-8(IL-8)含量变化, 用放射免疫法检测了66例SARS患者血清IL-8含量, 并与对照组作了比较.结果显示, SARS患者IL-8含量明显高于对照组, 恢复期血清IL-8含量变化多样.结论: SARS患者存在免疫反应异常, 血清IL-8含量变化可能在SARS发病机制中起重要作用.     

Long-Term Outcomes of Hematopoietic Stem Cell Transplantation for Severe Treatment-Resistant Autoimmune Cytopenia in Children

We analyzed the long-term outcomes of pediatric patients registered in the European Group for Blood and Marrow Transplantation database who underwent hematopoietic stem cell transplantation (HSCT) for severe treatment refractory autoimmune cytopenia. With a median follow-up of 100 months, event-free survival was 54% overall, with no significant difference between allogeneic HSCT (n = 15) and autologous HSCT (n = 7) recipients (58% versus 42%; P = .50). Despite a trend toward failure of response or relapse after autologous HSCT compared with allogeneic HSCT, the difference was not significant (43% versus 13%; P = .30). Treatment-related mortality was high in both HSCT groups (29% and 16%; P = .09). Based on the limited numbers of subjects in this retrospective analysis, both allogeneic and autologous HSCT may induce complete and persistent responses in approximately one-half of pediatric patients with severe refractory autoimmune cytopenia, although treatment-related toxicity is high.     

重症急性胰腺炎48例临床分析

目的探讨48例重症急性胰腺炎病例非手术治疗和手术治疗的指征、措施及其效果。方法回顾性分析48例重症急性胰腺炎病例的临床资料,并分组比较。结果确诊病例48例,手术治疗组22例,4例手术后10 d内死亡,死于多器官功能衰竭。2例于术后1个月死亡,死于胰周感染及营养不良。非手术治疗组26例,死亡2人,均死于多器官功能衰竭。结论重症急性胰腺炎(SAP)早期以非手术治疗为主。但是胆源性伴胆道梗阻当经积极治疗而病情不断加重时,则需采取早期手术治疗。