虫草多糖对荷瘤小鼠T淋巴细胞及其亚群数量与功能的影响

目的 研究虫草多糖对荷瘤小鼠T淋巴细胞功能的影响。方法 除正常对照组外,其余小鼠右前肢腋窝皮下注射S180肉瘤细胞悬液建立小鼠荷瘤模型。荷瘤小鼠随机分为荷瘤对照(等容生理盐水)组、香菇多糖(1 mg·kg^-1)组、虫草多糖高、中、低剂量(200,100,50 mg·kg^-1)组,腹腔注射,每天1次,连续13 d后,检测虫草多糖对荷瘤小鼠的抑瘤作用以及荷瘤小鼠外周血T淋巴细胞及其亚群数量、Th1/Th2类细胞因子水平和脾淋巴细胞转化功能。结果 虫草多糖高、中剂量组可明显抑制S180肉瘤生长,提高荷瘤小鼠脾脏重量和脾脏系数;提高外周血CD3⁺细胞(总T淋巴细胞)、CD4⁺CD8^-亚群数量及CD4⁺CD8^-/CD4^-CD8⁺比值,提高Th1淋巴细胞分泌的细胞因子TNF-α和IL-2水平,并显著促进脾脏T淋巴细胞增殖转化能力。结论 虫草多糖具有明显的抗肿瘤活性,其机制可能与调节机体T淋巴细胞及其亚群的数量与分泌功能有关。     

调节性T细胞及IL-17IL-23对多发性骨髓瘤预后及疗效评估的意义

目的 检测多发性骨髓瘤(MM)外周血中T淋巴细胞亚群、CD₄⁺CD₂₅^high/+CD₁₂₇^low/-调节性T细胞(Treg)及IL-17、IL-23水平并探讨其临床意义。方法 采用流式细胞术及ELISA方法检测34例初治MM患者T淋巴细胞亚群、Treg细胞及IL-17,IL-23水平。结果 初治MM患者中NK细胞、CD₈⁺T细胞比例高于对照组;CD₄⁺/CD₈⁺比值较对照组降低(P<0.05)。初治组及无效组Treg水平均高于对照组,同时也高于有效组;初治组中Ⅲ期患者Treg水平明显高于I期及Ⅱ期(P<0.05)。初治组IL-17、IL-23水平均高于对照组(P<0.05),且与Treg水平呈负相关性。结论 T淋巴细胞亚群、Treg及IL-17、IL-23的异常表达在MM的发生发展中起重要作用,可作为评估疗效及判断预后的潜在指标。     

藏药青叶胆对实验性慢性肝损伤小鼠T淋巴细胞亚群的影响

目的 观察青叶胆对小鼠慢性肝损伤的保护作用及其对小鼠脾脏T淋巴细胞亚群的调节作用。方法 采用腹腔注射四氯化碳（CCl₄）造成小鼠化学性肝损伤模型,检测小鼠血清天冬氨酸转氨酶（aspartate aminotransferase,AST）、丙氨酸转氨酶（alanine aminotransferase,ALT）、总蛋白（total protein,TP）及总胆红素（total bilirubin,TBI）;HE染色,观察肝组织形态;流式细胞术检测CD3⁺、CD4⁺及CD8⁺阳性细胞数的变化情况,计算CD4⁺/CD8⁺比例,并与模型组和对照组比较。结果 青叶胆对CCl₄造成的小鼠慢性肝脏损伤具有保护作用,与模型组相比,能明显降低小鼠血清ALT、AST含量（P<0.01）,升高TP含量（P<0.01）;与模型组相比,青叶胆低剂量组对CD3⁺细胞具有下调作用（P<0.05）,对CD8⁺细胞的上调作用和对CD4⁺/CD8⁺比值的下调作用具有显著性差异（P<0.01）;高剂量组对CD8⁺细胞的上调作用和对CD4⁺/CD8⁺比值的下调作用具有统计学意义（P<0.05）。结论 青叶胆对CCl₄诱导的小鼠慢性肝损伤具有保护作用,其机制可能是通过调节T淋巴细胞亚群,提高免疫功能。     

脐带来源间充质干细胞的免疫抑制功能研究

目的 观察人源脐带间充质干细胞（hUC-MSCs）对异体总淋巴细胞和不同淋巴细胞亚群增殖能力的影响,以及对细胞因子分泌的影响。方法 分离并培养hUC-MSCs及健康成人外周血淋巴细胞,以淋巴细胞为阴性对照,MTT法检测共培养（淋巴细胞：hUC-MSCs为1：0.5、1：1、1：5、1：10）3 d后淋巴细胞的增殖情况;流式细胞仪检测共培养体系中CD4⁺CD25⁺FOXP3⁺、CD3^-CD16⁺CD56⁺、CD4⁺CD45RA⁺CCR7⁺的细胞比例;ELISA法检测白细胞介素（IL）-2、IL-4、IL-10、γ-干扰素（INF-γ）细胞因子分泌情况。结果 与阴性对照组比较,hUC-MSCs对淋巴细胞的增殖具有显著抑制作用（P<0.05）,抑制效果随数量增加而增强;hUC-MSCs能够显著增加共培养体系中CD4⁺CD25⁺FOXP3⁺细胞比例（P<0.05）,显著降低CD4⁺CD45RA⁺CCR7⁺细胞比例（P<0.05）,对CD3^-CD16⁺CD56⁺细胞比例无显著影响;hUC-MSCs能够显著降低IL-2、IL-4、INF-γ水平,显著增加IL-10的分泌水平（P<0.05）。结论 hUC-MSCs具有免疫抑制功能。     

CD4+CD25+调节性T淋巴细胞在儿童传染性单核细胞增多症的变化及作用

目的 观察儿童传染性单核细胞增多症（IM）治疗前后外周血T淋巴细胞亚群和CD4⁺CD25⁺调节性T淋巴细胞（Treg细胞）比例变化,分析Treg对IM的影响。方法 选取2017年1月至2018年5月安徽医科大学第二附属医院儿科收治的IM患儿60例作为观察组,以同期于本院儿童保健门诊行体检的40例健康儿童作为对照组,采用流式细胞术检测观察组治疗前、后及对照组的外周血T细胞亚群（CD3⁺T细胞、CD3⁺CD4⁺T细胞、CD3⁺CD8⁺T细胞比例,CD4/CD8比值）、CD4⁺CD25⁺调节性T淋巴细胞比例,对比分析两组患者机体细胞免疫功能的变化。结果 观察组治疗前CD3⁺T细胞比例、CD3⁺CD8⁺T细胞比例显著高于对照组;CD3⁺CD4⁺T细胞比例、CD4/CD8比值低于对照组,差异均有统计学意义（P <0.05）。观察组治疗后CD3⁺T细胞比例、CD3⁺CD8⁺T细胞比例均低于观察组治疗前;CD3⁺CD4⁺T细胞比例、CD4/CD8比值高于治疗前,差异均有统计学意义（P <0.05）。观察组治疗前外周血Treg细胞比例低于正常对照组,差异有统计学意义（P <0.05）;而观察组治疗后外周血Treg细胞比例高于治疗前,差异有统计学意义（P <0.05）。结论 IM患儿存在T细胞亚群比例的变化,Treg细胞水平的降低,可能参与IM患儿疾病的发生发展过程。     

双歧四联活菌片联合复方谷氨酰胺颗粒对早产儿肠黏膜屏障功能的影响

目的 探讨复方谷氨酰胺颗粒联合双歧四联活菌片对早产儿肠道黏膜屏障免疫功能的影响。方法 选取2014年6月至2015年6月东营市人民医院儿科的148例早产儿为研究对象,将其随机分为A、B、C、D组,A组为复方谷氨酰胺颗粒联合双歧四联活菌片治疗,B组单独应用复方谷氨酰胺颗粒治疗,C组为单独双歧四联活菌片治疗,D组采用标准的肠内营养喂养,4组早产儿均给予新生儿监护室（NICU）常规治疗;监测治疗前、治疗1周和2周时检测4组早产儿的血清免疫球蛋白SIgA含量、T淋巴细胞亚群CD₃⁺含量、CD₄⁺含量及CD₄⁺/CD₈⁺比值,同时检测4组早产儿大便中的益生菌数量,并比较各组发生院内感染及并发症情况。结果 治疗1周时,4组早产儿的SIgA、CD₃⁺、CD₄⁺含量、CD₄⁺/CD₈⁺比值,及肠道益生菌数量5项指标较治疗前均有不同程度的升高,与治疗前比较,差异均有统计学意义（P<0.05）;A组上述5项指标均高于B、C、D组,差异有统计学意义（P<0.05）;治疗2周时,A组T淋巴细胞亚群（CD₃⁺、CD₄⁺、CD₄⁺/CD₈⁺比值）、SIgA、肠道菌群数量均高于B、C、D组,差异有统计学意义（P<0.05）;2周时,A组（8.1%）早产儿院内感染发生率低于其他3组（13.5%、13.5%、18.9%）,差异有统计学意义（P<0.05）。结论 谷氨酰胺与双歧四联活菌片联合应用,能够明显提高患儿T淋巴细胞亚群数量,增加肠道益生菌数量,降低院内感染的发病率,改善患儿预后。     

MiR-19反义核酸与CD133+HT29细胞亚群对多柔比星敏感性关系的研究

目的 探讨miR-19反义核酸与CD133⁺HT29细胞亚群对多柔比星敏感性的关系并研究其机制。方法 用RT-qPCR方法检测miR-19在结直肠癌细胞中的表达水平。流式细胞术检测miR-19反义核酸和多柔比星对HT29细胞系的CD133⁺细胞亚群种群比例的影响。MTT法检测miR-19反义核酸对多柔比星杀伤CD133⁺HT29细胞亚群能力的影响。利用生物信息学及Western blot法验证miR-19是否调节CD133⁺HT29细胞亚群中PTEN的表达。运用Western blot、免疫共沉淀、流式细胞术研究miR-19反义核酸影响多柔比星疗效的信号通路。结果 结直肠癌细胞系的miR-19表达水平显著高于正常结直肠上皮细胞系,并且CD133⁺细胞中的miR-19表达水平显著高于常规结直肠癌细胞。多柔比星体外单独治疗能提高HT29细胞系中CD133⁺细胞亚群的比例,然而联用miR-19反义核酸后CD133⁺HT29细胞亚群的种群比例显著下降。MTT结果表明miR-19反义核酸可显著增强多柔比星对CD133⁺HT29细胞亚群的杀伤活性。Western blot实验表明miR-19的靶基因可能为PTEN。MiR-19反义核酸可显著抑制CD133⁺HT29细胞亚群PI3K、AKT和Bad的磷酸化,增强Bad与Bcl-2和Bcl-xl的结合,从而提高CD133⁺HT29细胞亚群对多柔比星依赖的凋亡信号的敏感性,促进caspase-9和caspase-3的活化。结论 MiR-19反义核酸通过PTEN/PI3K/AKT/Bad途径提高CD133⁺HT29细胞亚群对多柔比星的敏感性。     

脾多肽辅助治疗婴幼儿迁延性慢性腹泻疗效及对Ｔ淋巴细胞亚群变化影响

摘 要 目的：探讨脾多肽辅助治疗迁延性慢性腹泻（PCDD）患儿的疗效,及对患儿T淋巴细胞（简称T细胞）亚群的影响。 方法：60 例PCDD病例随机分为联合治疗组（30例）和常规治疗组（30例）,所有患儿均给予常规口服蒙脱石散、益生菌及补液治疗;联合治疗组同时加用脾多肽静滴辅助治疗。两组疗程均为1周。分别对两组患儿治疗前后外周血T细胞亚群进行检测,以同期体检的20例健康儿童做为健康对照,比较两组患儿治疗前后外周血T细胞亚群变化,评价两组疗效。 结果：治疗前,两组患儿CD3⁺、CD4⁺及CD4⁺/CD8⁺ 等指标均低于健康对照组（P＜0.05）。治疗后,联合治疗组CD3⁺、CD4⁺及CD4⁺/CD8⁺较治疗前及常规治疗组明显升高（P＜0.05）,且恢复至健康水平。常规治疗组治疗前后CD3⁺、CD4⁺及CD4⁺/CD8⁺未见明显变化（P＞0.05）。联合治疗组疗效明显优于常规治疗组（P＜0.05）。 结论：PCDD患儿存在T细胞介导的免疫功能障碍,脾多肽可恢复PCDD患儿T细胞亚群的正常比例,改善患儿的细胞免疫功能。     

淋巴细胞亚群变化与糖皮质激素治疗早期乙肝肝衰竭患者的相关性研究

目的 探讨糖皮质激素治疗早期乙肝肝衰竭患者的病情转归及与淋巴细胞亚群的相关性。方法 纳入2011年12月—2014年12月收治的乙型病毒性肝炎慢加急(亚急性)早期肝衰竭患者60例,按知情同意分为2组,糖皮质激素治疗组32例,对照组28例。流式细胞仪检测治疗前后淋巴细胞亚群绝对计数的变化,观察2组的病情转归。结果 2组治疗前淋巴细胞亚群差异无统计学意义。治疗后,与对照组相比,治疗组CD4⁺/CD8⁺比例、CD3^-CD16⁺CD56⁺细胞增加,差异有统计学意义。与治疗前相比,治疗后治疗组CD3⁺CD4⁺T细胞绝对计数、对照组CD3⁺CD4⁺T细胞、CD3⁺CD8⁺T细胞绝对计数增多,差异有统计学意义。2组救治成功率比较,治疗组75.00%,对照组64.29%,差异无统计学意义(Z=0.816,P=0.366)。但10 d病情稳定率治疗组71.88%,高于对照组46.43%,差异有统计学意义(Z=4.029,P=0.044)。救治成功患者住院天数比较,治疗组35.00 d(29.00,51.00),低于对照组50.50 d(38.25,58.00),差异有统计学意义(Z=-2.241,P=0.025)。结论 在早期乙肝肝衰竭患者中应用糖皮质激素可较快稳定病情,减少住院时间;治疗后CD3⁺CD4⁺T淋巴细胞增高,CD3⁺CD8⁺水平稳定,CD4⁺/CD8⁺比例升高,CD3^-CD16⁺CD56⁺细胞增高可能预示患者预后良好。     

自体CIK细胞对晚期不同阶段肿瘤患者免疫状态和生活质量的影响

目的 探讨自体细胞因子诱导的杀伤细胞（CIK）治疗晚期恶性肿瘤患者,对其免疫状态和生活质量的影响。方法 选取2013年2月至2016年3月合肥市第一人民医院血液肿瘤科收治的42例晚期肿瘤患者,按照预计生存期分为A组（预计生存期<3个月）20例、B组（预计生存期≥3个月）22例,检测治疗前后A、B组患者外周血T细胞亚群的变化。观察治疗前后A、B组患者免疫功能的变化,生活质量改善情况及治疗相关不良反应。结果 CIK细胞治疗后,A组患者CD₃⁺T细胞水平较治疗前降低（P<0.05）;B组治疗后CD₃⁺、CD₄⁺和CD₄⁺/CD₈⁺水平较治疗前明显升高（P<0.05）,CD₈⁺T淋巴细胞亚群水平较治疗前降低（P<0.05）。A、B两组患者治疗后KPS评分分别较治疗前均有提高,其中A组差异无统计学意义（P>0.05）,而B组差异有统计学意义（P<0.05）。42例患者在输注CIK过程中未出现明显不良反应。结论 CIK细胞回输安全、副作用小,自体CIK细胞治疗可提高晚期恶性肿瘤患者的免疫功能,改善其生活质量,但应尽早进行。     

Analysis of the roles of dietary protein and calcium in fluoride‐induced changes in T‐lymphocyte subsets in rat

The roles of dietary protein (Pr) and calcium (Ca) levels on the changes in T‐lymphocyte subsets induced by excessive fluoride (F) intake were assessed using rats that were malnourished for 120 days as a model. The CD⁴⁺ and CD⁸⁺ T‐lymphocytes in the spleen tissue were determined by flow cytometry and immunofluorescence assay. The percentages of CD³⁺, CD⁴⁺, and CD⁸⁺ T‐lymphocytes were reduced in the spleen of rats exposed to excessive F, and malnutrition aggravated these changes in the T‐lymphocytes. In addition, the mRNA expression levels of IL‐1β, IL‐2, IL‐6, TNF‐α, and IFN‐γ in the spleen were downregulated significantly. We also reported herein the increased apoptosis ratio following caspase‐9 and caspase‐3 upregulation in the spleen of rats exposed to excessive amount of F. Light and transmisison electron microscopy revealed the irregularly arranged lymphocytes, few lymph nodules and the apoptotic characteristic of lymphocytes, which are caused by the increased expression of caspase. In addition, Pr and Ca supplementation reversed the morphologic and T‐lymphocytic changes in spleen under malnutrition. Taken together, our results revealed an endogenous caspase‐mediated mechanism of regulating the apoptosis of the T‐lymphocyte subsets, as well as the immune‐related cytokine secretion, which reduces the immune function in F‐induced rats. © 2016 Wiley Periodicals, Inc. Environ Toxicol 32: 1587–1595, 2017.     

Differential immune modulation by deoxynivalenol (vomitoxin) in mice

Mycotoxin deoxynivalenol (DON), a secondary metabolite produced by Fusarium fungi, is a contaminant in wheat, barley, and corn worldwide. It has been suggested that DON exhibits toxicity in various organs. Due to the lack of immunotoxicity data for DON, we investigated the differential immunomodulatory effects of DON in mice. DON was orally administered to female BALB/c mice at a dose of 0, 0.5, or 2 mg/kg body weight for 14 days and various immunotoxicity tests were performed with standard protocols. The population of CD19⁺ and CD11c⁺ cells in the spleen and mesenteric lymph node (MLN) and of F4/80⁺ cells in the spleen was significantly decreased in DON-treated mice, whereas the level of CD8⁺ and CD4⁺CD25⁺Foxp3⁺ cells in the spleen and CD4⁺ T cells in MLN was significantly increased. In intra-epithelial lymphocytes (IELs) of the small intestine, the population of CD4 ⁺ and CD19⁺ cells was increased but that of CD8⁺ cells was decreased. Levels of CD4 ⁺ and CD8⁺ cells were decreased in lamina propria lymphocytes (LPLs) of small intestine; however, the level of CD4⁺ and CD8⁺ lymphocytes was increased but that of CD19⁺ cells was decreased in Peyer's patches lymphocytes (PPLs). Normalized expression of TLR4 in spleen, TLR9 in PPs, and TLR2, TLR3 and TLR4 in MLNs was significantly decreased, whereas expression of TLR5 and TLR9 was increased in spleen. The concentration of IgA and IgE was decreased and increased, respectively, in serum; however, the mucosal IgA level was significantly increased in the duodenum. Levels of IFN-γ, IL-2, IL-4, and IL-6 were significantly increased in serum. Furthermore, DON induced apoptosis in spleen, MLNs, and PPs, and DON-induced apoptosis was promoted by increased expression of Bax and decreased expression of Bcl-2. The autophagy genes Atg5 and Beclin-1 were up-regulated in spleen but down-regulated in MLN. After priming of the RAW 264.7 macrophage cell line with different TLR ligands, DON exposure differentially modulated IL-1β, IL-10, and TNF-α production. These results indicate that DON can cause various immunomodulatory effects in mice, creating a milieu that might allow invasion by other microorganisms.     

Immune modulatory effects of the foodborne contaminant citrinin in mice

The mycotoxin citrinin can cause mycotoxic nephropathy, cytotoxicity and genotoxicity. To investigate the immune modulatory effects, CTN was orally administered to female BALB/c mice at the dose of 1, 5, or 10 mg/kg body weight for 14 days, and several immunotoxicity tests were performed. The populations of F4/80⁺ cells and CD19⁺ cells were significantly decreased in spleen and MLN. In MLN, CD4⁺, CD8⁺, and CD4⁺CD25⁺Foxp3⁺ cell populations were increased. CD8 ⁺ cells were increased but CD19⁺ cells were decreased in intra-epithelial, lamina propria and Peyer’s patches lymphocytes. In a cell proliferation assay, along with the increased proliferative capacities of ConA-induced splenocytes and MLN cells, IFN-γ production was increased. The expression of TLR 2 was increased in spleen, but TLR 3 expression in MLN was decreased. The level of serum IgM was reduced. Furthermore, apoptosis was induced in spleen, MLN and Peyer’s patches and promoted by the change in the ratio of Bax/Bcl-2 activities. Autophagy gene Atg5 and Beclin-1 were up-regulated in spleen. The expressions of IL-1β, IL-10, and TNF-α were inhibited in murine macrophage cells pre-exposed with TLR ligands. These results indicate that CTN has multiple immune modulatory effects in mice that may alter normal functions of immune system.     

百令胶囊联合别嘌醇治疗痛风性肾病的临床研究

目的观察百令胶囊联合别嘌醇治疗痛风性肾病的临床疗效。方法选取2015年6月—2016年12月在天津中医药大学第一附属医院老年病科就诊的56例痛风性肾病患者,随机分为对照组和治疗组,每组各28例,对照组患者口服别嘌醇缓释胶囊,0.25 g/次,1次/d。治疗组患者在对照组的基础上口服百令胶囊,4粒/次,3次/d。两组患者均治疗8周。观察两组患者的临床疗效,比较治疗前后两组患者尿素氮(BUN)、肌酐(Cr)、血尿酸(UA)、24 h尿蛋白定量以及外周血淋巴细胞亚群水平。结果治疗后,对照组和治疗组的总有效率分别为71.43%、89.29%,两组比较差异有统计学意义(P0.05)。两组BUN、Cr、UA和24 h尿蛋白水平均较治疗前降低,同组治疗前后差异有统计学意义(P0.05);且治疗后治疗组上述指标均低于对照组,两组比较差异有统计学意义(P0.05)。治疗后,治疗组CD~(3+)、CD~(3+)/CD~(4+)、CD~(3+)/CD~(8+)和CD~(3-)/CD~(16+56+)升高,CD~(3-)/CD~(19+)和CD~(4+)/CD~(8+)降低,同组治疗前后比较差异有统计学意义(P0.05);且治疗后治疗组外周血淋巴细胞亚群水平均优于对照组,两组比较差异有统计学意义(P0.05)。结论百令胶囊联合别嘌醇治疗痛风性肾病具有较好的临床疗效,可以明显改善患者的临床症状,提高肾功能,调节细胞免疫紊乱,且安全性较好,具有一定的临床应用价值。     

外周血T淋巴细胞对乙肝病毒相关慢加急性肝衰竭患者预后的影响

目的 探讨乙肝病毒相关慢加急性肝衰竭(HBV-ACLF)患者外周血T淋巴细胞亚群比例对其预后的影响.方法 选择HBV-ACLF患者43例,随访观察3个月后患者的存活率,应用流式细胞仪测定外周血CD3+、CD4+和CD8+T淋巴细胞及CD4+ CD25+ Treg细胞的百分比,并计算CD4+和CD8+T淋巴细胞比值,分析T淋巴细胞亚群对乙肝病毒相关慢加急性肝衰竭患者预后的影响,选择门诊同期健康体检者20例为健康对照组.结果 3个月后,43例HBV-ACLF患者存活26例,死亡17例.与肝衰竭存活组相比,肝衰竭死亡组CD3+细胞百分率(22.96±20.59)％、CD8+细胞百分率(31.63±12.69)％均低于存活组(37.89±17.36)％和(36.52±9.75)％,而CD4+细胞百分率(55.15±14.23)％、CD4+/CD8+(1.77±1.38)高于存活组(48.51±13.35)％、(1.32±0.68),均差异有统计学意义(P＜0.05),但两组之间CD4+ CD25+ Treg细胞比例差异无统计学意义.与健康对照组相比,肝衰竭死亡组患者外周血CD3+、CD8+T淋巴细胞及CD4+ CD25+ Treg细胞比例下降,CD4+T淋巴细胞、CD4+/CD8+升高,肝衰竭存活组患者CD3+T淋巴细胞及CD4+ CD25+ Treg细胞百分比下降,均差异有统计学意义(P＜0.05).结论 T淋巴细胞亚群比例的变化在一定程度上可以预测HBV-ACLF患者的预后,外周血T淋巴细胞CD3+、CD8+、CD4+ CD25+ Treg比例下降的程度越重,预后可能越差.     

肺痨灵合剂对初治肺结核患者疗效及细胞免疫功能的影响

目的探讨肺痨灵合剂对初治肺结核患者细胞免疫功能的影响。方法将59例初治肺结核患者,随机分为治疗组(n=30)和对照组(n=29)。治疗组用肺痨灵合剂加常规抗结核药治疗,并与单纯常规抗结核药组进行对照。观察2组临床疗效、治疗前后外周血T淋巴细胞群和白介素水平变化及不良反应发生情况。结果治疗组临床症状改善明显优于对照组,差异有统计学意义(P<0.05);治疗后2组患者T淋巴细胞亚群CD3+、CD4+、CD4+/CD8+较治疗前均有不同程度的上升,CD8+、IL-1及IL-6水平均有不同程度下降,治疗组上升、下降幅度明显优于对照组(P<0.05);治疗组在白细胞降低、肝功能损害方面明显优于对照组,2组间比较差异有统计学意义(P<0.01)。结论肺痨灵合剂有助于增强肺结核患者的免疫功能,减轻西药不良反应,从而提高治愈率。     

Comparison of peripheral blood B cell subset ratios and B cell-related cytokine levels between ocular and generalized myasthenia gravis

BackgroundThe pathogenesis of myasthenia gravis (MG) depends upon T and B cells, as well as complement and cytokines. The activation of functional subpopulations of T and B cells is the basis of the immune response. However, the activation levels of T and B cell subsets remain unclear in the pathogenesis of MG. Here, we evaluated the proportions of T and B cell subsets and related cytokines in ocular MG (oMG) patients and generalized MG (gMG) patients, and analyzed the potential roles of T and B cell subsets in the pathogenesis of oMG.MethodsIn total, 16 patients with oMG, 31 patients with gMG, and 20 healthy controls (HCs) were included in this study. Peripheral blood mononuclear cells (PBMCs) were separated from venous blood via density centrifugation. The percentages of CD3⁺CD4⁺ T cells, CD3⁺CD8⁺ T cells, CD4⁺CD25⁺CD127^- regulatory T cells (Tregs), CD19⁺CD27⁺CD38^- memory B cells, CD19⁺CD24^hiCD27⁺ regulatory B cells (Bregs), CD19⁺CD38⁺CD138⁺ plasma cells, and CD19⁺CD40⁺ B cells in PBMCs were detected by flow cytometry. The levels of interleukin (IL)-2, IL-4, IL-6, IL-10, IL-17, and interferon (IFN)-γ in serum were detected by enzyme linked immunosorbent assay (ELISA). Differences in T and B cell subsets and related cytokines were compared among the three groups of participants.ResultsThe proportions of CD19⁺CD27⁺CD38^- memory B cells were significantly higher in the oMG and gMG groups than in the HC group (P = 0.004; P < 0.001), whereas the proportion of CD19⁺CD27⁺CD38^- memory B cells was significantly lower in the oMG group than in the gMG group (P < 0.001). Moreover, the proportion of CD19⁺CD24^hiCD27⁺ Bregs was significantly higher in the oMG group than in the gMG and HC groups (P = 0.001). The proportion of CD4⁺CD25⁺CD127^- Tregs was significantly lower in the gMG group than in the oMG and HC groups (P < 0.001). Finally, the level of serum IL-10 was significantly higher in the oMG group than in the gMG and HC groups (P < 0.05). Compared with the HC group, serum IL-2 levels were significantly increased in the oMG and gMG groups (P = 0.016; P = 0.002).DiscussionThe reduced ratios of Tregs and Bregs may contribute to the progression of oMG to gMG, and the increased proportion of memory B cells may be closely related to the progression of oMG. IL-2 and IL-10 are important in the development of oMG.     

老年原发免疫性血小板减少症患者治疗前后T淋巴细胞亚群的临床研究

目的 检测老年原发免疫性血小板减少症(ITP)患者治疗前后T淋巴细胞亚群的动态变化, 探讨其在ITP发生发展中的作用。方法 采用流式细胞术测定ITP患者治疗前后及正常对照组外周血T淋巴细胞亚群的水平。结果 ITP患者治疗前后T淋巴细胞绝对值、CD3⁺、CD4⁺、CD8⁺、CD4⁺CD25⁺T淋巴细胞比例及CD4⁺/CD8⁺比值分别为(0.83±0.16)vs(1.74±0.36)、(71.71±1.07)% vs(72.69±1.35)%、(41.78±0.71)% vs(42.46±1.20)%、(29.67±0.97)% vs(28.56±1.75)%、(8.76±0.56)% vs(9.39±1.26)%、(1.42±0.07)vs(1.49±0.13), CD8⁺T淋巴细胞比例治疗后显著降低, 其余均显著升高, 差异有统计学意义(P<0.05)。结论 T淋巴细胞亚群的异常改变, 破坏自身免疫, 与病情相关, 可指导临床治疗, 并作为评估预后的参考指标。