日本血吸虫97kDa DNA疫苗与致弱尾蚴疫苗诱导免疫应答特征的比较研究

目的　对比观察日本血吸虫大陆株副肌球蛋白基因疫苗(Sjc97DNA)与紫外线致弱尾蚴(UVC)疫苗免疫C57BL6小鼠诱导的抗感染保护力及免疫应答特征。　方法　以Sjc97DNA核酸疫苗经后腿胫前肌免疫C57BL6小鼠共2次,每次间隔3wk,末次免疫后3wk攻击感染日本血吸虫尾蚴;UVC疫苗接种同种小鼠后5wk攻击感染上述等量尾蚴。均于攻击感染后7wk计数虫负荷及肝卵负荷。并设空质粒对照及感染对照组。用ELISA分析免疫鼠攻击感染前后血清特异性IgG、IgA及亚型抗体水平,以及脾淋巴细胞体外诱生的细胞因子水平。　结果　Sjc97DNA疫苗及UVC疫苗免疫小鼠均诱生出以Th1型免疫应答为主的IL2、IFNγ及特异性抗AWA、SEAIgG2a、IgG2b亚型及IgA抗体,UVC疫苗组小鼠各细胞因子及抗体水平均显著高于Sjc97DNA疫苗组,但两疫苗组均未测及IL4。攻击感染后,Sjc97DNA疫苗组的减虫率36.3%、减卵率42.4%,明显低于UVC疫苗组的66.9%和75.6%。攻击感染后7wk,两疫苗组小鼠Th2型免疫应答虽有所增强,但仍以Th1型免疫应答占优势;而空质粒对照组和感染对照组小鼠则以Th2型免疫应答为主。　结论　核酸疫苗与紫外线致弱尾蚴疫苗均能诱导产生抗感染免疫保护力,致弱尾蚴疫苗的免疫保护力高于Sjc97DNA。两疫苗诱导的抗感染     

日本血吸虫副肌球蛋白全基因核酸疫苗对小鼠的抗病免疫效应

目的 探讨日本血吸虫副肌球蛋白全基因核酸疫苗（Sjc97 DNA）免疫小鼠诱导的抗病免疫效应。 方法 将40只C57BL/6小鼠随机分成4组：疫苗组,以Sjc97 DNA疫苗100 μg经后腿胫前肌注射免疫小鼠,共2次,间隔3周;空质粒组,以同法、同剂量的空质粒载体免疫小鼠;上述2组分别于末次免疫后3周攻击感染30±2条日本血吸虫尾蚴;感染对照组,不作免疫,感染相同数量的日本血吸虫尾蚴;空白对照组,未作任何处理。攻击感染后7周剖杀小鼠,测量肝脏单个虫卵肉芽肿大小,测定鼠血清透明质酸及层黏连蛋白含量,PCR?鄄ELISA检测肝组织转化生长因子（TGF-β1） mRNA的表达水平。 结果 Sjc97 DNA疫苗组小鼠肝脏虫卵肉芽肿的直径为（183.75±42.36）μm,显著小于空质粒对照组的（303.12±37.36）μm和感染对照组的（304.38±53.23）μm （P<0.01）。血清透明质酸和层黏连蛋白水平,疫苗组显著低于感染对照组（P<0.01）。肝组织TGF-β1 mRNA表达水平,疫苗组亦明显低于两对照组（P<0.05）。 结论 Sjc97 DNA核酸疫苗具有一定的抗虫卵肉芽肿及抗肝纤维化作用。     

紫外线减毒日本血吸虫尾蚴免疫小鼠的皮肤组织细胞反应

目的 :探讨紫外线减毒血吸虫尾蚴免疫宿主的皮肤组织在抗攻击感染中的作用。方法 :88只小鼠分为 4组 ,1、2组分别以 50± 3条紫外线减毒日本血吸虫尾蚴免疫或日本血吸虫尾蚴感染 ,5wk后以 10 0 0± 10 0条尾蚴进行攻击感染 ;3、4组分别以减毒尾蚴或尾蚴 10 0 0± 10 0条免疫或初次感染。各组均于感染或接种后 6- 12 0 h定时取局部皮肤组织作病理观察。结果 :( 1)免疫攻击组皮肤组织内炎症细胞杀伤童虫现象最明显、炎症反应最强且持续时间最长 ,嗜酸性粒细胞( EOS)浸润百分数最高 ;( 2 )感染攻击组呈现相似炎症反应但程度略轻 ;( 3)免疫对照组减毒童虫在皮肤内滞留时间延长 ,至 12 0 h皮下仍可见较多童虫 ;( 4 )感染对照组皮肤内的童虫数于 72 h后明显减少 ,童虫周围轻微炎症反应。电镜观察可见免疫攻击组童虫内部结构破坏 ,虫体周围 EOS、淋巴细胞增多 ,肥大细胞颗粒溶解。结论 :提示皮肤组织的细胞免疫反应在血吸虫减毒尾蚴免疫的宿主抗攻击感染保护性免疫中起重要作用。     

血吸虫硫氧还蛋白免疫原性研究Ⅱ日本血吸虫硫氧还蛋白DNA疫苗小鼠保护性免疫研究

目的观察日本血吸虫(大陆株)硫氧还蛋白DNA疫苗(pcDNA3-SjcTrx)在小鼠诱导抗血吸虫感染的免疫保护作用。方法制备pcDNA3-SjcTrx重组质粒,将30只雌性C57BL/6小鼠随机分为3组,每组10只:pcDNA3-SjcTrx核酸疫苗免疫组、pcDNA3空质粒对照组和攻击感染对照组。核酸疫苗免疫组每只小鼠经股四头肌注射100μg核酸疫苗,共注射3次,间隔2周。空质粒对照组每只小鼠在相应时间经股四头肌注射100μgpcDNA3空质粒,感染对照组则不注射任何质粒。于末次免疫后3周,每只小鼠经腹部感染(30±1)条日本血吸虫尾蚴。小鼠于攻击感染后42天剖杀,门脉灌注收集成虫,计数成虫数和肝内虫卵数。分别在免疫前、攻击感染前和小鼠剖杀前采血并分离血清,用ELISA检测血清中特异性IgG抗体。另取6只雌性C57BL/6小鼠经股四头肌注射核酸疫苗,分别于注射后24、48小时和72小时取肌肉注射部位局部组织制备冰冻切片,用免疫酶染色试验(IEST)检测注射局部组织抗原的表达情况,以注射pcDNA3空质粒者为对照。结果IEST结果表明该DNA疫苗在小鼠肌肉组织内表达,ELISA检测表明DNA疫苗免疫小鼠后产生明显的抗体(IgG)免疫应答,并诱导出对攻击感染的45.7%的减虫率和41.4%的肝组织减卵率(P<0.05)。结论日本血吸虫(大陆株)硫氧还蛋白DNA疫苗具有较好的免疫原性,在小鼠诱导出明显的免疫保护作用,可作为疫苗候选分子作进一步的研究。     

肺细胞反应对经疫苗接种小鼠抗曼氏血吸虫感染的作用

作者观察了正常小鼠和经尾蚴疫苗免疫的小鼠感染曼氏血吸虫后童虫所引起的肺组织学和超微结构变化,发现免疫小鼠对血吸虫再感染的抗性与童虫所致肺脏炎症反应有关。C57BL/6小鼠分两组:正常对照组和免疫组。免疫组用300条灭活尾蚴(20 000radγ射线照射)腹部皮下接种。9周后两组鼠同时     

日本血吸虫混合DNA疫苗免疫效果观察

目的 为提高日本血吸虫DNA疫苗免疫效力,观察日本血吸虫抗原分子的混合DNA疫苗诱导小鼠的抗攻击感染的保护性免疫。方法 大量制备真核质粒pBK-CMV-Sj26和pBK-CMV-Sj23,然后将单价DNA疫苗pBK-CMV-Sj26和pBK-CMV-Sj23混合后免疫小鼠。实验分为4组：混合疫苗组、单价疫苗pBK-CMV-Sj23组、空质粒对照组及生理盐水对照组。各组于0周、3周、5周在小鼠股四头肌注射相应质粒DNA或生理盐水,第9周小鼠用血吸虫尾蚴攻击感染,第15周剖杀小鼠计算减虫率及减卵率。结果 与对照组比较,实验组小鼠减虫率及减卵率有极显著性意义（P＜0．01）;与单价pBK-CMV-Sj23组比较,混合DNA疫苗组的减虫率及减卵率有显著性意义（P＜0．05）。结论 血吸虫混合DNA疫苗诱导小鼠对血吸虫的保护力优于单价DNA疫苗。     

日本血吸虫肌球蛋白部分重链基因核酸疫苗的构建与小鼠保护性研究

目的研究日本血吸虫肌球蛋白部分重链基因核酸疫苗对小鼠的保护效果。方法用致弱童虫免疫血清筛选日本血吸虫成虫cDNA文库,获得的阳性克隆之一与曼氏血吸虫肌球蛋白重链基因同源。PCR法扩增该片断基因,产物克隆入真核表达载体pcDNA3中,构建成肌球蛋白部分重链基因核酸疫苗。将50μg肌球蛋白(myosin)核酸疫苗注射C57BL/6小鼠的两侧股四头肌,免疫3次,间隔2周,末次免疫后2周经腹部皮肤攻击感染尾蚴30条/鼠,感染6周后用门静脉灌注法收集成虫,计算核酸疫苗免疫组减虫率与空质粒对照组减虫率。结果核酸疫苗免疫组获得了33.02%的减虫率,空质粒对照组获得了24.50%的减虫率,经t检验,两组差异无显著性。结论肌球蛋白部分重链基因核酸疫苗在小鼠中未能诱导出保护力。     

日本血吸虫DNA疫苗proVAX/GMCSF-SjFer的构建及免疫保护性效果的观察

目的 构建日本血吸虫铁蛋白proVAX/GMCSF-SjFer DNA疫苗,观察其诱导小鼠产生抗攻击感染的免疫保护性效果. 方法 小量制备pGMC/SjFer重组质粒DNA,PCR扩增GMCSF-SjFer基因,将此目的 片段亚克隆到真核表达载体proVAX中,构建重组真核表达质粒proVAX/ GMCSF-SjFer.雌性昆明鼠随机分为对照组、免疫组和空质粒组.空质粒组小鼠股四头肌注射proVAX,免疫组同法注射重组质粒proVAX/GMCSF-SjFer,对照组注射生理盐水.按0、2、6周设计接种3次.末次接种后第2周,感染血吸虫尾蚴(40±2)条/鼠.感染后第42 d剖杀小鼠,灌注法冲虫,计数虫荷和克肝卵数.免疫前和免疫后2周留取小鼠血清,用ELISA法检测抗血吸虫成虫抗体水平. 结果 经PCR和双酶切鉴定,获得1条约为960 bp的目的 片段和2条酶切片段.免疫组小鼠的减虫率及减卵率分别为22.46%和29.40%,空质粒对照组分别为3.11%和7.79%,差异有统计学意义(P<0.05).ELISA检测免疫组小鼠血清特异性IgG抗体水平增高. 结论 构建的DNA疫苗proVAX/GMCSF-SjFer能诱导小鼠产生一定水平的保护性免疫.     

日本血吸虫组织蛋白酶B DNA疫苗与IL-4真核表达质粒联合免疫诱导小鼠保护性的研究

目的　观察日本血吸虫组织蛋白酶BDNA疫苗与IL 4真核表达质粒联合免疫小鼠的效果。　方法　将小鼠IL 4基因PCR扩增片段克隆入真核表达载体pcDNA3以构建重组表达质粒。小鼠分为 4组 ,每组 12只 ,实验组 (A)每鼠肌注组织蛋白酶BDNA疫苗和IL 4表达质粒各 10 0 μg ,同时设立组织蛋白酶BDNA疫苗对照组 (B)、IL 4表达质粒对照组 (C)和空载体对照组 (D) ,共免疫 3次。 2周后用免疫组化检测表达质粒在小鼠肌细胞的表达 ,3周后经皮肤攻击感染小鼠 40± 1条日本血吸虫尾蚴。计算减虫和减卵率 ,观察免疫保护性。　结果　重组IL 4质粒和组织蛋白酶BDNA疫苗均在小鼠肌细胞表达。用重组IL 4质粒和组织蛋白酶BDNA疫苗联合免疫诱导小鼠产生 43 .2 0 %的减虫率和 76.63 %的减卵率 ,与组织蛋白酶BDNA疫苗单独免疫比较差异均有显著性 (P <0 .0 0 1,P <0 .0 5 )。　结论　联合IL 4表达质粒免疫可能提高日本血吸虫组织蛋白酶BDNA疫苗的抗血吸虫保护性免疫。     

日本血吸虫DNA疫苗pCDSj32不同免疫次数及末次免疫后不同攻击时间对小鼠保护性免疫力的观察

目的　观察日本血吸虫 DNA疫苗 p CDSj32不同免疫次数及末次免疫后不同攻击时间对小鼠保护性免疫力的影响。方法　分别以 10 0 μg/ 10 0 μl的 p CDSj32经股四头肌注射免疫 BAL B/ c小鼠 ,并分为一次免疫组合三次免疫组。各组于末次免疫后 4wk或 8wk,每只小鼠用 40条日本血吸虫尾蚴攻击感染。 6 wk后剖杀小鼠 ,观察各组小鼠的减成虫率和肝组织减卵率。结果　各免疫组与对照组相比均产生较好的保护免疫效果 ,减成虫率为 35 .6 1%～ 44 .44 % ,肝组织减卵率为 39.6 4%～6 9.0 6 %。结论　 DNA疫苗不同免疫次数及末次免疫后不同攻击时间对小鼠抗血吸虫尾蚴攻击感染效果有一定的影响。该疫苗免疫一次及免疫后 8wk攻击感染可获得最佳免疫效果     

肿瘤病人弓形虫感染分析

在肿瘤的发生和发展进程中 ,多伴有免疫功能低下或缺陷 ,从而极易遭受各种感染。弓形虫是机会感染因子 ,当患者免疫功能受损时 ,易于感染 ,还会使隐性感染激活 ,引起低热不退、淋巴结肿和脑神经系统的反应 ,此现象尚未引起临床医师的重视。近年来 ,我们对 4 0 9例肿瘤病人进行了弓形虫感染及弓形虫病的分析观察 ,报告如下 :1　材料与方法1 1　材料　 30 4例病人血清取自江西省肿瘤医院住院或门诊病人 ,随机抽样后低温保存待检 ,10 5例取自其他医院送检样品 ,有急性症状者随到随检 ,以便及时做病原学检测。1 2　弓形虫病诊断方法1 2 1　免疫…     

A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent urgent surgical treatment for perforated peritonitis. The 54-year-old man suddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side approximately 10 cm distant from the stenosis were found, with massive abdominal purulent fluid. He was treated by rectosigmoid colon resection with transverse colon loop colostomy. Histopathologically, the stenosis was caused by ulceration extending to all muscular layers of the rectum, with inflammatory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likelihood of this disease in differentiation from rectal cancer. Received: December 21, 1998 / Accepted: May 28, 1999     

Infection with Rhodococcus equi in a patient with sarcoidosis treated with corticosteroids

A 51-year-old female farmer was diagnosed as having sarcoidosis. During 4 years of observation, slow radiological progression was observed. Cough then developed, necessitating treatment with corticosteroids. After 28 months of continuous treatment with prednisolone in low doses (5-7.5 mg daily), she suffered fever episodes, recurrent haemoptyses, general malaise and loss of weight. A chest roentgenogram showed a left upper lobe infiltrate, which progressed and finally cavitated, and rib destruction. Despite efforts, including a thoracotomy, 22 months passed before a diagnosis could be made. Blood and sputum cultures and cultures from the destroyed rib showed growth of Rhodococcus equi, a common soil organism which can cause infections in foals and other animals. Treatment with rifampicin and erythromycin was successful. R. equi has been reported to cause infection in patients with neoplastic disease and/or immunosuppression, but the disease might be more common than is suggested by the sparse case reports in the literature, owing to lack of familiarity with the organism, which will tend to be overlooked as a contaminant.     

Evaluation of atrial vulnerability with transoesophageal stimulation in patients with atrioventricular junctional: Comparison with patients with ventricular pre-excitation and with normal subjects

The aim of our work was to evaluate the inducibility of atrialfibrillation in a group of patients with atrioventricular junctionalreentrant tachycardia and to compare it with that of patientswith a Kent-type ventricular pre-excitation (Wolff-Parkinson-Whitesyndrome) and a control group. One hundred and twenty-five subjects were separated into groups.Group 1 comprised 49 Wolff-Parkinson-White patients, with amean age of 26.4, range 10.66 years; group 2, 51 patients withatrioventricular junctional reentrant tachycardia inducibleby transoesophageal atrial stimulation andlor clinically documented,with a mean age of 43.4, range 16–78 years; group 3, 25control subjects with a mean age of2.64, range 13–76 years. Each subject underwent atrial transoesophageal stimulation withthe following protocol: programmed atrial stimulation with 1and 2 stimuli during atrial pacing of 100. min^–1 and 150.min^–1; atrial stimulation for 10 s at a rate of 200–300–400–500–600.min^–1 with intervals of 10 s between stimulations, fivesuccessive ‘ramp-up’ atrial stimulations for 9 swith the rate increasing from 100 to 800. min^–1 with intervalsof 10 s between stimulations. The end point was the completionof the protocol or induction of sustained atrial fibrillation(>1 min). The chi-square test was used for statistical analysis. Our resultsshowed that in group 1 atrial fibrillation was induced in 27149patients (55.1%); this was sustained in 13149 (26.5%) and non-sustainedin 14149 (28.5%); in group 2, atrial fibrillation was inducedin 22151 patients (43.0%); it was sustained in 7151 (13.7%)and non-sustained in 15151 (29.4%); in group 3, sustained atrialfibrillation was not induced in any subject and in only onesubject was a non-sustained atrial fibrillation (4 s) induced. The chi-square test showed that group 2 vs group 1 were non-significant,while group 2 vs group 3 and group 1 vs group 3 were significant(P<0.003 and P<0.0007, respectively). Therefore group 2 patients showed a greater atrial vulnerabilityin comparison to the control subjects and a similar vulnerabilityto group 1 patients. It is possible that the greater atrialvulnerability in the patients of group 2 was due to the doublenodal pathway.     

Treating patients with lupus with B-cell depletion

A new era in the treatment of systemic lupus erythematosus has dawned with the increasing introduction of monoclonal antibodies and other approaches, that target the key molecules involved in the pathogenesis of the disease. At present the ability to block the CD20 molecule on those B cells that carry this marker has proved the most effective way to treat patients resistant to conventional immunosuppressive drugs. However, these studies have all been open label and the results of double blind controlled studies are eagerly awaited.