Changes of CD4^＋CD25^＋ Regulatory T Cells in Patients with Acute Coronary Syndrome and the Effects of Atorvastatin

The function of CD4＋CD25＋ regulatory T lymphocytes （Treg） in patients with acute coronary syndrome （ACS） and the effects of atorvastatin were investigated. Forty-eight patients with ACS were randomly divided into two groups： group C receiving conventional therapy （n=24）, and group C＋A receiving conventional therapy＋atorvastatin （10 mg/day, n=24）. T lymphocytes from ACS patients （before and 2 weeks after the treatment） or 18 healthy subjects were separated and the flow cytometry was used to measure the percentage of Treg. The inhibitory ability of Treg on effector T cells was determined by mixed lymphocyte reaction （MLR）. ELISA was used to measure the serum levels of cytokines （IL-10, TGF-β1 and IFN-γ） before and after treatment. The results showed that as compared with normal control group, Treg percentage was decreased significantly （P〈0.01）, the inhibitory ability of Treg on the T lymphocytes proliferation was reduced （P〈0.01）, IFN-γ levels were increased and IL-10 and TGF-β1 levels were lowered in ACS patients. After treatment with atorvastatin, Treg percentage and the inhibitory ability of Treg on T lymphocytes proliferation were significantly increased in ACS patients. Serum IFN-γ was decreased significantly, while IL-10 and TGF-β1 were elevated significantly as compared with the non-atorvastatin group. The number of Treg was positively correlated with serum TGF-β1, but negatively with serum IFN-γ and CRP. It was concluded that ACS was associated with decreased number and defected function of Treg, which may play an important role in initiating immune-inflammatory response in ACS. The inhibitory effects of atorvastatin on inflammation in ACS may be due to its beneficial effects on Treg and restoration of immune homeostasis.     

Effects of Serum from Aplastic Anemia patients on the Expression of Cyclin D3 Isoform in Umbilical Cord Blood CD34＋ Cells

The pathogenesis of aplastic anemia (AA) was explored and the effects of AA serum on the expression of crucial cyclin D isoform (cyclin D3) in umbilical cord blood hematopoietic stem/progenitor cells were observed. The CD34 cells were isolated from the cord blood with MIDIMACS Semi-solid methylcellulose culture technique was used to measure the formation of CFUGM; The expression level of cyclin D3 was assayed by semi-quantitative RT-PCR and Western-blot after the hematopoietic stem/progenitor cells were incubated in AA serum. The results showed that the AA serum could inhibit the formation of CFU-GM and down regulate the expression level of the cyclin D3 at the mRNA and protein level respectively. In conclusion, the AA serum could inhibit the proliferation of hematopoietic stem cells and down regulate level of cyclin D3, which might be one mechanism of hematopoiesis inhibition in AA.     

Screening of aplastic anaemia-related genes in bone marrow CD4+ T cells by suppressive subtractive hybridization

Background CD4(+) T cells play a crucial role in the pathogenesis of aplastic anaemia. However, the mechanisms of over-proliferation, activation, infiltration of bone marrow and damage to haematopoietic cells of CD4(+) T cells in aplastic anaemia are unclear. Therefore, we screened differentially expressed genes of bone marrow CD4(+) T cells of aplastic anaemia patients and normal donors by suppressive subtractive hybridization to investigate the pathogenesis of aplastic anaemia. Methods The bone marrow mononuclear cells of a first visit aplastic anaemia patient and a healthy donor of the same age and sex were isolated using lymphocyte separating medium by density gradient centrifugation. With the patients as “tester” and donor as “driver”, their CD4(+ )T cells were separated with magnetic bead sorting and a cDNA library established by suppressive subtractive hybridization. Then 15 of the resulting subtracted cDNA clones were randomly selected for DNA sequencing and homological analysis. With semiquantitative RT-PCR, bone marrow samples from 20 patients with aplastic anaemia and 20 healthy donors assessed the expression levels of differentially expressed genes from SSH library.Results PCR detected 89 clones in the library containing an inserted fragment of 100 bp to 700 bp. Among 15 sequenced clones, 12 were known genes including 3 repeated genes. Compared with normal donors, there were 9/12 genes over-expressed in bone marrow CD4(+ )T cells of patients with aplastic anaemia. The effects of these genes included protein synthesis, biology oxidation, signal transduction, proliferative regulation and cell migration. Not all these genes had been reported in the mechanisms of haematopoietic damage mediated by CD4(+) T cells in aplastic anaemia. Conclusions Screening and cloning genes, which regulate functions of CD4(+) T cells, are helpful in elucidating the mechanisms of over proliferation, activation, infiltrating bone marrow and damaging haematopoietic cells of CD4(+) T cells in aplastic anaemia.     

再生障碍性贫血血清抑制物诱导脐血造血细胞凋亡

目的 :研究再生障碍性贫血血清抑制物诱导人脐血造血细胞凋亡的作用。方法 :提纯的再障血清抑制物加到人脐血造血细胞培养体系中 ,采用形态学观察及 TUNNL 法测定细胞凋亡。结果 :2 0例脐血造血细胞分别与 0 .1μg/m l,1μg/m l,10 μg/m l的再障血清抑制蛋白组份共同培养后 ,凋亡细胞发现率分别为 3.5± 1.6 % (P>0 .0 5 ) ,41± 9.8 (P<0 .0 1) ,6 0 .3± 18.2 (P<0 .0 1) ,而对照组为 2 .6± 1.5 %。结论 :再障血清抑制蛋白组分量与脐血造血凋亡细胞数量呈正相关。证明再障血清抑制蛋白组份与造成血细胞凋亡有一定的量效关系 ,推测造血细胞凋亡增加可能是再障发病的主要机制     

Analysis of CD4^＋CD25^＋ Regulatory T Cells and Foxp3 mRNA in the Peripheral Blood of Patients with Asthma

The changes of CD4 CD25 regulatory T cells (CD4 CD25 Treg) and Foxp3 mRNA in peripheral blood mononuclear cells (PBMCs) from patients with asthma were investigated in order to elucidate the possible roles of CD4 CD25 Treg in the development of asthma. The peripheral blood samples were collected from 29 healthy controls (normal control group) and 78 patients with asthma which included 30 patients in exacerbation group, 25 patients in persistent group, and 23 patients in remission group. By using flow cytometry and RT-PCR, the CD4 CD25 Treg ratio and Foxp3 mRNA in PBMCs were detected. The CD4 CD25 Treg ratio and Foxp3 mRNA in PBMCs of exac-erbation and persistent groups were lower than that of remission and normal control groups (P<0.05). Although the CD4 CD25 Treg ratio and Foxp3 mRNA of remission group were also lower than that of normal control group, there was no significant difference between them (P>0.05). As compared with persistent group, exacerbation group had lower CD4 CD25 Treg ratio and Foxp3 mRNA (P<0.05). It was indicated that the decrease of CD4 CD25 Treg ratio and its function in PBMCs may be responsible for pathogenesis of asthma.     

间充质干细胞联合单倍体异基因造血干细胞移植治疗27例重型再生障碍性贫血临床疗效

目的 回顾性分析重型再生障碍性贫血（severe aplastic anemia,SAA）行脐带间充质干细胞（umbilical cord mesenchymal stem cells,UC-MSCs）联合单倍体异基因造血干细胞移植（haploidentical stem cells transplantatio,haplo-HSCT）治疗的临床疗效.方法 总结解放军总医院第一附属医院血液科2007年1月-2013年12月住院收治的27例SAA患者进行UC-MSCs联合haplo-HSCT治疗的资料,观察移植后细胞植入、移植物抗宿主病（graft-versus-host disease,GVHD）发生率及严重程度和2年总生存率（overall survival,OS）.结果 干细胞全部植入成功,无MSC回输不良事件发生.白细胞及血小板植入时间分别为12（8～ 21）d及14（10～26）d;Ⅱ～Ⅳ度和Ⅲ/Ⅳ度aGVHD发生率分别为40.7％和22.2％,cGVHD发生率为50.0％,广泛性仅为15.4％;2年OS为76.3％.结论 UC-MSCs联合haplo-HSCT对无全相合亲缘或无关供者的SAA患者疗效可行有效,可作为SAA患者挽救治疗选择.     

Expression of CD28 and CTLA4 on T Cells in Bone Morrow of Immune-mediated Aplastic Anemia Mice

Summary： To investigate the expression and significance of CD28 and CTLA4 on T cells in bone marrow of aplastic anemia （AA） mice, in vitro bone marrow mononuclear cells （BMMNCs） were activated through being incubated with PHA （15 μg/mL）. The expression of CD28 and CTLA4 on T cells incubated with or without PHA was detected by two-color flow cytometry. The expression of CD28 and CTLA4 was significantly increased after PHA stimulation. In the AA mice. the expression of CD28 with or without PHA stimulation was both higher than that in the normal mice （both P〈0.01）, but the expression of CTLA4 with or without PHA stimulation showed no significant difference in comparison to that in the normal mice （both P〉0.05）. In the AA mice, there were more activation and activated potential of T cells than the normal, and the abnormal expression of CD28 and CTLA4 may participate in immunological disorder mediated by T cells.     

单倍体造血干细胞联合脐带间充质干细胞移植治疗急性重型再生障碍性贫血的护理

目的探讨单倍体异基因造血干细胞移植(allo-HSCT)治疗重型再生障碍性贫血(severe aplastic anemia,SAA)的护理方法。方法观察抗胸腺细胞球蛋白(antithymosyte globulin,ATG)药物应用时的不良反应、严格控制骨髓干细胞及脐带间充质干细胞(UC-MSC)的输入速度、时间,掌握移植物抗宿主病(graft vs host disease,GVHD)预防措施。结果 5例患者应用ATG药物均无反应,骨髓干细胞及UC-MSC输入顺利,未出现溶血及输血反应,全部获得异体造血重建;GVHD发生3例皮肤排异(其中2例并肝脏排异);1例肠道排异。到随访期止,除例4于+78d出院失去联系,其余4例均无病存活。结论对移植后发生的GVHD采取有效的预防护理是保证移植成功的关键。     

脐带间充质干细胞联合HLA单倍型相合造血干细胞治疗重型再生障碍性贫血的临床观察

目的 观察人脐带间充质干细胞(HUC-MSC)在联合人类白细胞抗原(HLA)单倍型相合移植治疗重型再生障碍性贫血的疗效和安全性.方法 对8例重型再生障碍性贫血患者进行HUC-MSC联合HLA单倍型相合移植治疗,观察移植疗效及相关并发症.结果 所有患者均重建供者造血,中性粒细胞大于0.5×109/L和血小板大于20×109/L的恢复中位时间分别为12.1 d和15.2 d.8例患者均出现粒细胞缺乏症伴感染,1例(12.5%)发生急性移植物抗宿主病(aGVHD),予甲泼尼松龙和布地奈德后治疗控制.巨细胞病毒(CMV)感染1例,无1 例发生肝静脉闭塞病(VOD).结论 HUC-MSC联合HLA单倍型相合移植治疗重型再生障碍性贫血安全有效,可加快造血重建.     

Changes of CD4＋ CD25＋ Regulatory T Cells in Peripheral Blood in Patients with Hepatocellular Carcinoma Before and after TACE

This study investigated the changes of CD4＋ CD25＋ regulatory T cells （Tregs） in periph-eral blood of patients with hepatocellular carcinoma before and after transcatheter arterial chemoem-bolization （TACE）. The proportion of CD4＋ CD25＋ Tregs among CD4＋ T lymphocytes in peripheral blood of 33 patients with hepatocellular carcinoma was determined by flow cytometry before, 1 week and 1 month after TACE. And 25 healthy volunteers served as control. One month after TACE, the patients were divided into two groups： 22 in group A, who were in stable condition or getting better; and 10 in group B, who were deteriorating. One patient died and was excluded. The results showed that the percentage of CD4＋CD25＋ Tregs among CD4＋ T lymphocytes did not significantly change in the 33 patients 1 week after TACE as compared with that before TACE, however, the difference was significant （P〈0.01） between the patients with hepatocellular carcinoma and the healthy subjects. The percentage of CD4＋ CD25＋ Tregs among CD4＋ T lymphocytes in group A 1 month after TACE was decreased significantly in comparison with that before and 1 week after TACE （P〈0.01）, whereas, that in group B was increased significantly 1 month after TACE （P〈0.01）. It was concluded that patients with hepatocellular carcinoma had a higher proportion of CD4＋CD25＋ Tregs in peripheral blood. TACE did not significantly affect the level of CD4＋ CD25＋ Tregs within short time （such as 1 week）. The proportion of CD4＋CD25＋ Tregs in peripheral blood 1 month after TACE was related to the prognosis of hepatocellular carcinoma.     

人脐带沃顿胶间充质干细胞对重型再生障碍性贫血调节性T细胞及Foxp3基因的影响

目的研究脐带沃顿胶间充质干细胞(WJCs)对重型再生障碍性贫血(SAA)患者外周血CD4+CD25+调节性T细胞及Foxp3基因表达水平的影响,探讨WJCs对SAA患者T淋巴细胞(TLCs)免疫调节作用的可能机制。方法从人脐带中分离培养WJCs,通过流式细胞术检测其表面标记并进行鉴定;采用密度梯度离心法从SAA患者外周血中分离TLCs;在植物凝集素(PHA)刺激下,将SAA患者TLCs(1×105个)进行体外培养,实验组加入不同数量级WJCs(1×103、1×104、1×105个)共培养,3 d后采用MTT法检测淋巴细胞抑制率;流式细胞仪检测实验组及正常对照组SAA患者TLCs中CD4+CD25+T细胞比例的变化,RT-PCR方法检测Foxp3基因mRNA水平的变化。结果 WJCs能明显抑制SAA患者TLCs增殖,且抑制作用与WJCs呈剂量依赖性;实验组CD4+CD25+T细胞比例以及Foxp3基因表达水平均比对照组明显增加,且与TLCs增殖水平呈负相关。结论 WJCs对SAA患者TLCs的抑制作用呈剂量依赖性,通过上调Foxp3的表达而发挥CD4+CD25+调节性T细胞的免疫调节作用可能是其机制之一。     

CAA患者造血干细胞内Ca2+含量、CD95+表达水平及相关因素的研究

目的 :探讨慢性再生障碍性贫血 (CAA)患者骨髓造血干细胞内Ca2 + 含量及CD34、CD95阳性细胞率及其相关因素IFN -r、TNF -a之间的内在联系 ;方法 :我们分别采用钙离子邻%D甲酚酞络合酮直接比色法、流式细胞仪双标记法及放免法 ,检测 30例CAA患者的骨髓造血干细胞内Ca2 + 含量、CD34、CD95阳性细胞率及IFN -r、TNF -a水平 ,并与正常手术组 (14例 )和健康献血员 (14例 )比较。结果 :CAA患者骨髓造血干细胞内Ca2 + 及CD34、CD95阳性细胞率与手术组比较 ,有明显差异 (P <0 .0 1) ,患者外周血清中IFN -r、TNF -a的表达水平也与正常人有较显著的差异 (P <0 .0 1)。结论 :CAA患者其造血干细胞存在凋亡现象 ,是通过IFN -r、TNF -a作用靶细胞后触动靶细胞的CD95表面蛋白受体 ,进而引起靶细胞内的连锁生化反应 ,包括Ca2 + 升高 ,使DNA降解而凋亡     

慢性粒细胞白血病患者PBMCs中CD4+CD25+细胞体外增殖及对CD4+CD25-细胞增殖的影响

目的 探讨慢性粒细胞白血病(CML)患者外周血单个核细胞(PBMCs)来源的CD4 CD25 细胞体外增殖及对CD4 CD25-细胞增殖的影响.方法 以免疫磁性分离方法(MACS)分选出CML患者外周单个核细胞中的CD4 CD25 及CD4 CD25-细胞后,用流式细胞仪分析细胞的纯度及活力;再以小鼠抗人CD3单抗、小鼠抗人CD28单抗及rh IL-2作为刺激因子,CD4 CD25 细胞与CD4 CD25-细胞共培养,观察CD4 CD25 细胞对CD4 D25-细胞增殖的抑制效应.结果 (1)分选后健康对照组及CML患者PBMC中CD4 CD25 细胞纯度分别为(84.93±2.55)%、(86.32±2.40)%,两者相比,无显著差异(P＞0.05);(2)经MACS分选后正常对照组与CML患者CD4 CD25 细胞活力分别为(98.12±0.68)%、(97.33±0.78)%,两者相比,无显著差异(P＞0.05);(3)无论是健康对照还是CML患者的CD4 CD25 细胞均具有明显抑制效应性细胞如CD4 CD25-细胞的增殖,随着CD4 CD25 细胞数的增加,这种抑制增殖的能力也相应增加,当CD4 CD25 T:CD4 CD25-T为1:1时,抑制率最大.结论 MACS分选法能够分选出高纯度及高活力的CD4 CD25 细胞,分选后CD4 CD25 细胞在体外均能抑制CD4 CD25-细胞增殖,且这种抑制效应呈一定效靶比关系.     

不同细胞因子对脐血CD34+细胞扩增的影响

目的探讨不同细胞因子促进脐血CD34 细胞扩增的效应,为下一步的临床应用奠定基础。方法采用EasySep免疫磁珠阳性选择系统分离脐血中CD34 细胞,在无血清、无基质细胞培养体系中添加不同细胞因子培养2周,分组:A组,SCF FL TPOB组,SCF FL TPO IL-3C组,SCF FL TPO G-CSF。结果CD34 细胞数目于培养后7d达到峰值,3组间差异无显著性;B组扩增至14d时细胞总数达(384.40±17.48)倍,显著高于另外2组。扩增7d后的脐血细胞经体外培养可形成造血集落。结论体外扩增脐血CD34 细胞理想的细胞因子组合为SCF TPO FL,以7d为宜。     

骨髓增生异常综合征中骨髓CD34~+、CD34~-细胞凋亡和增殖的实验研究

目的:分析骨髓增生异常综合征(MDS)患者骨髓CD34+细胞和CD34-细胞凋亡和增殖情况,从该角度探讨MDS的发病机制。方法:流式细胞术分析20例高危MDS、20例低危MDS患者及10例正常对照者骨髓CD34+细胞的比例,CD34+细胞和CD34-细胞凋亡、增殖的百分率,计算各组中的凋亡/增殖(A/P)比。结果:(1)MDS患者CD34+细胞的比例明显高于对照组,其中高危组CD34+细胞的比例明显高于低危组(P<0.05),而低危组与对照组比较无显著差异;(2)CD34+,CD34-细胞的凋亡率在MDS低危组中均为最高,明显高于MDS高危组和对照组,在低危组中,CD34-细胞的凋亡率(80.36±1.82)%明显高于CD34+细胞(54.75±2.18)%(P<0.05),而在高危组中,CD34+,CD34-细胞的凋亡率无显著差异;(3)CD34+细胞的增殖率在MDS高危组中最高,明显高于低危组和对照组,而CD34-细胞的增殖率在MDS高危和低危组间无显著差异,在高危组中,CD34+细胞的增殖率(50.67±3.37)%明显高于CD34-细胞的(30.99±1.96)%(P<0.05);(4)无论CD34+,CD34-细胞的A/P值在MDS低危组中均明显高于高危组和正常对照组,而在MDS各亚组中,CD34-细胞的A/P值明显高于CD34+的A/P值(P<0.05)。结论:CD34+细胞百分率随MDS危险度增加而逐渐增加,在低危组中以CD34-细胞的凋亡占主导,随着病情进展,在高危组中则以CD34+细胞的增殖占主导,提示异常的凋亡和增殖在MDS的发生和发展中起重要作用。     

化疗对食管癌患者外周血CD4+CD25+调节性T细胞的影响

目的  探讨化疗对食管癌术后患者外周血CD4+CD25+调节性T细胞的影响。方法  随机选择35例食管癌术后化疗患者,应用流式细胞仪检测其化疗前、化疗1周后外周血CD4+CD25+调节性T细胞的比例,并进行比较,选择30例健康志愿者作为对照。结果  食管癌患者术后化疗前外周血中CD4+CD25+调节性T细胞的比例(10.44±1.45)%高于同期健康对照组（9.35±1.41）%,差异有统计学意义（t=3.059,P＜0.05）。35例患者其化疗前及化疗1周后外周血CD4+CD25+调节性T细胞比例分别为：(10.44±1.45)%、(11.67±1.56)%,两者比较差异具有统计学意义（t=6.342,P＜0.01）。结论  化疗可增高食管癌术后患者外周血CD4+CD25+调节性T细胞的比例。     

再生障碍性贫血患者T细胞亚群及HLA-DR抗原表达的意义

目的 :检测再生障碍性贫血患者外周血T淋巴细胞亚群CD4 + 、CD8+ 及HLA DRT抗原的表达 ,探讨再生障碍性贫血发病的免疫机制 ,为再障的临床诊断和治疗提供理论依据。方法 :采用免疫组化斑点印迹技术进行检测 ,并用薄层扫描仪对所有班点印迹信号进行扫描。结果 :再障患者CD4 + 降低 ,CD8+ 升高 ,CD4 + /CD8+ 比值倒置 ,HLA DR表达增高。结论 :T淋巴细胞亚群比例失衡及HLA DR表达升高可能参与再障的发病过程     

成人骨髓间充质干细胞对脐血CD34+细胞的体外扩增作用

目的: 探讨骨髓间充质干细胞(MSCS)对脐血CD34 细胞体外扩增作用. 方法: 分离培养成人MSCS作为滋养层,联合SCF, IL-11和GM-CSF分别组成对脐血CD34 细胞的不同扩增体系,培养3 wk后观察脐血有核细胞、CFCs以及CD34 细胞扩增倍数的变化. 结果: MSCS联合细胞因子组较其他组培养体系对有核细胞总数、CFCs含量及CD34 细胞含量均具有明显的扩增作用,分别扩增了114.2±2.4, 40.5±8.6, 11.3±0.4 倍. 结论: 成人MSCS协同其他细胞因子可增强脐血CD34 细胞的体外扩增作用.     

亲缘单倍体造血干细胞联合间充质干细胞共移植治疗重型再生障碍性贫血1例报告

目的探讨亲缘单倍体造血干细胞联合间充质干细胞共移植治疗重型再生障碍性贫血的疗效。方法报告1例亲缘单倍体造血干细胞联合间充质干细胞共移植治疗重型再障患者的疗效并对有关文献进行复习。结果移植后患者造血功能恢复迅速,仅有Ⅱ度急性移植物抗宿主病发生,无明显感染及其他并发症发生。结论单倍体造血干细胞联合间充质干细胞治疗重型再生障碍性贫血是有效、可行的。     

骨髓增生异常综合征与再生障碍性贫血患者骨髓细胞免疫表型比较分析

目的探讨骨髓细胞免疫表型对骨髓增生异常综合征(MDS)与再生障碍性贫血(AA)的临床鉴别诊断价值。方法采用单克隆抗体-生物素-亲和素酶标法对本院4年内初诊未治疗的23例AA患者、19例MDS患者及50例缺铁性贫血患者(对照组)骨髓细胞免疫表型进行检测,统计分析CD3、CD5、CD10、CD13、CD19和CD33抗原在三种疾病中表达差异。结果 AA患者骨髓细胞CD3和CD5抗原表达率明显高于对照组和MDS组(P<0.05),CD10、CD13和CD33抗原表达在AA组与对照组间无差异(P>0.05)。MDS患者骨髓细胞CD13和CD33抗原表达率均明显比对照组和AA组高(P<0.05),CD19表达低于AA组和对照组,CD3抗原表达在MDS组与对照组间差异无统计学意义(P>0.05)。结论骨髓细胞免疫表型对于AA与MDS的鉴别有一定参考价值。