特异性免疫治疗与支气管哮喘患儿肺功能水平影响的相关性研究

目的探讨特异性免疫治疗对支气管哮喘患儿肺功能水平的影响,分析其对改善支气管哮嚙患儿气道功能方面的疗效。方法依据《儿童支气管哮喘诊断与防治指南2016版》制定的纳入与排除标准,选取2017年2月至2018年4月贵州省贵阳市妇幼保健院儿童呼吸哮喘专科收治的60例支气管哮喘忠儿作为研究对象,采用随机数字表分为实验组和对照组,各30例。对照组30例患儿接受常规糖皮质激素吸入剂等基础用药治疗:实验组在基础用药治疗的同时给子特异性免疫(specifc immunotherapy,SIT)治疗。运用德国Jaeger公司MasterScreen肺功能仪分别于治疗前、治疗3个月、6个月、9个月及1年后检测并对比两组患儿.肺功能变化,观察两组患儿肺换气及通气功能的改善情况。结果治疗前两组患儿第-秒最大呼吸容积(Forced expiratory volume in one second,FEV1)、呼气峰值流速(Peak expioratoryflow,PEF)、呼出50%肺活量时最大呼气流量(Forced expiratory flow at 50%of FVC,FEF50)、呼出75%肺活量时最大呼气...     

哮喘患儿屋尘螨特异性免疫治疗的疗效及依从性分析

目的探讨儿童哮喘标准化尘螨特异性免疫治疗(SIT)的临床疗效及依从性。方法 67例进行标准化屋尘螨特异性免疫治疗的哮喘患儿,3年疗程结束后分为完成治疗SIT组(满3年组,42例)和未完成治疗SIT组(<3年组,25例),对哮喘患儿的临床症状、哮喘控制情况及依从性进行随访,并对结果进行统计学分析。结果满3年组与<3年组比较,其哮喘发作、急诊次数和输液日数均有显著改善(P<0.01);2组规范用药比较有显著差异(P<0.01);对SIT的效果,家属主观感觉,2组无显著差异,客观评价有显著差异(P<0.05),2组的主观评价无显著差异,但哮喘控制的客观评价存在显著差异(P<0.05);不完全依从的原因中,怀疑治疗效果和好转停药为最主要的原因,分别占32%和36%。结论 3年标准化屋尘螨特异性免疫治疗可显著改善哮喘患儿的临床症状,加强医、护、患沟通等措施对提高患者的依从性和哮喘的控制有积极的影响。     

支气管哮喘患者血清嗜酸性粒细胞阳离子蛋白（ECP）在特异性免疫治疗中的变化

目的通过观察支气管哮喘患者接受特异性免疫治疗前后血清嗜酸性粒细胞阳离子蛋白（eosinophilcationicprotein,ECP）的变化,评价免疫治疗的效果,探讨其治疗机制。方法60例支气管哮喘患者随机分为治疗组40例,对照组20例,治疗组用阿罗格变应原浸液特异性免疫治疗（specificimmu．notherapy,SIT）,对照组吸人布地奈德,在治疗前后抽静脉血查ECP。结果两组治疗后患者血清ECP均有降低,有显著性差异（治疗组P〈0．01,对照组P〈0．05）,但治疗组明显优于对照组（P〈0．01）。结论特异性免疫治疗能有效降低患者血清ECP,其可能的免疫机制是有效地抑制了嗜酸性粒细胞在气管的聚集与活化,降低其释放ECP的能力,起到治疗作用。     

快速特异性免疫治疗对哮喘患者血清嗜酸性粒细胞阳离子蛋白的抑制作用

<正>嗜酸性粒细胞阳离子蛋白(eosinophil cationic protein,ECP)是活化的嗜酸性粒细胞释放的毒性蛋白,在支气管哮喘的发生、发展中起重要作用,可作为评价哮喘疗效的指标。为探索变应原快速特异性免疫治疗(fast specific immuno-therapy FSIT)的机制,笔者对60例支气管哮喘患者进行了     

支气管哮喘的特异性免疫治疗

支气管哮喘的特异性免疫治疗（SIT）即通过逐渐增加特异性抗原的量使机体对该过敏原耐受,从而在机体再次接触相应抗原时不再产生相应的过敏反应或降低过敏反应的程度。SIT不仅可以减轻因过敏产生的症状,也可达到长期预防目的,是目前惟一可以改变过敏性疾病进程的治疗方法。本综述重点介绍常用免疫治疗方案、治疗机制,以及疗效和不良反应等。     

特异性免疫治疗在儿科的应用进展

特异性免疫治疗(SIT)是目前唯一可能改变变态反应性疾病病程进展的方法. 主要机制是诱导生成封闭抗体;纠正Th1/Th2平衡;调节性T细胞的调节作用及诱导体外耐受. 主要用于治疗儿童过敏性哮喘、鼻炎等,可以改善哮喘的预后,并有可能使一些哮喘患者治愈. 目前其主要的治疗方法为尘螨变应原制剂皮下注射和舌下含服法,对于儿童来说,舌下含服法依从性好,不良反应小,安全性高.     

支气管哮喘的特异性免疫治疗

综述从极早期脱敏效应、诱导和维持外周免疫耐受、调节抗体类型和调节效应细胞的功能等四个方面对特异性免疫治疗支气管哮喘的机制。     

特异性免疫治疗变应性支气管哮喘62例疗效观察

目的 评估特异性免疫治疗变应性哮喘的有效性和安全性.方法 选择114例变应原检测阳性的支气管哮喘患者,随机分为治疗组(62例)和对照组(52例),在GINA方案治疗的同时,治疗组进行特异性免疫治疗(SIT).所有患者在治疗初始时记录哮喘症状评分、用药评分、生活质量影响程度,治疗结束后回访以上指标.结果 治疗组中疗程满1...     

标准化霉菌变应原特异性免疫治疗哮喘的疗效及安全性

<正>变应原特异性免疫治疗(脱敏)支气管哮喘被世界卫生组织认为唯一能缩短哮喘病程的病因性治疗方法,目前临床上大多数都是对螨、花粉致敏性哮喘治疗,应用霉菌变应原治疗报道较少。笔者对真菌致敏性哮喘患者应用阿罗格标准化变应原进行特异性免疫治疗,并对其疗效和安全性进行分     

嗜碱性粒细胞CD63分子表达变化在过敏性疾病诊断中的意义

通过流式细胞术进行的体外嗜碱性粒细胞激发试验不仅能够敏感地、特异性诊断多种过敏性疾病,而且可以有效检测特异性免疫治疗的疗效。CD63表达于细胞内颗粒内,在激活状态的嗜碱性粒细胞,由于胞吐作用使细胞内颗粒与细胞膜融合则CD63高表达于细胞膜,CD63是目前最常用的流式细胞术检测嗜碱性粒细胞激发试验的标记分子之一。     

标准化特异性免疫治疗儿童哮喘的不良反应观察

目的探讨标准化特异性免疫治疗(specific immunotherapy,SIT)儿童哮喘的不良反应。方法对673例儿童哮喘患者采用标准化屋尘螨过敏原制剂(安脱达)进行特异性免疫治疗21 860次,观察其不良反应。结果出现不良反应776例次(3.5%),种类有局部肿块、咳嗽、胸闷、眼鼻症状、皮疹、瘙痒、肺部哮鸣音、喉痒、发热等症状。各种不良反应发生率均低于3%(属于小概率事件);以局部反应较多而全身反应较少,无一例哮喘急性发作和过敏性休克发生;主要发生在维持治疗阶段。结论 SIT用于治疗过敏性哮喘是一种较安全的治疗措施。     

氨茶碱治疗儿童哮喘的疗效再评价

目的　探讨氨茶碱对轻中度儿童哮喘的临床疗效。方法　对 5 6例轻中度小儿哮喘随机分为两组 ,即氨茶碱治疗组 (观察组 ) 30例和氨茶碱加地塞米松组 (对照组 ) 2 6例 ,以观察治疗后临床症候的变化。结果　两组临床疗效差异无显著性 (P>0 .0 5 )。结论　对轻中度小儿哮喘 ,单一用氨茶碱治疗疗效满意、安全。     

非霍奇金淋巴瘤患者外周血T淋巴细胞亚群与NK细胞功能监测的临床意义

目的探讨外周血T淋巴细胞亚群与NK细胞功能联合监测在非霍奇金淋巴瘤(NHL)发生发展及临床疗效评价中的意义。方法以52名正常献血员为对照组,采用直接免疫荧光标记法检测97例NHL患者化疗前外周血T淋巴细胞亚群与NK细胞的变化。结果与正常人组比较,非霍奇金淋巴瘤患者化疗前外周血CD3、CD4细胞数明显降低(P<0.05),而CD8细胞数、NK细胞数则高于正常对照组(P>0.05)。结论非霍奇金淋巴瘤患者化疗前外周血T细胞亚群及NK细胞的联合监测对NHL的诊断、治疗方案的选择制订、预后判断有一定的参考意义。     

Natural killer cell dysfunction in hepatocellular carcinoma and NK cell-based immunotherapy

The mechanisms linking hepatitis B virus (HBV) and hepatitis C virus (HCV) infection to hepatocellular carcinoma (HCC) remain largely unknown. Natural killer (NK) cells account for 25%–50% of the total number of liver lymphocytes, suggesting that NK cells play an important role in liver immunity. The number of NK cells in the blood and tumor tissues of HCC patients is positively correlated with their survival and prognosis. Furthermore, a group of NK cell-associated genes in HCC tissues is positively associated with the prolonged survival. These facts suggest that NK cells and HCC progression are strongly associated. In this review, we describe the abnormal NK cells and their functional impairment in patients with chronic HBV and HCV infection, which contribute to the progression of HCC. Then, we summarize the association of NK cells with HCC based on the abnormalities in the numbers and phenotypes of blood and liver NK cells in HCC patients. In particular, the exhaustion of NK cells that represents lower cytotoxicity and impaired cytokine production may serve as a predictor for the occurrence of HCC. Finally, we present the current achievements in NK cell immunotherapy conducted in mouse models of liver cancer and in clinical trials, highlighting how chemoimmunotherapy, NK cell transfer, gene therapy, cytokine therapy and mAb therapy improve NK cell function in HCC treatment. It is conceivable that NK cell-based anti-HCC therapeutic strategies alone or in combination with other therapies will be great promise for HCC treatment.     

特异性免疫治疗对哮喘大鼠白细胞介素-10和CD_4~＋CD_（25）~＋调节性T细胞的影响

目的：探讨特异性免疫治疗（specific immunotherapy,SIT）对哮喘大鼠白细胞介素-10（IL-10）和CD4＋CD25＋调节性T细胞（CD4＋CD25＋Tr）的影响。方法：40只健康雄性清洁级Wistar大鼠随机均分成正常对照组、哮喘组、SIT对照组和SIT治疗组,每组10只。通过卵蛋白（OVA）雾化吸入的方法对致敏大鼠进行SIT干预,观察各组支气管肺泡灌洗液（BALF）中细胞分类及计数结果、血清和BALF中IL-10水平及外周血CD4＋CD25＋Tr百分率变化。结果：正常对照组BALF和血清中IL-10浓度分别高于哮喘组和SIT对照组（均为P〈0.01）,哮喘组和SIT对照组BALF和血清中IL-10浓度低于SIT治疗组（P〈0.01,P〈0.05）;正常对照组外周血CD4＋CD25＋Tr百分率显著高于哮喘组、SIT对照组和SIT治疗组（P〈0.01）,而SIT治疗组CD4＋CD25＋Tr百分率分别高于哮喘组和SIT对照组（P〈0.05）。结论：通过上调体内IL-10和CD4＋CD25＋Tr趋于正常状态可能是SIT治疗哮喘有效的重要机制。     

Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on blood and spleen natural killer (NK) cell activity in the mouse.

The immunotoxic effects of 2,3,7,8-tetrachlorodibenzo-P-dioxin (TCDD) were studied in male A/J mice after a loading dose of 5 μg TCDD/kg body wt. followed by 3 weekly maintenance doses of 1.42 μg TCDD/kg b.w. administered intraperitoneally. Tissue samples and immune cells were prepared on two occasions, i.e. on days 28 and 120 after the first injection of TCDD. This dose of TCDD evoked classical histological signs of liver damage and lipid accumulation, as well as thymic atrophy. Red (RBC) blood cell counts were significantly lowered in the TCDD group on day 28, but were normal on day 120. White (WBC) blood cell counts were normal in the TCDD group. Natural killer (NK) cell activity increased 3.4-fold (P < 0.01) and 2.2-fold (P < 0.01) in the blood and spleen, respectively, after 28 days, and these effects persisted on day 120. The increased NK-cell activity occurred concomitantly with a decreased proliferativc response of spleen lymphocytes to the T-cell mitogen concanavalin A after both 28 (65%) and 120 days (58%). The proliferative response of spleen cells to the B-ccll mitogen lipopolysaccharide seemed, however, unaffected. We have thus shown for the first time that TCDD induces an increased activity of NK cells that occurs simultaneously in the blood and spleen. This effect may indicate a general compensatory activation of the body's defences brought about by disturbances in the function of other arms of the immune system.     

Treg细胞在儿童过敏性哮喘SIT治疗过程中的变化

目的：本研究通过观察对室尘螨（HDM）过敏的儿童哮喘患者,过敏原特异性免疫治疗（allergen specific immunotherapy, SIT）后外周血CD4＋CD25＋CD127-Treg细胞（regulatory T cell, Treg）细胞）占CD4＋T cell的百分比的变化,以及它们在SIT治疗中的作用,初步探讨儿童过敏性哮喘SIT的机制,从而为哮喘的防治提供新思路。方法选取郑州大学第一附属医院儿科门诊48例儿童过敏性哮喘患者分两组,一组进行标准化SIT 1.5-2年后,采集两组患者的外周静脉血。用流式细胞仪检测每组标本中CD4＋CD25＋CD127-T细胞占CD4＋T细胞的百分比,结果采用统计学软件进行统计学分析。结果CD4＋CD25＋CD127-T细胞占CD4＋T细胞的百分比在HDM-SIT组显著增高。结论本实验进一步证实了哮喘患者SIT治疗有效;在HDM-SIT组CD4＋CD25＋CD127-T细胞占CD4＋T细胞的百分比升高,提示CD4＋CD25＋CD127-T细胞可能在儿童过敏性哮喘特异性免疫治疗中起重要作用。     

Effect of immunotherapy in bronchial asthma: treatment with mite extract adsorbed on tyrosine

Summary

A trial was carried out in 18 asthmatic patients to assess the effectiveness of a vaccine of house dust mite extract (Dermatophagoides pteronyssinus) adsorbed on tyrosine. Patients were initially given 6 graduated doses of the vaccine subcutaneously at 7-day intervals. Maintenance injections were then given at 2-week intervals, the total dose being determined by clinical response.

About 66% of the treated patients showed a significantly beneficial response to immunotherapy as assessed by symptomatic improvements. Seventy-two per cent of the patients required less oral anti-asthmatic therapy and 50% of the patients had a demonstrable increase in blocking antibodies. Local reactions were not severe and occurred infrequently. None of the patients developed systemic reactions to immunotherapy. Clinical response was found to depend to some extent on the dosage of antigen administered and rise in blocking antibodies of the patient's serum.     

Sublingual immunotherapy in children and its potential beneficial collateral effect on respiratory tract infections

Although directed to the control of allergic symptoms, a possible effect of sublingual immunotherapy (SLIT) on susceptibility to infections has been hypothesized. Two hundred sixty-five children aged between 3 and 4 years of age affected by allergic rhinitis completed a 6 year prospective case–control study. One hundred forty-three children after 2 years of SLIT reported a lower prevalence of respiratory tract infections when compared to children not undergoing SLIT.