大鼠肾移植后抗波形蛋白抗体升高与慢性移植肾肾病的相关性

目的 研究大鼠肾移植术后抗波形蛋白抗体的表达水平与慢性移植肾肾病(CAN)的相关性.以及不同免疫抑制剂对其的影响.方法 选取近交系F344大鼠作为同系肾移植的供、受者(共9对),选取F344和Lewis大鼠分别作为同种肾移植的供、受者(共27对).同系移植组受者术后不给予免疫抑制剂;同种移植组受者术后10 d内给予环孢素A(CsA),然后将同种移植组受者随机平均分为生理盐水(NS)组、CsA组和霉酚酸酯(MMF)组(每组9只),分别给予NS、CsA和MMF灌胃.术后第4、8和12周时分别处死每组受者3只,观察CAN的进展、波形蛋白及其基因的表达以及抗波形蛋白抗体的水平,取正常大鼠(包括F344和Lewis大鼠)作为对照.结果 观察期内同系移植组未发生CAN;而同种移植组发生了CAN,且不断加重,其中CsA组和NS组的CAN病理改变非常明显,而MMF组明显较轻.术前所有受者血清中均未检测到抗波形蛋白IgM和IgG抗体,术后也未检测到抗波形蛋白IgM抗体;术后同系移植组仅检测到微量的抗波形蛋白IgG抗体,同种移植组检测到大量的抗波形蛋白IgG抗体.随着CAN的进展,同种移植中,CsA组和NS组血清抗波形蛋白IgG抗体的水平逐渐增高,而MMF组抗体水平的增高显著低于NS组(P<0.05),但仍显著高于同系移植组(P<0.05).结论 大鼠同种肾移植术后,受者体内可产生抗波形蛋白IgG抗体,且产生的时间早于CAN,抗波形蛋白IgG抗体水平也会随着CAN的进展而增高.MMF可抑制抗波形蛋白IgG抗体的产生,CsA无此作用.     

1O-羟基喜树碱和环孢素A诱导异基因大鼠心脏移植受者免疫耐受的实验研究

目的以中药制剂10-羟基喜树碱(HCPT)和环孢素A(CsA)诱导异基因大鼠心脏移植受者免疫耐受,并探讨免疫耐受的特异性和形成机制.方法以纯系SD大鼠为供者,纯系Wis-tar大鼠为受者行异体颈部心脏移植.将移植后50只受者大鼠随机分成5组,分别接受不同剂量HCPT、CsA或二者联合应用.A组接受安慰剂.B组接受HCPT 1.0mg·kg-1·d-1,腹腔注射.C组接受HCPT 2.0 mg·kg-1·d-1,腹腔注射.E组接受CsA10.0 mg·kg·d-1,导管灌胃.F组联合应用HCPT和CsA,方法剂量同B组和E组.心脏移植物长期存活受者术后60 d停用免疫抑制剂,120 d同时行供者来源(SD)大鼠和无关供者(SHR)大鼠皮肤移植.结果3只C组大鼠和5只F组大鼠心脏移植术后停用免疫抑制剂长期存活超过730 d.8块SD大鼠皮肤移植物长期存活超过610 d,而8块SHR大鼠皮肤均被排斥,平均存活时间(4.50±1.25)d.结论大剂量HCPT或小剂量HCPT与CsA联合应用可诱导异基因大鼠心脏移植受者免疫耐受,且形成的免疫耐受具有明确的抗原特异性.     

ICOS-Ig 融合蛋白联合亚剂量环孢素A诱导小鼠移植心脏长期存活

目的 探讨可诱导共刺激分子-Ig融合蛋白(ICOS-Ig)联合亚剂量环孢素A(CsA)对小鼠移植心脏存活时间的影响及其机制.方法 自行构建ICOS-Ig.以Balb/c小鼠为供者,C57BL/6小鼠为受者,套管法制备小鼠颈部心脏移植模型,然后将模型分为5组:(1)未处理组,不做任何处理;(2)对照IgG组,移植当天以及术后第2、4、6天腹腔注射IgG 250 μg;(3)IcoS-Ig组,移植当天以及术后第2、4、6天腹腔注ICOSIg250 μg;(4)CsA组,移植当天以及术后第1～7天腹腔注射CsA 10mg/kg;(5)ICOS-Ig+CsA组,同时给予ICOS-Ig和CsA,使用时间和剂量同前.术后观察移植心脏存活时间,观察移植后第7天移植心脏的病理变化,并进行供、受者混合淋巴细胞反应(MLR),测定受者血清中供者特异性的同种抗体水平.结果 各组小鼠移植心脏存活时间分别为:未处理组(8.5±1.5)d,对照IgG(8.00.8)d,ICOSIg(29.57.7)d.CsA处理组(21.0±5.0)d,ICOS-Ig+CsA组移植心脏存活时间均超过50d,6只(6/9)移植心脏存活时间>100d,ICOS-Ig+CsA组与其他4组比较,差异均有统计学意义(P<0.01).移植后7d,未处理组及对照IgG组心肌明显变性,纤维断裂,间质水肿,肌束间及血管周围有大量炎症细胞浸润,而ICOS-Ig组和CsA组心肌无明显变性,间质略水肿,血管周围有少量淋巴细胞浸润,ICOS-Ig+CsA组的病理改变明显I(X)S-Ig组和CsA组.移植后7d,ICOS-Ig组和CsA组的脾脏淋巴细胞对同种抗原刺激反应比未处理组和对照IgG组明显降低(P<0.05),而ICOS-Ig+CsA组的抑制作用明显强于ICOS-Ig组和CsA组(P<0.05).移植后7d,ICOS-Ig组和CsA组受者血清中针对特异性供者的抗体水平明显低于未处理组和对照IgG组(P<0.05),ICOS-Ig+CsA组的抗体水平明显低于ICOS-Ig组和CsA组(P<0.05).结论 ICOS-Ig可以降低受者对供免疫反应性,延长移植心脏的存活时间,联合亚剂量CsA可使异体移植心脏长期存活.     

沈阳市男性不育患者弓形虫感染情况的研究

目的:探讨男性不育患者弓形虫(TOX)感染的状况及感染后对男性生殖功能的影响。方法:用酶联免疫吸附试验(ELISA)法检测男性不育患者血中弓形虫循环抗原(CAg)、IgG及IgM抗体。结果:100例男性不育患者血清中CAg阳性者13例(13%),TOX-IgM阳性者16例(16%);而100例生殖功能正常的男性血清中CAg阳性者仅为1例(1%),TOX-IgM阳性者3例(3%);两者间差异非常显著(P<0.01)。两者TOX-IgG阳性者均为7例(7%)。结论:TOX急性(早期)感染可能会影响男性生育能力,并导致男性不育。因此,男性也应注意避免感染弓形虫,防止导致不育的情况发生。     

肾移植术后供者特异性抗体对移植肾近期效果的影响

目的 评价肾移植术后供者特异性抗体(Ds-Ab)对移植肾近期效果的影响。方法 对2001年1月至2002年7月间进行尸肾移植的92例受者，使用酶联免疫吸附(ELISA)法，检测受者血清中HLA抗体水平，随访1年。结果 16例(17．4％)受者术后出现供者特异性抗体。抗体阳性组急性排斥发生率(56．3％)高于抗体阴性组(11．9％)，P=0．000；移植肾功能延迟恢复的发生率(12．5％)与抗体阴性组(9．2％)比较，差异无显著性，P=0．102；供者特异性抗体阳性组受者发生急性排斥后，移植肾肌酐水平高于抗体阴性组或无急性排斥组。结论 供者特异性抗体与肾移植术后急性排斥有关，可能影响近期移植肾功能。     

门静脉预输注供者凋亡骨髓细胞延长大鼠移植心脏的存活时间

目的探讨门静脉输注供者的凋亡骨髓细胞对大鼠移植心脏存活时间的影响。方法以Wistar大鼠为供者、SD大鼠为受者,将其随机分为4组,每组15只,A组为对照组,受者术前6d经门静脉输注RPMI1640培养基0.5ml,术后不注射环孢素A(CsA);B组为骨髓细胞输注组,受者术前6d经门静脉输注供者的骨髓细胞5×107个,术后不用CsA;C组为凋亡细胞输注组,受者术前6d经门静脉输注供者的凋亡骨髓细胞5×107个,术后不用CsA;D组为CsA组,受者术前3d起腹腔注射CsA5mg/kg,直至术后10d。60Coγ射线照射诱导骨髓细胞凋亡,各组大鼠建立腹部异位心脏移植模型。观察各组移植心的存活时间、组织病理学改变,测定受者血清中白细胞介素10(IL-10)及转化生长因子β1(TGF-β1)的含量及单向混合淋巴细胞培养(MLR)结果。结果C组移植心的存活时间为(14.00±0.95)d,较A组明显延长(P<0.01),但仍未达到长期存活(存活时间短于CsA组)。术后7d,C组移植心组织切片呈现中度急性排斥反应,心肌细胞损害不明显,但有大量淋巴细胞浸润。除术后7d的TGF-β1外,C组其它各测定时点的血清IL-10及TGF-β1均高于其它3个组。C组大鼠的脾细胞在供鼠脾细胞的刺激下,细胞增殖反应明显低于A组、B组(P<0.01),而对第三品系大鼠的脾细胞仍有较强的增殖反应,具有明显的抗原特异性;CsA组的细胞增殖均被抑制。结论门静脉预输注供者的凋亡骨髓细胞,可明显延长大鼠移植心脏的存活时间,但单纯单剂量的输注凋亡细胞并不足以建立长期、稳定的免疫耐受。     

ABO血型不相容肾移植中高抗体滴度O型受者采用供者同型血浆预处理的初步探索

目的探讨ABO血型不相容肾移植(ABO-incompatible kidney transplantation, ABOi-KT)中的O型受者采用供者同型血浆置换进行预处理的可行性和安全性。方法回顾性分析2021年1月至2021年11月中国科学技术大学附属第一医院肾移植科收治的15例O型ABOi-KT受者预处理过程和术后3个月内的临床资料。按术前预处理过程中血浆置换采用的血浆类型分为AB型组(8例)和供者同型组(7例), 采用秩和检验比较两组受者血浆去除治疗(plasmapheresis, PP)次数以及血型抗体滴度, 采用t检验比较两组受者PP频率和术后血肌酐值。结果 15例受者均预存高滴度血型抗体(IgM或IgG滴度≥1∶256)。预处理过程行PP(8.1±2.5)次, 其中双重血浆滤过(4.0±1.4)次, 血浆置换(4.1±2.0)次, PP频率为(0.8±0.1)次/d。供者同型组受者行供者同型血浆置换3～4次, 共计24次, 置换过程中未发生溶血等特殊副反应。两组受者血型抗体滴度经预处理后均达到ABOi-KT手术标准(IgM和IgG滴度均≤1∶8)并顺利手术。15例受者术后...     

注射供者的肝匀浆提取液延长大鼠异位心脏移植存活时间

目的探讨注射供者的肝匀浆提取液对大鼠淋巴细胞功能及大鼠异位移植心的影响。方法以Wistar大鼠为供者,SD大鼠为受者。制作Wistar大鼠的肝匀浆提取液；建立大鼠同种异体异位心脏移植模型。(1)经受者阴茎静脉注射肝匀浆提取液0．3 ml,14d后取供、受者的血液,用四甲基偶氮唑盐(MTT)法分别测定受者对同一供者和无关供者的单向混合淋巴细胞反应(MLR)。(2)心脏移植术前2h经受者阴茎静脉注射肝匀浆提取液0．3 ml。心脏移植术后分别观察受者注射同一供者和无关供者的肝匀浆提取液后移植心脏的存活时间；心脏停跳后取移植心做病理检查及免疫组织化学检测。结果受者对同一供者和无关供者的单向MLR比较,前者明显减轻,吸光度A值分别为：0．434±0．034和0．522±0．015,两组比较,差异有统计学意义(P＜0．01)。心脏移植术前,受者接受同一供者和无关供者的肝匀浆提取液后,前者移植心脏存活时间延长,分别为(38．05±17．07)d和(9．86±2．67)d,两组比较,差异有统计学意义(P＜0．01)；且前者心肌出血、坏死程度更轻,心肌组织内IgM和IgG沉积更少。结论注射同一供者的肝匀浆提取液能特异性抑制相应个体抗原引起的淋巴细胞增殖反应,减轻大鼠移植心脏的排斥反应,明显延长其存活时间。     

猕猴预致敏后肾移植加速性排斥反应的免疫学及病理学特点

目的 观察猕猴预致敏后肾移植加速性排斥反应的免疫学及病理学变化特点.方法 建立猕猴皮肤预致敏后肾移植加速性排斥反应模型(供、受者各3只).检测3只受者皮肤移植预致敏前、后及肾移植后血清内供者特异性抗体的变化.并在发生排斥反应时对移植肾进行免疫组织化学(测定补体、抗体的沉积及各类型淋巴细胞浸润情况)及病理学分析.结果 3只受者均发生了加速性排斥反应.其中2只受者在预致敏后血清中供者特异性抗体明显增加,对供者的淋巴毒反应明显升高;肾移植后受者血清中供者特异性抗体及针对供者的淋巴毒进一步升高.苏木精-伊红染色显示排斥反应的移植肾内有明显的动脉坏死、血栓形成、间质出血、中性粒细胞浸润;免疫组织化学及荧光染色显示移植肾内有大量的补体、抗体沉积(主要为IgG),而各种类型的淋巴细胞浸润少见.另1只受者体内的供者特异性抗体及对供者淋巴毒反应的升高程度不如前2只明显,病理学变化以肾小管损伤为主.结论 皮肤移植预致敏可以诱导受者产生程度不等的预存抗体,导致大多数移植肾在术后早期发牛主要南抗体和补体介导的严重的急性体液性排斥反应.     

儿童ABO血型不相容活体肝移植术后供者血型抗原不完全免疫耐受状态的研究

目的结合临床数据及文献分析儿童ABO血型不相容活体肝移植针对血型抗原低免疫应答状态的潜在免疫机制。方法回顾性收集首都医科大学附属北京友谊医院2013年6月至2020年12月期间施行的术后长期生存的儿童ABO血型不相容活体肝移植受者29例, 受者血型均为O型, 其中A型供者10例, B型供者19例。移植物类型包括左外侧叶26例, 左半肝3例;肝移植手术中位年龄10月龄, 中位体重为8.0 kg, 中位随访时间41.9个月。连续监测移植术前及移植术后1、3、6、12、24、36个月受者体内针对供者血型相关抗体与供者血型非相关抗体滴度(IgG、IgM), 并进行比较分析。对纳入受者进行程序性肝脏病理穿刺活检或事件性肝脏病理穿刺活检判断是否存在抗体介导排斥反应。结果受者移植术前及术后血型抗体(IgG、IgM), 受者体内抗供者血型相关抗体滴度呈持续低水平状态, 较体内非供者血型相关抗体滴度水平显著降低, 差异有统计学意义(P<0.001)。对于纳入研究的29例受者, 共有18例完成程序性肝脏病理活检, 其中2例提示血管内皮C4d阳性;5例完成肝功能异常事件性肝脏病理活检, 其中1例存在胆...     

Significant changes in the alloantibody after lung transplantation in the cyclosporine treated rat model

BACKGROUND: The diagnosis of acute rejection after organ transplantation is often complicated by other possibilities, such as infection. Despite many attempts to identify rejection episodes after transplantation, only the detection of the humoral anti-human leukocyte antigen antibody has been effective in measuring alloimmunization, especially detected with flow cytometry cross-match (FCXM). As an initial step towards gaining a better understanding of the correlation between humoral responses and graft rejection in an immunosuppressant recipient, we investigated responses of alloantibodies (allo-Abs) after lung transplantation (LTx) in a rat model treated with adequate or inadequate cyclosporine A (CsA) therapy. METHODS: Orthotopic LTx was performed using a major histocompatibility complex fully incompatible combination (Brown Norway to Lewis rat). CsA was given subcutaneously to recipients at an optimal or a sub-optimal dosage for 3 days after transplantation. A FCXM technique was used to determine the time-course of changes in titers of allo-Abs in serum. The allo-Ab deposition in the grafted lung was detected with an immunofluorescent staining method. RESULTS: Circulating IgM allo-Ab levels were significantly elevated on day 4 in both groups when histological findings revealed early stage of acute rejection. IgM levels in the sub-optimal dosage group were maximal and significantly higher than those in the optimal dosage group on day 4, and levels then decreased after day 8. IgG allo-Ab levels increased significantly on day 8 and continued to increase throughout the observation period. CONCLUSIONS: Our data suggest that the monitoring IgM allo-Abs might be effective for identifying acute rejection in recipients with inadequate immunosuppression therapy.     

免疫球蛋白在肾移植后肺部感染治疗中的辅助作用

目的　探讨静脉注射大剂量免疫球蛋白在肾移植后肺部感染治疗中的辅助作用。方法　肾移植后发生肺部感染的14例患者,在常规针对病原体治疗基础上辅以静脉注射免疫球蛋白,其中8例给予大剂量免疫球蛋白(A组)7~10 d,6 例接受小剂量免疫球蛋白组(B组)3~7 d;另有12例肾移植后发生肺部感染者仅接受针对病原体的治疗(C组)。观察各组重症肺部感染发生率,A、B组治疗前后血清IgG、IgA、IgM的浓度以及T淋巴细胞亚群的变化。结果　A、B、C组重症肺部感染发生率分别为0、66.7 %和66.7 %,死亡率为0、16.7 %和25.0 %;A组治疗后血清IgG浓度升高(P<0.01),并明显高于B组(P<0.01);A、B组治疗前后T淋巴细胞亚群的差异均无统计学意义(P>0.05)。结论　早期联合静脉注射大剂量免疫球蛋白作为一种辅助治疗,能阻止肾移植后肺部感染的进一步发展,降低重症肺部感染的发生率和死亡率。     

大鼠心脏移植术后弓形虫感染时淋巴细胞亚群变化的观察

目的 观察大鼠器官移植术后机体免疫状态与环孢素A(CsA)使用和弓形虫发病的关系。方法 流式细胞术测定移植术后第5、10、15及20受体的T淋巴细胞亚群的变化。结果 CD4^ 和CD8^ T淋巴细胞酚率均有变化；使用环孢素组术后5d CID8^ T淋巴细胞较术前明显升高；术后10d，无论是否使用环孢素，CD8^ T淋巴细胞亦较术前明显升高；感染发作时CD8^ T淋巴细胞明显升高，CD4^ ／CD8^ 比值降低或倒置；移植术后供体携带病原体可致受体CD4^ ／CD8^ 比值低于受体隐性感染组的比值。结论 器官移植术后CsA使用导致免疫抑制，CD4^ 和CD8^ T淋巴细胞均参与对弓形虫的免疫作用；感染发作时CD8^ 明显升高，是主要的细胞毒细胞；CD4^ ／CD8^ 比值可用于评估机体免疫状态，预测弓形虫感染的发生。     

Antigenemia,immunoblotting, and enzyme immunoassay for early diagnosis of cytomegalovirus infection in renal transplant patients

Timely and rapid diagnosis of cytomegalovirus (CMV) infection is important for the management of transplant patients. We compared three serological assays, IgM immunoblot and IgG/IgM enzyme immunoassay (EIA), as well as the detection of CMV antigens in polymorphonuclear blood leukocytes (antigenemia), for their value in the early diagnosis of CMV infection. Thirty-one patients were monitored longitudinally for 3 months after renal transplantation. Laboratory documented CMV infection occurred in 20 patients. All of these cases showed a positive IgM immunoblot result that was confirmed by at least one of the other test assays (IgG EIA 19/20, antigenemia assay 13/20, and IgM EIA 12/20). All of the ten patients whose clinical picture was compatible with symptomatic CMV disease were positive for CMV infection according to IgM immunoblot and IgG EIA, nine were positive according to the antigenemia assay, and seven were positive according to IgM EIA. With reference to the temporal pattern, the antigenemia assay indicated CMV infection significantly earlier than the serological tests (P0.05). In symptomatic patients CMV antigen-positive leukocytes were, on the average, detected on the day of onset of symptoms, whereas detection by IgM immunoblot, IgG EIA, and IgM EIA followed 8, 13, and 14 days later, respectively. These results show that: (1) the CMV antigenemia assay is very useful for the early diagnosis of symptomatic CMV infections; (2) CMV antibodies, as an indicator of CMV infection, are detectable earlier and more frequently by IgM immunoblot than by IgG/IgM EIA; (3) compared to CMV anti-genemia, the IgM immunoblot indicated CMV infection more often but significantly later; and (4) only a combination of several diagnostic methods allows optimal detection of CMV infections in renal transplant patients.     

Fatal disseminated toxoplasmosis in a cardiac transplantation with seropositive match for Toxoplasma: should prophylaxis be extended?

In cardiac transplant, toxoplasmosis in the immunocompromised recipient can result either from the transmission of the parasite from a seropositive donor (D+) to a seronegative recipient (R-) with the transplanted organ (more common) or from the reactivation of a pre-transplant latent infection (D-/R+ or D+/R+). In the immunocompromised patient, toxoplasmosis is a life-threatening disease. We report a case of disseminated toxoplasmosis following heart transplantation in a Toxoplasma seropositive recipient before transplantation (R+) (IgG 1:160, IgM negative) who received an organ from a Toxoplasma seropositive donor (D+) (IgG 1:640, IgM negative). No anti-Toxoplasma prophylactic treatment was administered. A number of complications arose in the postoperative period, as well as Enterobacter cloacae and Cytomegalovirus (CMV) (reactivation) infections, but neither serological nor histological toxoplasma recrudescence was evidenced. The patient died on post transplant day 41. Post-autopsy histological examinations revealed an unexpected diffuse toxoplasmosis (lungs, brain, heart).     

Suppression of delayed xenograft rejection by specific depletion of elicited antibodies of the IgM isotype.

BACKGROUND: Hamster hearts transplanted into untreated rats undergo delayed xenograft rejection (DXR). This acute inflammatory response is associated with the deposition of anti-graft antibodies of the immunoglobulin (Ig)M isotype in the vasculature. We have previously shown that these antibodies are generated in a T cell-independent manner. In this study, we tested whether the generation of anti-graft IgM antibodies is involved in the pathogenesis of DXR. In addition, we tested whether the suppression of this antibody response would overcome DXR. METHODS: Hamster hearts were transplanted into rats treated with an anti-mu monoclonal antibodies (mAb) to deplete circulating IgM or with an isotype-matched control mAb recognizing the dinitrophenyl epitope. T cell immunosuppression was achieved with cyclosporin A (CsA). RESULTS: Depletion of circulating IgM by anti-mu mAb inhibited DXR, whereas the control mAb had no effect on DXR. In anti-mu-treated rats, xenografts were rejected 5-7 days after transplantation through a T cell-dependent mechanism associated with the generation of antibodies of the IgG isotype. Combination of anti-mu with CsA suppressed the anti-graft IgM and IgG response and resulted in long-term xenograft survival (> 50 days). Xenograft long term survival occurred despite the return of anti-graft IgM antibodies to the circulation, a phenomenon referred to as accommodation. CONCLUSION: This study demonstrates that the pathogenesis of DXR can be initiated by anti-graft antibodies of the IgM isotype, which are generated in a T-cell independent manner. In addition, we show that under T cell immunosuppression, specific depletion of this IgM response by anti-mu mAb administration results in xenograft long-term survival and accommodation.     

Testicular toxoplasmosis: a rare case of a testicular mass

Toxoplasma gondii is an intracellular protozoan infecting birds and mammals. Acute infection is asymptomatic in immune competent people. For immune deficient patients (acquired immune deficiency syndrome, lymphoma patients or those under steroids to prevent organ transplantation rejection) infection may be lethal. We describe an uncommon case of testicular toxoplasmosis in patient under steroids after organ transplantation with no positive serum test for HIV and/or systemic toxoplasmosis.     

肾移植患者术后早期应用霉酚酸酯的临床观察

目的 观察肾移植术后早期不同剂量霉酚酸酯（ＭＭＦ）与环孢素Ａ（ＣｓＡ）和泼尼松（Ｐｒｅｄ）联用预防急性排斥反应的效果及安全性。方法 将６４例肾移植患者分为３组,分别给予ＭＭＦ２．０ｇ／ｄ（Ａ组）、１．５ｇ／ｄ（Ｂ组）及Ａｚａ ５０～１００ｍｇ／ｄ（Ｃ组）,每组均联用ＣｓＡ及Ｐｒｅｄ（剂量相同）。观察肾移植术后６个月内急性排斥反应的发生率、移植肾功能及药物的副作用。结果 Ａ、Ｂ、Ｃ组急性排斥反应的发     

河南省3084例育龄男女弓形虫、风疹病毒、巨细胞病毒、单纯疱疹病毒感染状况调查分析

目的了解目前河南省育龄人群感染弓形虫（Tox）、风疹病毒（RV）、巨细胞病毒（CMV）、单纯疱疹病毒（HSV）Ⅰ／Ⅱ型的现状。方法采用酶联免疫吸附试验（ELISA）对2011年7—9月来郑州大学第一附属医院进行孕前咨询的3084例育龄男女进行上述病原（TORCH）感染的特异性IgM及IgG抗体检测。依据研究人群的性别及年龄进行分组,并对组间的TORCH特异性抗体阳性率采用X^2检验进行统计学分析。结果育龄人群TORCHIgM抗体总阳性率为5．5％（170／3084）,其中RVIgM抗体阳性率最高（2．9％）,其次为HSV（1．0％）;在IgG抗体方面,HSVIgG抗体阳性率最高（90．4％）,其次为CMVIgG（89．7％）、RVIgG（48．1％）和Tox IgG（0．7％）。从年龄来看,〉30～40岁组各病原体的IgM抗体阳性率普遍较低;而IgG抗体方面,Tox、CMV及HSV IgG抗体阳性率随着年龄的增长呈现上升趋势,但RVIgG抗体阳性率却随着年龄的增长呈下降趋势。育龄女性人群的CMV和HSV IgG抗体阳性率显著高于男性（矿=83．470和7．026,P〈0．01）。结论河南省育龄人群中存在一定比例的TORCH现症感染及较低的RV IgG阳性率,建议育龄人群孕前进行TORCH筛查。     

Early emergence of anti‐HCV antibody implicates donor origin in recipients of an HCV‐infected organ

Hepatitis C virus (HCV) seroconversion among HCV‐uninfected transplant recipients from HCV‐infected (NAT+/Antibody+) or HCV‐exposed (NAT?/Antibody+) donors has been reported. However, the origin of anti‐HCV antibody and the implications of seroconversion remain unknown. We longitudinally tested plasma from HCV‐uninfected kidney (n = 31) or heart transplant recipients (n = 9) of an HCV NAT+ organ for anti‐HCV antibody (both IgG and IgM isotypes). Almost half of all participants had detectable anti‐HCV antibody at any point during follow‐up. The majority of antibody‐positive individuals became positive within 1‐3 days of transplantation, and 6 recipients had detectable antibody on the first day posttransplant. Notably, all anti‐HCV antibody was IgG, even in samples collected posttransplant day 1. Late seroconversion was uncommon (≈20%‐25% of antibody+ recipients). Early antibody persisted over 30 days in kidney recipients, whereas early antibody dropped below detection in 50% of heart recipients within 2 weeks after transplant. Anti‐HCV antibody is common in HCV‐uninfected recipients of an HCV NAT+ organ. The IgG isotype of this antibody and the kinetics of its appearance and durability suggest that anti‐HCV antibody is donor derived and is likely produced by a cellular source. Our data suggest that transfer of donor humoral immunity to a recipient may be much more common than previously appreciated.