不同类型银屑病患者全血中Th17细胞因子mRNA表达及血清IL-26蛋白水平的临床分析

目的:分析不同类型银屑病患者全血中Th17细胞因子m RNA表达及血清IL-26蛋白水平。方法:选取2012年12月-2017年12月在笔者医院接受治疗的80例进行期银屑病患者,选取同期体检健康者80例作为对照组,检测两组对象血清白细胞介素-26(IL-26)含量,实时荧光定量PCR检测IL-26、白细胞介素-22(IL-22)、白细胞介素-17A(IL-17A)m RNA表达状况,并行统计分析。结果:银屑病及不同分型患者血清IL-26、IL-22、IL-17A m RNA表达量和IL-26蛋白含量均高于对照组,差异有统计学意义(P0.05)。关节型银屑病患者IL-26 m RNA表达量和血清IL-26含量高于寻常型银屑病、红皮型银屑病和局限性脓疱型银屑病,差异有统计学意义(P0.05)。Pearson相关分析显示,患者疾病严重程度和IL-26蛋白含量呈正相关(r=0.702,P0.05)。结论:银屑病患者血清IL-26蛋白含量及IL-26、IL-22、IL-17A m RNA表达量较健康者升高,且关节型银屑病患者IL-26 m RNA表达量高于其他类型患者。     

他克莫司联合复方甘草酸苷片对白癜风稳定期患者血清Th1/Th2型细胞因子水平的影响

目的:探讨他克莫司联合复方甘草酸苷片对白癜风稳定期患者血清Th1/Th2型细胞因子水平的影响。方法:选取2015年6月-2017年6月于笔者医院接受治疗的80例白癜风稳定期患者作为研究对象,随机数字表分为对照组(n=40)和观察组(n=40)。对照组给予他克莫司治疗,观察组在对照组基础上联合复方甘草酸苷片治疗。治疗2年后对患者效果进行评估,比较两组患者治疗前后血清Th1/Th2型细胞因子水平、治疗效果及并发症发生情况。结果:治疗后观察组稳定期白癜风患者血清Th1/Th2型细胞因子中IFN-γ、IL-2、IL-4、IL-10水平的下降幅度大于对照组,差异具有统计学意义(P0.05);观察组疗效为97.50%优于对照组的80.00%,差异具有统计学意义(P0.05);两组间并发症发生率比较差异无统计学意义(P0.05)。结论:他克莫司联合复方甘草酸苷片用于治疗白癜风稳定期患者,能有效改善患者症状,提高患者治疗效果,降低白癜风稳定期患者血清Th1/Th2型细胞因子IFN-γ、IL-2、IL-4、IL-10水平,安全性好,患者满意度较高,值得推广应用。     

浆细胞性乳腺炎患者外周血Treg细胞及Treg/Th17比率的检测及意义

目的:探讨浆细胞性乳腺炎(PCM)患者外周血Tre g细胞及Tre g/Th17比率的变化及意义。方法:采用流式细胞术检测18例急性期PCM患者(APCM)、32例亚急性期PCM患者(SPCM)、26例慢性期PCM患者(CPCM)和20例健康对照者(HC)外周血中Tre g细胞水平;采用ELISA检测血浆中IL-10和TGF-β1水平。结果 :APCM、SPCM和CPCM三组患者外周血Tre g数量、Tre g/Th17比率、IL-10和TGF-β1水平依次增高,但均低于HC组(P0.05)。Tre g/Th17比率与白细胞计数(WBC)呈负相关(r=-0.261,P=0.025),血浆TGF-β1水平与PTL水平呈负相关(r=-0.259,P=0.026)。结论:PCM患者外周血Treg细胞及相关细胞因子数量下降,导致Treg/Th17比率下降,表明Treg/Thl7失衡在PCM发生发展及转归中具有重要作用。     

马拉色菌感染对寻常型银屑病患者血清SP、Th1/Th2有关因子的影响及与病情关联性

目的:探讨马拉色菌感染对寻常型银屑病(Psoriasis vulgaris,PV)患者血清P物质(Substance P,SP)、Th1/Th2有关因子的影响及与病情关联性。方法:选取2017年4月-2019年10月笔者科室就诊的62例马拉色菌感染PV患者为感染组,同期62例未感染马拉色菌PV患者为未感染组。对比两组患者一般资料、血清SP、Th1/Th2有关因子[白细胞介素-10(Interleukin-10,IL-10)、白细胞介素-4(Interleukin-4,IL-4)、白细胞介素-2(Interleukin-2,IL-2)、干扰素-γ(Interferon-γ,INF-γ)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)]水平,Spearman相关系数分析马拉色菌感染与患者血清SP、Th1/Th2有关因子表达的关联性,并比较不同马拉色菌密度感染患者病情程度,分析马拉色菌密度与病情程度的相关性。结果:感染组血清SP、Th2有关因子水平高于未感染组,血清Th1有关因子水平低于未感染组(P0.05);感染组病情程度为重度患者马拉色菌密度显著高于中度、轻度患者(P0.05);血清SP、Th2有关因子水平与马拉色菌感染呈正相关,血清Th1因子水平与马拉色菌感染呈负相关,马拉色菌密度与感染组患者病情程度呈正相关(P0.05)。结论:马拉色菌感染PV患者存在血清SP、Th1/Th2有关因子异常波动情况,其机制可能是马拉色菌感染后引起的免疫异常,进一步增加马拉色菌增殖活性,加重病情,临床可根据上述因子表达情况制定治疗方案。     

腰椎间盘突出症与Th细胞、NK细胞的相关性研究

目的:探讨辅助性T细胞17(T help cell 17,Th17)、自然杀伤细胞(natural killer cell,NK)在腰椎间盘突出症发生发展中的作用,以求进一步明确神经根痛的病理机制.方法:选取南通大学附属医院脊柱外科收治接受手术治疗的腰椎间盘突出症患者20例作为观察组(椎间盘突出组),同时选取腰椎骨折需摘除椎问盘的患者6例作为对照组(正常髓核组).运用流式细胞术(Flow Cytometry,FCM),分别测定观察组和对照组患者髓核组织中CD3、CD4、T细胞胞内产物白介素-17(IL-17)及NK细胞表面因子CD16CD56的含量.结果:观察组髓核中的CD4、IL-17和CD16CD56含量分别为(3.18±0.15)％、(2.94±0.04)％、(3.24±1.65)％,有高表达;而对照组髓核中的CD4、IL-17和CD16CD56含量分别为(0.08±0.02)％、0％、(1.73±0.71)％,低表达或者不表达,两组间比较差异有显著性(P值分别为0.000,0.000,0.003).观察组与对照组髓核中CD3的表达分别为(23.42±5.84)％和(26.54±4.17)％,两组间差异无显著性(P＞0.05).结论:髓核作为自身抗原可促使Th细胞分化成以IL-17为主的Th17细胞,并诱导CD 16CD56为表面标志的NK细胞的表达,可能参与了腰椎间盘突出症的发生发展.     

Th17细胞和调节性T细胞在肝包虫病免疫逃避中的作用

目的 探讨辅助性T细胞17(Th17)和调节性T细胞(Treg细胞)在肝包虫病免疫逃避中的作用.方法 前瞻性分析2008年8月至2009年9月新疆医科大学第一附属医院74例受试者的临床资料,将74例受试者分为4组:健康对照组20例,肝囊型包虫病组21例,肝复发囊型包虫病组15例和肝泡型包虫病组18例.应用ELISA法检测各组受试者血清中Treg相关细胞因子转化生长因子(TGF-β1)和IL-10,Th17细胞相关细胞因子IL-17和IL-23的表达,并用单因素方差分析,两两比较采用LSD-t法和Pearson相关性检验分析其结果.结果 IL-17在健康对照组、肝囊型包虫病组、肝复发囊型包虫病组和肝泡型包虫病组的表达分别为(16±5)、(13±4)、(13±5)和(11±3)ng/L,4组比较,差异有统计学意义(F=6.35,P<0.05);而肝囊型包虫病组与肝复发囊型包虫病组比较,差异无统计学意义(t=0.22,P＞0.05).IL-23在健康对照组、肝囊型包虫病组、肝复发囊型包虫病组和肝泡型包虫病组的表达分别为(139±50)、(106±53)、(107±48)和(72±27)ng/L,4组比较,差异有统计学意义(F=6.74,P<0.05);而肝囊型包虫病组与肝复发囊型包虫病组比较,差异无统计学意义(t=0.02,P＞0.05).IL-10在健康对照组、肝囊型包虫病组、肝复发囊型包虫病组和肝泡型包虫病组的表达分别为(3.1±0.8)、(4.3±2.0)、(4.2±1.4)和(5.5±2.2)ng/L,4组比较,差异有统计学意义(F=9.78,P<0.05);而肝囊型包虫病组与肝复发囊型包虫病组比较,差异无统计学意义(t=0.14,P＞0.05);TGF-β1在健康对照组、肝囊型包虫病组、肝复发囊型包虫病组和肝泡型包虫病组的表达分别为(26±7)、(37±7)、(33±9)和(38±7)μg/L,4组比较,差异有统计学意义(F=6.73,P<0.05);而3种肝包虫病组比较,差异无统计学意义(t=0.56,1.81,P＞0.05).Th17/Treg(IL-17/IL-10)在健康对照组、肝囊型包虫病组、肝复发囊型包虫病组和肝泡型包虫病组的表达比例分别为5.7±2.6、3.6±1.5、3.4±1.9和2.1±0.7,4组比较,差异有统计学意义(F=13.76,P<0.05);而肝囊型包虫病组与肝复发囊型包虫病组比较,差异无统计学意义(t=0.23,P＞0.05).血清中,IL-17和TGF-β1呈负相关(r=-0.23,P<0.05);IL-17和IL-23呈正相关(r=0.70,P<0.05);IL-10和TGF-β1呈正相关(r=0.46,P<0.05).结论 Th17/Treg相关细胞因子平衡在肝泡型和肝囊型包虫病患者中明显向Treg应答偏倚,Th17/Treg相关细胞因子失衡可能参与肝包虫所致免疫逃避.     

Th1/Th17细胞在肺部感染中的作用

目的：观察Th1、Th17型细胞因子在肺部感染性疾病中的动态变化,深入探讨机体抵抗肺部感染的免疫机制,为肺部感染性疾病的特异性诊治提供实验依据。方法：收集临床肺部感染患者血清、外周血淋巴细胞样本,分别用ELISA方法检测血清中Th1型细胞因子（IFN-γ）及Th17型细胞因子白细胞介素-17（IL-17）的表达水平,用FACS检测外周血中CD4＋IFN-γ＋Th1及CD4＋IL-17＋Th17细胞的比例变化,同时用Realtime-PCR方法检测外周血中Th17型细胞因子IL-17在基因水平的表达变化。以上指标的检测均以临床公认的CRP水平的变化作为参考。结果：ELISA结果显示,肺部感染患者血清IFN-γ的水平较健康对照组显著升高,动态检测结果显示IFN-γ变化水平与反映临床疾病状态的CRP出现显著的相关性。而IL-17的表达在不同的疾病过程未出现显著的变化。FACS及Real-time-PCR结果均显示CD4＋IFN-γ＋Th1的活性变化与疾病状态相关,而CD4＋IL-17＋Th17细胞在肺部感染不同阶段未出现显著的变化。结论：相对于Th17细胞而言,Th1细胞在机体防御肺部感染的过程中发挥更为关键的作用。Th17细胞在该类感染性疾病中的作用尚需进一步探讨。     

特应性皮炎患者外周血Th17/Treg和IL-17、TGF-β的表达及与病情相关性研究

目的:探讨特应性皮炎(Atopic dermatitis,AD)患者外周血辅助性T细胞17(Th17)/调节性T细胞(Treg)平衡和白细胞介素-17(IL-17)、转化生长因子-β(TGF-β)的表达水平,并分析其与病情的相关性.方法:选取2015年3月-2019年6月在笔者医院确诊的AD患者126例作为观察组,再选...     

痤疮患者血清中Th1细胞和Th17细胞活化水平与病情严重程度的关系研究

目的：研究痤疮患者血清中辅助性T细胞1(T helper cell 1,Th1)和辅助性T细胞17(T helper cell 17,Th17)活化与病情严重程度的关系。方法：选取2019年6月-2021年6月笔者医院就诊的143例痤疮患者，根据Pillsbury法将其分为轻度48例、中度55例及重度40例。比较不同患者病情严重程度、一般资料、Th1细胞和Th17细胞水平。采用Pearson相关系数分析Th1细胞和Th17细胞水平与病情严重程度的关联性，采用Logistic回归分析重度痤疮的影响因素。结果：不同病情严重程度痤疮患者年龄、家族史、治疗情况比较，差异无统计学意义（P>0.05）；重度痤疮患者男性、饮食喜好油腻或辛辣、吸烟或喝酒、每天使用手机或电脑时间、皮肤类型为油性占比大于轻中度患者，痤疮初发年龄、每日睡眠时间小于轻中度患者（P<0.05）；随着痤疮病情程度的加重，Th1细胞和Th17细胞水平呈逐渐升高趋势（P<0.05）；经Pearson相关性分析，痤疮患者Th1细胞和Th17细胞水平与病情严重程度呈正相关（P<0.05）；经Logistic回归分...     

慢性非细菌性前列腺炎/慢性骨盆疼痛综合征患者外周血Th1/Th2细胞的检测

目的:探讨慢性非细菌性前列腺炎/慢性骨盆疼痛综合征(CAP/CPPS)患者外周血Th1/Th2细胞分布的变化情况及其在CAP/CPPS临床分型中的意义。方法:采用流式细胞术检测35例CAP/CPPS患者和12例健康体检者外周血CD3+CD8-T细胞胞内细胞因子干扰素γ(IFN-γ)和白细胞介素4(IL-4)的表达。结果:与正常对照组相比,ⅢA型、ⅢB型CAP/CPPS患者的Th1细胞数均升高,Th1/Th2比值升高,差异有显著性(P<0.05),Th2细胞数差异无统计学意义(P>0.05);ⅢA型与ⅢB型患者比较,Th1、Th2细胞数与Th1/Th2比值差异均无统计学意义(P>0.05)。结论:CAP/CPPS患者Th1型反应模式占优势状态,Th1/Th2平衡失调,Th1/Th2平衡向Th1方向变化,提示Th1细胞在CAP/CPPS的病理发生中可能起重要作用。     

Th1 and Th17 Cells Induce Proliferative Glomerulonephritis

Th1 effector CD4+ cells contribute to the pathogenesis of proliferative and crescentic glomerulonephritis, but whether effector Th17 cells also contribute is unknown. We compared the involvement of Th1 and Th17 cells in a mouse model of antigen-specific glomerulonephritis in which effector CD4+ cells are the only components of adaptive immunity that induce injury. We planted the antigen ovalbumin on the glomerular basement membrane of Rag1^−/− mice using an ovalbumin-conjugated non-nephritogenic IgG1 monoclonal antibody against α3(IV) collagen. Subsequent injection of either Th1- or Th17-polarized ovalbumin-specific CD4+ effector cells induced proliferative glomerulonephritis. Mice injected with Th1 cells developed progressive albuminuria over 21 d, histologic injury including 5.5 ± 0.9% crescent formation/segmental necrosis, elevated urinary nitrate, and increased renal NOS2, CCL2, and CCL5 mRNA. Mice injected with Th17 cells developed albuminuria by 3 d; compared with Th1-injected mice, their glomeruli contained more neutrophils and greater expression of renal CXCL1 mRNA. In conclusion, Th1 and Th17 effector cells can induce glomerular injury. Understanding how these two subsets mediate proliferative forms of glomerulonephritis may lead to targeted therapies.Although proliferative and crescentic glomerulonephritides occur in different primary renal diseases and are an important component of several systemic diseases, features of human renal biopsies suggest some common effector pathways. In most cases of rapidly progressive GN there is evidence for an important role for cellular immune effectors: T cells, macrophages, and neutrophils,^1–3 a role confirmed in animal models.^4–7 CD4+ T cells are key components of renal injury.^4,8 When activated, CD4+ cells tend to differentiate into subsets (T helper cells—Th1, Th2 and Th17) that engage immune effectors in different ways. In proliferative forms of GN, T cells direct adaptive immune responses that drive glomerular disease, but also, in rapidly progressive GN, CD4+ cells themselves accumulate in glomeruli as effectors. These effector T helper cells activate innate effector cells, predominantly neutrophils and macrophages, and activate and damage intrinsic renal cells.In GN, the variable Th1-Th2 predominance of responses influences the histologic patterns and severity of GN.⁹ Th1 cells, which secrete IFNγ and activate macrophages, are important in some forms of experimental proliferative GN. Th2 cells, characterized by IL-4 production, promote humoral immunity and are important in several forms of GN, but there is little evidence that Th2 cells play primary roles as effector cells within glomeruli in rapidly progressive GN. A binary Th1/Th2 model explains many of the differences in the patterns of immune responses in GN. However, there are discrepancies¹⁰ that might be explained by defining a role for a third major subset, Th17 cells, characterized by the production of IL-17A. Its biology has recently been comprehensively reviewed.¹¹ Th17 subset effects potentially relevant to rapidly progressive GN include direct effects on neutrophils and stimulating the production of neutrophil chemoattractants by tissue cells. Thus, in most rapidly progressive types of GN, cell-mediated injury, a key component of injury, may be directed by the Th17 subset, the Th1 subset, or both subsets.Although antigen-specific T cells are critical to adaptive immune responses, the cells themselves are relatively infrequent. T cell receptor (TcR) transgenic mice help define the contributions of different antigen-specific T helper cell subsets in organ-specific disease.^12–14 In the studies presented here we have established a new antigen-specific model of GN. Ovalbumin (OVA)-specific OT-II TcR transgenic CD4+ cells¹⁵ are polarized ex vivo under Th1- or Th17-inducing conditions. Effector cells are transferred into recombination activating gene-1 deficient (Rag1^−/−) mice with OVA planted in their glomeruli by injecting an OVA conjugate. OVA is conjugated to a mouse IgG1 mAb binding to α3(IV) collagen in murine glomerular basement membrane (GBM). The mAb-OVA conjugate dose is capable of planting significant OVA in glomeruli as an antigen to induce effector responses, but is insufficient to induce significant histologic or functional injury as an antibody. This model allows us to understand effector CD4+ T cell and Th subset-induced injury, with no effects from CD8+ cells or B cells.CD4+ cells, isolated from OVA-specific TcR transgenic (OT-II) mice and cultured under Th1 or Th17 priming conditions (see Concise Methods), were confirmed to be Th1 or Th17 by cytokine production before transfer. Th1 polarized cells expressed IFNγ, whereas no IL-17A or IL-4 production was detected (Figure 1A). Th17 polarized cells were strong IL-17A producers, showing only weak IFNγ production, with >20% of cells producing IL-17A, but few IFNγ or double-positive cells (Figure 1B). To plant OVA in glomeruli, the mAb 8D1, a non-nephritogenic, murine IgG1 binding to mouse α3(IV)NC1,¹⁶ was conjugated to OVA and purified by size-exclusion chromatography so that no free OVA or unconjugated 8D1 mAb remained, confirmed by Western blotting (Figure 1C). Antigen-specific CD4+ cells recognized OVA bound to the 8D1 anti-GBM mAb. Culture of CFSE-labeled naive OT-II cells incubated with the 8D1-OVA conjugate enhanced their survival (30% to 40% survival after 72 h versus 5% to 6% with unconjugated antibody) and induced OT-II cell proliferation (72 h: 27% of cells, up to 4 cycles, Figure 1D). OT-II cells incubated with unconjugated 8D1 did not proliferate (Figure 1E). After intravenous injection, 8D1-OVA conjugates bound to the GBM in a linear manner; no fluorescence signal was observed after transfer of Th1 cells without 8D1-OVA (Figure 1G). Western blotting showed OVA in the kidney after injection of 8D1-OVA conjugate (Figure 1H). Lungs from 8D1-OVA-injected mice were weakly positive for mouse IgG, whereas no IgG was detected in the spleen or liver (detecting antibody titer 1:100) 3 or 21 d after injection. Mouse IgG was not detected in sera (ELISA, dilution 1:100) at day 3 or day 21. As expected (given the transfer of only CD4+ cells to Rag1^−/− mice), no anti-OVA antibodies in sera were detected in recipient mice (data not shown).Open in a separate windowFigure 1.Differentiation of OVA-specific OT-II Th1 and Th17 cells, antibody-OVA conjugation, glomerular IgG and intrarenal OVA detection, and recipient immune responses after cell transfer. (A) After stimulating naive OT-II cells with OVA in a Th1 environment, IFNγ was produced and intracellular cytokine staining of CD4+ cells demonstrated strong IFNγ staining with minimal IL-17A or IL-4. (B) Culturing cells in a Th17-stimulating environment led to strong IL-17A production, whereas cells stained positive for IL-17A but not IL-4, and only 2% of cells produced IFNγ. (C) Chromatographic profile of 8D1-OVA conjugation. The numbers 1 to 7 represent fractions collected for analyses by Western blotting, which confirmed that all OVA-conjugated fractions contained OVA and IgG (lanes 1–6), whereas unconjugated fractions (represented as “Un”) contained IgG alone. The lane labeled “M” contained molecular weight markers. (D and E): 8D1-OVA was recognized by OT-II cells because multiple cycles of proliferation of cultured naive OT-II cells (D) were seen with 8D1-OVA conjugate and (E) not seen with unconjugated antibody. Strong linear IgG staining of glomeruli was seen after (F) the administration of 8D1-OVA to Rag1^−/− mice, but not after (G) the injection of Th1 cells without antibody. Western blotting of homogenized kidney (H) 24 h after the administration of 8D1-OVA demonstrated OVA in the kidneys (labeled as OVA-Ab); this was not seen after the administration of unconjugated antibody (labeled as Un Ab). (I) Systemic immune responses of recipient Rag1^−/− mice at 21 d assessed by splenic cytokine production demonstrated enhanced IFNγ production in mice given 8D1-OVA and Th1 cells, with enhanced IL-17A production by mice receiving 8D1-OVA and Th17 cells. (J) DTH to OVA (at 21 d) was induced only in mice given 8D1-OVA and Th1 cells. *P < 0.05, ***P < 0.001.To determine whether transfer of either Th1 or Th17 antigen-specific effector cells induces glomerular injury, 8D1-OVA conjugate was administered intravenously to Rag1^−/− mice (lacking adaptive immunity). Three hours later, 5 × 10⁶ Th1 or Th17 cells were injected intravenously. Groups of mice injected with 8D1-OVA alone (without cells) or Th1 cells alone (without 8D1-OVA) served as controls. At 21 d, the injected T cells largely maintained their initial phenotype, because host splenocytes from mice given Th1 cells showed enhanced OVA-stimulated IFNγ production whereas IL-17A production was enhanced in mice given Th17 cells (Figure 1I). Dermal-delayed-type hypersensitivity (DTH) was induced by footpad injection of OVA and measured after 24 h. Only mice that received the 8D1-OVA conjugate and Th1 polarized cells developed dermal DTH (Figure 1J), a classical Th1 response.¹⁷After planting OVA in glomeruli, administration of Th1 or Th17 cells induced glomerular disease. Urinary albumin excretion was not increased in mice given 8D1-OVA conjugate alone or Th1 cells alone, but Th1 or Th17 cells with 8D1-OVA induced significant albuminuria (Figure 2A). Albuminuria was consistent throughout the time course of the study in the Th17 group, whereas in the Th1 group there was a progressive increase in albuminuria until day 21 (Figure 2B). Control mice given Th1 cells alone or the 8D1-OVA conjugate alone exhibited only mild histologic changes (no crescent formation, fibrinoid necrosis, or hyalinosis). Analysis of histologic injury demonstrated substantially more abnormal glomeruli in the mice given 8D1-OVA conjugate with Th1 or Th17 cells compared with control groups (Figure 2C). Th1 and Th17 (+8D1-OVA) recipients developed proliferative GN, [glomerular hypercellularity: 8D1-OVA and Th1 cells: 32.1 ± 1.0 cells/glomerular cross section (c/gcs), 8D1-OVA and Th17 cells: 29.8 ± 1.1 c/gcs, 8D1-OVA alone: 21.3 ± 0.2 c/gcs, Th1 cells alone: 18.9 ± 2.0 c/gcs; P < 0.001]. Representative kidney sections from each group are shown (Figure 2, D through G). Crescent formation and fibrinoid necrosis, although seen in only a few glomeruli, was observed exclusively in mice given 8D1-OVA conjugate and Th1 cells (5.5 ± 0.9% at day 21; Figure 2, H and I). No crescent formation was observed in mice receiving 8D1-OVA conjugate and Th17 cells. Mice did not develop significant renal impairment (measured by BUN; data not shown).Open in a separate windowFigure 2.Renal injury in mice injected with 8D1-OVA conjugate, then either Th1 or Th17 cells. (A) Mice given 8D1-OVA conjugate or Th1 cells alone did not develop albuminuria above values for noninjected Rag1^−/− mice (dotted line). At 21 d, albuminuria was increased in mice given 8D1-OVA and Th1 cells or 8D1-OVA and Th17 cells. (B) In mice given 8D1-OVA and Th17 cells, albuminuria had plateaued by day 7 and did not progress. In mice given 8D1-OVA and Th1 cells there was a progressive rise in albuminuria. (C) Histologic injury was significant in mice given 8D1-OVA and either Th1 or Th17 cells. Representative glomeruli from mice given (D) 8D1-OVA alone, (E) Th1 cells alone, (F) 8D1-OVA and Th1 cells, and (G) 8D1-OVA and Th17 cells are shown. (H and I) Crescentic injury and fibrinoid necrosis were only seen in mice given 8D1-OVA and Th1 cells. ***P < 0.001Recruitment and activation of leukocyte subpopulations differed in mice administered Th1 or Th17 cells (Figure 3A). Although glomerular CD4+ cell and macrophage numbers were similarly increased in mice given 8D1-OVA conjugate and either Th1 or Th17 cells at day 21, more neutrophils were found in mice given 8D1-OVA and Th17 cells compared with mice given 8D1-OVA and Th1 cells. Interstitial leukocyte infiltrates followed a similar pattern (Figure 3B). Consistent with the finding of increased neutrophils in kidneys of mice receiving Th17 cells, renal mRNA expression of the primary neutrophil attracting chemokine CXCL1 was elevated (Figure 3C). Th17 cells attract neutrophils¹⁸ and in vitro studies have shown that neutrophil recruitment is achieved via production of CXCL8, the human homologue of CXCL1, by Th17 cells.¹⁹ It is therefore likely that at least some of the Th17-induced renal injury is mediated by neutrophils. In mice receiving 8D1-OVA and Th1 cells, macrophages were likely to be more activated; only these mice developed dermal DTH and increased expression of mRNA for the macrophage chemoattractants CCL2 and CCL5 (Figure 3, D and E), which have been associated with experimental crescentic GN.²⁰ Furthermore, type 2 nitric oxide synthase (NOS2/iNOS) mRNA, a marker of macrophage activation²¹ and urinary nitrate, a marker of intrarenal macrophage NOS2 production, were increased in this group (Figure 3, F and G).Open in a separate windowFigure 3.Leukocytes in kidneys of mice with either Th1- or Th17-induced injury 21 d after cell transfer. (A) Glomerular CD4+T cells, neutrophils, and macrophages were increased in mice given 8D1-OVA and Th1/Th17 cells. Neutrophil recruitment was incrementally increased in mice given 8D1-OVA and Th17 cells compared with 8D1-OVA and Th1 cells. (B) A similar pattern of recruitment was seen in the cortical interstitium. Renal chemokine mRNA expression demonstrated (C) enhanced CXCL1 mRNA in mice given 8D1-OVA and Th17 cells, whereas (D) CCL2 and (E) CCL5 were increased in mice given 8D1-OVA and Th1 cells. (F and G) NOS2 and urinary nitrate, markers of macrophage activation, were increased in mice receiving 8D1-OVA and Th1 cells. For mRNA, values for the 8D1-OVA alone group are presented as 1. *P < 0.05, **P < 0.01, ***P < 0.001.Further studies were performed 3 d after cell transfer. At this time point, albuminuria was present in mice receiving 8D1-OVA conjugate and Th17 cells, but not 8D1-OVA conjugate and Th1 cells (Figure 4A), and a higher proportion of glomeruli were abnormal in mice that had received Th17 cells (Figure 4B). Therefore, Th17-induced glomerular injury occurred earlier than Th1-induced injury. Leukocytes were present in glomeruli (Figure 4C) with increased numbers of neutrophils in glomeruli of mice receiving Th17 cells (compared with Th1 cell recipients), whereas Th1 cell recipients exhibited more macrophages. At day 3, these findings were glomerulo-specific; differences between Th1 and Th17 cell recipients were not seen in the interstitium (Figure 4D).Open in a separate windowFigure 4.Renal disease in mice 3 d after injection with 8D1-OVA and either Th1 or Th17 cells. (A) Pathologic albuminuria (dotted line represents values for noninjected Rag1^−/− mice) and (B) increased numbers of abnormal glomeruli were evident in mice that received 8D1-OVA and Th17 cells. (C) Leukocyte recruitment to glomeruli demonstrated CD4+ cells (more in mice receiving Th1 cells), with comparatively more neutrophils in glomeruli of Th17 cell recipients and more macrophages in glomeruli of Th1 cell recipients. (D) Interstitial leukocytes were similar in Th1 and Th17 cell recipients 3 d after cell transfer. *P < 0.05, **P < 0.01, ***P < 0.001.These studies used Rag1^−/− mice as recipients of effector antigen-specific Th1 or Th17 cells. Because these mice do not possess T or B cells, OVA planted in glomeruli cannot induce CD8+ or B cell responses, and regulatory T cells are unable to influence the pattern of injury. A major advantage of this strategy is that Th1- and Th17-mediated injury can be assessed in a pure experimental system. However, T cells transferred into Rag1^−/− mice can undergo homeostatic expansion, and it is possible that the transferred Th1 cells might have expanded more rapidly than Th17 cells. Recently, studies in experimental type 1 diabetes induced by transfer of cells from a TcR transgenic mouse specific for an islet autoantigen showed conversion of Th17 cells to a Th1 phenotype after transfer.^22,23 Although our Th17 polarized OT-II cells, specific for a foreign antigen, showed some IFNγ production after 21 d, they were still capable of producing IL-17A. Furthermore, dermal DTH and renal disease were different in Th1 recipients compared with the Th17 recipients at 21 d, supporting the maintenance of separate phenotypes after transfer. Although the studies presented here are the first to demonstrate a role for Th17 and Th1 cells in the same experimental system, other studies^24–26 have used genetically deficient mice to implicate Th17 cells in experimental renal disease.These studies describe a novel model of cell-mediated proliferative GN for which adaptive components are only effector antigen-specific CD4+ T cells. They demonstrate that both Th1 and Th17 cells can induce proliferative GN. Th17 cells induce albuminuria early, with persistent accumulation of leukocytes. Administration of Th1 cells lead to a slower rise in albuminuria, but more macrophage activation and DTH-like injury, including, in some glomeruli, crescent formation and fibrinoid necrosis. It is likely that Th1 and Th17 responses play a role in proliferative forms of GN and both represent potential therapeutic targets.     

Th1/Th2细胞与肿瘤复发

目的探讨T辅助淋巴细胞Ⅰ型（Th1）／T辅助淋巴细胞Ⅱ型（Th2）在肿瘤复发中的研究进展。方法复习国内、外相关文献并进行综述。结果肿瘤治疗后体内出现Th1向Th2漂移，使肿瘤细胞逃避机体的免疫监视，导致肿瘤的复发。结论Th1向Th2型漂移与肿瘤治疗后的复发有关，促使肿瘤治疗后的机体细胞因子由Th2向Th1逆转，重新达到平衡，成为肿瘤免疫治疗的新思路。     

The Th1 and Th2 paradigm in ANCA-associated vasculitis

In the pathogenesis of anti-neutrophil cytoplasm antibodies (ANCA)-associated vasculitis, T cell contribution is indicated by T cell-dependent ANCA production combined with the presence of T cells in inflammatory infiltrates. However, the exact pathogenic role of T cells in ANCA-associated vasculitis remains to be determined. The Th1/Th2 concept is useful for understanding T cell involvement in pathological processes. This review focuses on T cells and particularly the Th1/Th2 paradigm in ANCA-associated vasculitis. Most research has been done in Wegener's granulomatosis, where a shift in T cell response, from a Th1 pattern in localized disease towards a Th0/Th2 pattern in generalized disease, appears to occur. Although less thoroughly studied, data in Churg-Strauss syndrome and microscopic polyangiitis indicate that these diseases are predominantly associated with Th2 patterns. Further studies elucidating the true nature of the polarization towards Th1 or Th2 in ANCA-associated vasculitis are clearly needed.     

Influence of Th1, Th2, and Th3 cytokines during the early phase after liver transplantation

To investigate the change of Th1, Th2, Th3 cytokines during early liver transplantation. IFN-r, IL-4, TGF-beta production by CD4+ T cells were determined by fluorescence activated cell sorter analysis. Comparing the acute rejection with the non-acute rejection groups on the 7th, 14th, and 28th day showed that high interferon-gamma production associated with acute rejection in the early posttransplant period. There was no evidence of significant changes in interleukin-4 and transforming growth factor beta (TGF-beta) levels between non-acute rejection groups with acute rejection groups. Th1 cytokine high production is significantly associated with acute rejection in liver transplant recipients.     

T lymphocyte subsets and Th1/Th2 balance after laparoscopy-assisted distal gastrectomy

Background: Laparoscopic surgery provides for a less invasive procedure than open surgery in patients with gastric cancer, but the immune responses after laparoscopic surgery for early gastric cancer remain unknown. Methods: Peripheral blood mononuclear cells from 20 patients with early gastric cancer who underwent laparoscopy-assisted distal gastrectomy (LADG) or open distal gastrectomy (ODG) were obtained; the cell surface molecules and intracellular cytokines (IFN-gamma and IL-4) were measured by flow cytometry. Results: The populations of T lymphocytes after LADG, including CD3-, 4-, 8-, 57-, and HLA-DR-positive lymphocytes, showed patterns similar to those after ODG. The production of IFN-gamma as Th1 cell function decreased significantly on the third postoperative day after ODG but increased after LADG. The production of IL-4, representing Th2 cell function, increased postoperatively after ODG but not after LADG. Conclusions: When compared with ODG, LADG contributes to the preservation of postsurgical Th1 cell-mediated immune function.     

Characteristic cytokine products of Th1 and Th2 cells in hemodialysis patients.

Dysfunction of the host defense against infection in hemodialysis (HD) patients has major clinical and socioeconomic implications. T helper type 1 (Th1) and type 2 (Th2) cytokines are implicated in regulating the immune responses and, therefore, may be involved in impaired status. The present study was designed to examine Th1 and Th2 cytokine profiles in 22 stable HD patients (aged 63 +/- 11 years) and 22 healthy controls (aged 60 +/- 6 years). The T cell activity was significantly retarded in HD patients as compared with normal persons. The proportions of T cytotoxic/suppressor cells and natural killer cells were significantly higher in HD patients than in controls. In contrast, the proportions of T helper/inducer and B cells were significantly lower in HD patients than in controls. The production of interleukin (IL) 2, which is involved in cell-mediated immune responses, and the production of IL-4 and IL-10, which affect humoral immunity, were significantly lower in patients than in controls. The production of IL-12 by macrophages and of interferon gamma by Th1 cells was significantly higher in HD patients than in controls. The concentration of plasma sIL-2R was significantly higher in patients than in controls. These results suggest that both cellular immunity induced by Th1 and humoral immunity induced by Th2 decrease in HD patients, but that improved IL-12 secretion by macrophages activated natural killer cells to produce interferon gamma, which in turn induced macrophage activity.     

Th1/Th2 balance in childhood idiopathic nephrotic syndrome

AIMS: In view of the conflicting evidence of helper T cell type 1 (Th1) or type 2 (Th2) pattern of cytokine synthesis in childhood idiopathic nephrotic syndrome (INS) this study examined the balance of Th1 and Th2 which are characterized by intracellular cytokine production of interferon-gamma (IFNgamma) and interleukin-4 (IL-4), respectively. SUBJECTS AND METHODS: Sixteen children with steroid-sensitive INS (mean age 9.0 years) were included in this study, together with 15 healthy normal children (mean age 7.9 years) for the control group. Intracellular production of both IFNgamma and IL-4 in helper T cell (CD4+ cell) was investigated by a 3-color flow cytometry. RESULTS: The cross-sectional data showed no significant differences of percentages of Th0 (IFNgamma+ IL-4+ CD4+ cell), Th1 (IFNgamma+ lL-4- CD4+ cell) and Th2 (IFNgamma- IL-4+ CD4+ cell) in CD4+ cells (p > 0.05). The Th1/Th2 ratio during nephrotic relapse did not differ from those during nephrotic remission and in normal healthy children (p > 0.05). CONCLUSION: We conclude that there is no significant skew of Th1/Th2 balance in childhood INS and that the cardinal immunological abnormality does not lie in helper T cells but in other cells, such as suppressor/cytotoxic T cells, natural killer cells or monocytes/macrophage. To clarify the pathogenesis of INS, comprehensive studies for these cells would be worthwhile.