人外周血CD4~+ IL-21~+记忆T细胞的特征

目的:探讨人外周血中白细胞介素21(IL-21)的产生细胞及其特征。方法:分离人外周血单个核细胞(PBMC),分为不刺激或anti-CD3(OKT3)、OKT3+anti-CD28、PMA+ionomycin刺激四个组,流式细胞术(FCM)检测产生IL-21的细胞亚群。PMA+ionomycin刺激PBMC、纯化CD4+、CD4+CD45RA-、CD4+CD45RA+细胞、脐带血单个核细胞(CB-MC),FCM分析产生IL-21细胞的表型特征和IL-21与Th1、Th2、Th17和Th22细胞因子之间的关系。结果:与OKT3、OKT3+anti-CD28相比,PMA+ionomycin能诱导最高量的IL-21产生。产生IL-21的主要细胞为CD4+T细胞,少数CD8+T细胞。CD4+IL-21+T细胞表达CD45RO,不表达CD45RA,其中部分细胞表达CCR6、CCR7或CXCR5。CD4+CD45RA-细胞表达IL-21远高于CD4+CD45RA+细胞。进一步研究表明,PBMC产生IL-21,而CBMC不产生。此外,大约24%的CD4+IL-21+细胞表达IFN-γ,小于10%CD4+IL-21+细胞表达IL-4、IL-17或IL-22。结论:人PBMC在多克隆刺激的条件下,可以诱导IL-21的产生。产生IL-21的主要细胞亚群具有记忆CD4+T细胞的表型。其中一部分CD4+IL-21+T细胞的表型独立于Th1、Th2、Th17和Th22细胞亚群。     

外周血CD4+CXCR5+滤泡辅助性T细胞与慢性乙型肝炎患者高球蛋白血症相关

目的 检测外周血CD4+ CXCR5+滤泡辅助性T细胞(Tfh细胞)的频率及其表面标志,分析与慢性乙型肝炎(乙肝)患者高球蛋白血症的关系.方法 收集健康人、乙肝患者及乙肝高球蛋白血症患者的外周血,分离血浆及外周血单个核细胞(PBMC),ELISA检测血浆中IL-21、CXCL13和IFN-γ水平,流式细胞术检测PBMC中CD4+ CXCR5+ Tfh细胞的频率及其表面PD-1、ICOS及CD40L的表达情况.结果 乙肝高球蛋白血症患者外周血CD4+ CXCR5+ Tfh细胞占CD4+T细胞的百分比(22.6±4.7)％明显高于普通慢性乙肝患者(11.9±3.9)％及健康志愿者(6.8±3.9)％,CD4+ CXCR5+ Tfh细胞上PD-1和CD40L的表达水平升高,血清IL-21及CXCL13水平升高,而IFN-γ水平降低,差异具有统计学意义(P＜0.05).结论 外周血CD4+ CX-CR5+ Tfh细胞与乙肝高球蛋白血症的发病相关.     

人肠道正常粘膜组织与外周血中记忆性IL-22~+T淋巴细胞频率及表型的比较

目的比较人肠道正常粘膜组织与外周血中IL-22+T淋巴细胞的频率及其表型特征。方法分离人肠道正常粘膜与外周血中单个核细胞,anti-CD3+anti-CD28刺激后,采用流式细胞术(FACS)检测IL-22的产生及其与IFN-γ、IL-17的关系,分析IL-22+T淋巴细胞CD45RO,CD62L,CCR7,CCR6,CCR10,CCR4等表面分子的表达。结果与anti-CD3+anti-CD28刺激外周血中CD4+和CD8+T淋巴细胞产生少量的IL-22(0.6%;0.57%)相比,肠道粘膜CD4+T细胞产生大约3.15%的IL-22,CD8+T淋巴细胞产生4%左右的IL-22。此外,肠道粘膜CD4+和CD8+T细胞中存在一群产生IL-22并独立于Th1、Th17,Tc1、Tc17的细胞亚群。肠道粘膜IL-22+T细胞表达较高比例的CD45RO,其中部分细胞表达CCR7,而较少表达CD62L。进一步研究表明,肠道粘膜CD4+IL-22+和CD8+IL-22+T细胞表达较高水平的CCR10(55.3%;73.9%),部分细胞表达CCR6或CCR4。结论人肠道正常粘膜组织中IL-22主要由效应型或中央型记忆T细胞产生,部分IL-22+T细胞独立于Th1、Th17,Tc1、Tc17细胞亚群。     

Th22细胞的研究进展

Th22细胞是最近发现的CD4~+T细胞功能亚群,表达CCR6、CCR4和CCR10,产生IL-22和IL-13,但是不产生IFN-γ、IL-4和IL-17,是独立于Th1、Th2和Th17的细胞亚群.IL-6和TNF能够诱导初始CD4~+T细胞向Th22细胞分化.     

IL-4、IL-10和抗IL-12受体β1 mAb抑制IL-23诱导正常人记忆T细胞 IFN-γ产生

目的 探讨重组人白介素23（IL-23）是否能够诱导正常人T细胞IFN-γ的产生，作用的靶细胞亚群和调节因素。方法 正常人PBMC在抗CD3（anti-CD3）单克隆抗体或anti-CD3和抗CD28（anti-CD28）单克隆抗体刺激的条件下与IL-23进行培养，采用酶联免疫吸附试验（ELISA）检测细胞培养液中IFN-γ的水平；同时采用流式细胞仪，在单个细胞水平上分析IL-23诱导PBMC IFN-γ表达的T细胞亚群。结果 在未经任何刺激的情况下，PBMC产生很低或不产生IFN-γ。IL-23呈剂量依赖方式促进由anti-CD3活化的PBMC IFN-γ产生。细胞亚群分析的结果表明，IL-23诱导记忆CD4^＋和CD8^＋T细胞表达IFN-γ，对活化的CD4^＋T细胞作用较为明显。Th2细胞因子（IL-4、IL-10）和抗IL-12受体β1 mAb（IL-12Rβ1）抑制IL-23诱导T细胞IFN-γ产生。结论 IL-23促进活化的记忆CD4^＋和CD8^＋T细胞IFN-γ的产生。Th2细胞因子和抗IL-12Rβ1 mAb抑制由IL-23诱导IFN-γ产生，提示这些细胞因子和抗体对IL-23引起的自身免疫病具有拮抗作用。     

外周血循环滤泡辅助性T 细胞及IL-21 在银屑病中的表达及意义

目的:探讨外周血循环滤泡辅助性T 细胞(Follicular helper T cells,Tfh)及相关细胞因子IL-21 在银屑病患者中的表达水平及其与疾病活动度的关系。方法:收集38 例银屑病患者及32 例健康对照者,流式细胞术检测外周血循环CD4+CXCR5+ Tfh 和CD4+ CXCR5+ ICOS+ Tfh 细胞比例以及Th17 细胞比例;ELISA 检测血清IL-21 浓度;分析这些指标间及与银屑病疾病活动度评分PASI 间的相关性。结果:与健康对照者相比,银屑病患者外周血循环CD4+ CXCR5+ Tfh 和CD4+ CXCR5+ ICOS+Tfh 细胞比例更高,血清IL-21 浓度和Th17 细胞比例亦显著高于对照组(P<0.05);IL-21 浓度与CD4+ CXCR5+ Tfh 和CD4+CXCR5+ ICOS+ Tfh 细胞比例均显著正相关,而与Th17 细胞比例间无显著相关性(P>0.05);且CD4+ CXCR5+ ICOS+ Tfh 细胞比例和血清IL-21 与银屑病疾病活动度PASI 评分显著正相关,而CD4+ CXCR5+ Tfh 则与之无显著相关性(P>0.05)。结论:银屑病患者外周血循环Tfh 比例、IL-21 浓度上调与银屑病患者疾病活动度密切相关,提示Tfh 可能参与银屑病的发生发展过程,这一效应可能是通过分泌高水平IL-21 实现;IL-21 浓度与Tfh 细胞比例相关,而与Th17 细胞比例无相关性提示银屑病患者IL-21可能主要由Tfh 细胞分泌。     

IL-21在不同乙型肝炎病毒感染者外周血CD4~+T细胞中表达的初步研究

目的:探讨乙肝病毒感染不同临床表现患者外周血CD4+T细胞中IL-21表达的差异及其在发病机制中的作用。方法:分离乙肝病毒感染不同临床表现患者及健康人外周血单个核细胞(PBMC),使用PMA+ionomycin进行刺激,同时每份标本未加PMA+ionomycin刺激做阴性对照,流式细胞术(FCM)检测IL-21的表达情况及其与Th17细胞亚群的关系。结果:PMA+ionomycin刺激能够诱导IL-21的产生,产生IL-21的主要为CD4+T细胞,IL-17A+IL-21+CD4+T细胞几乎检测不到,IL-21+CD4+T细胞比例在急性乙型肝炎组、乙肝病毒携带组中较正常对照组和慢重肝组有所升高,Th17细胞亚群比例在各组中没有统计学差异;除急性乙型肝炎组外,其余各组中IL-21+CD4+T细胞比例与Th17细胞亚群比例均有较好的相关性。结论:IL-21在HBV感染不同临床表现患者外周血CD4+T的表达有一定差异,并且其与Th17细胞亚群有相关性,提示IL-21在HBV感染的发病机制可能发挥一定作用。     

环孢素A抑制正常人外周血记忆CD4~＋T细胞产生IL-22的实验研究

目的探讨环孢素A（CsA）是否能够抑制正常人CD4＋T细胞产生白细胞介素22（IL-22）。方法使用密度梯度离心法制备正常人外周血单个核淋巴细胞（PBMCs）,加入PMA＋Inomycin刺激细胞后,做细胞内细胞因子染色,流式细胞仪检测正常人外周血PBMCs中产生IL-22的T细胞亚群,以及IL-17-IFN-γ-IL-22＋CD4＋T细胞亚群（Th22）;PMA＋Inomycin刺激正常人PBMCs,同时加或不加环孢素A（CsA）后,做细胞内细胞因子染色,流式细胞仪检测IL-22＋CD4＋T细胞和IFN-γ＋CD4＋T细胞的比例,以及IL-22＋CD4＋T细胞表达记忆表型分子CD45RO情况。结果正常人外周血中产生IL-22的T细胞以CD4＋T细胞为主,且存在仅分泌IL-22,不分泌IL-17和IFN-γ的Th22亚群;CsA以剂量依赖方式抑制CD4＋T细胞产生IL-22和IFN-γ;CsA抑制外周血PBMCs中记忆CD4＋T细胞产生IL-22。结论 CsA能抑制正常人外周血中记忆CD4＋T细胞产生IL-22。     

CD4~+效应T细胞在自身免疫性溶血性贫血患者外周血的变化研究

目的研究自身免疫性溶血性贫血(AIHA)患者外周血中效应T细胞亚群Th1和Th17数量和比例的变化,探讨其在AIHA发病中的作用。方法选择30例AIHA患者,分离外周血单核细胞(PBMC),采用流式细胞术检测Th1和Th17细胞频率,用ELISA测定培养上清中IFN-γ和IL-17水平,并与健康对照组比较。结果 AIHA患者PBMC中IFN-γ+Th1和IL-17+Th17细胞频率均显著高于健康对照组(P<0.01);而且,AIHA患者外周血IL-17水平明显高于健康对照组(P<0.05),但IFN-γ水平在患者和正常人之间差异不显著。结论Th17与Th1细胞亚群可能参与AIHA患者的免疫学发病机制。     

流式细胞术鉴定人外周血滤泡辅助性T细胞

目的:用免疫荧光染色和流式细胞术(FCM)鉴定正常人外周血单个核细胞(PBMC)中滤泡辅助性T(Tfh)细胞, 以便对其功能进行进一步研究.方法:密度梯度离心法分离人PBMC, 采用不同荧光素标记的抗CXCR5、 CD4及CD19抗体进行染色FCM分析, 鉴定出表型为CD4+CXCR5+的T细胞亚群.结果:外周血可以检测到CD4+CXCR5+T细胞亚群, 占CD4+T淋巴细胞百分比为(11.09±0.38)%, MFI值为25.78±0.72, 低于B细胞膜表面CXCR表达水平(MFI值为99.6±8.1).结论:健康人外周血存在一定比例的Tfh细胞, 应用FCM可以成功鉴定Tfh细胞, 为进一步研究其功能提供了良好的技术平台.     

Pain and Effusion and Quadriceps Activation and Strength

Context:

Quadriceps dysfunction is a common consequence of knee joint injury and disease, yet its causes remain elusive.

Objective:

To determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion affect the magnitude of quadriceps dysfunction.

Design:

Crossover study.

Setting:

University research laboratory.

Patients or Other Participants:

Fourteen (8 men, 6 women; age = 23.6 ± 4.8 years, height = 170.3 ± 9.16 cm, mass = 72.9 ± 11.84 kg) healthy volunteers.

Intervention(s):

All participants were tested under 4 randomized conditions: normal knee, effused knee, painful knee, and effused and painful knee.

Main Outcome Measure(s):

Quadriceps strength (Nm/kg) and activation (central activation ratio) were assessed after each condition was induced.

Results:

Quadriceps strength and activation were highest under the normal knee condition and differed from the 3 experimental knee conditions (P < .05). No differences were noted among the 3 experimental knee conditions for either variable (P > .05).

Conclusions:

Both pain and effusion led to quadriceps dysfunction, but the interaction of the 2 stimuli did not increase the magnitude of the strength or activation deficits. Therefore, pain and effusion can be considered equally potent in eliciting quadriceps inhibition. Given that pain and effusion accompany numerous knee conditions, the prevalence of quadriceps dysfunction is likely high.Key Words: arthrogenic muscle inhibition, central activation failure, voluntary activation, muscles

Key Points

• Knee pain and effusion resulted in arthrogenic muscle inhibition and weakness of the quadriceps.
• The simultaneous presence of pain and effusion did not increase the magnitude of quadriceps dysfunction.
• To reduce arthrogenic muscle inhibition and improve muscle strength, clinicians should employ interventions that target removing both pain and effusion.

Quadriceps weakness is a common consequence of traumatic knee joint injury^1,2 and chronic degenerative knee joint conditions.^3,4 Arthrogenic muscle inhibition (AMI), a neurologic decline in muscle activation, results in quadriceps weakness and hinders rehabilitation by preventing gains in strength.⁵ The inability to reverse AMI and restore muscle function can lead to decreased physical abilities,⁶ biomechanical deficits,⁷ and possibly reinjury.⁵ Furthermore, researchers^8,9 have suggested that quadriceps weakness resulting from AMI may place patients at risk for developing osteoarthritis in the knee. In light of the substantial influence of quadriceps AMI on these clinically relevant outcomes, we need to improve our understanding of the factors that contribute to this neurologic decline in muscle activity so efforts to target and reverse it can be implemented and gains in strength can be achieved more easily.Joint injury and disease are accompanied by numerous sequelae (ie, pain, swelling, tissue damage, inflammation), so ascertaining which one ultimately leads to neurologic muscle dysfunction is difficult. Whereas a joint effusion can result in AMI,^10–12 the effects of pain are less understood despite many clinicians attributing AMI to pain. Using techniques that introduce knee pain without accompanying injury may provide insights into the role of pain in eliciting AMI.The degree of knee joint damage may play a role in the quantity of AMI that manifests. Hurley et al^13,14 demonstrated that quadriceps AMI, measured using an interpolated-twitch technique, was greater in patients with extensive traumatic knee injury (eg, fractured tibial plateau, ruptured medial collateral ligament, and medial meniscectomy) than patients with isolated joint trauma (ie, isolated anterior cruciate ligament [ACL] rupture). Similarly, patients with more knee joint symptoms (ie, greater number of symptoms and increased severity of symptoms) may present with greater magnitudes of quadriceps inhibition. Recently, investigators¹⁵ have suggested that patients with more pain display less quadriceps strength, supporting this tenet. Given that effusion and pain often present simultaneously with joint injuries and diseases, such as ACL injury and osteoarthritis, examining both the isolated and cumulative effects of these sequelae appears warranted to determine if they influence the magnitude of muscle inhibition.Experimental joint-effusion and pain models are safe and effective experimental methods that allow for the isolated examination of their effects on muscle function. The effusion model, whereby sterile saline is injected directly into the knee joint capsule,⁷ produces a clinically relevant magnitude of the joint effusion that may be present with traumatic injury. Effusion is thought to activate group II afferents responding to stretch or pressure,^16–18 which in turn may facilitate group Ib interneurons and result in quadriceps AMI.⁵ The pain model involves injecting hypertonic saline into the infrapatellar fat pad to produce anteromedial knee pain similar to that described in patients with patellofemoral pain syndrome.¹⁹ Pain is considered to initiate AMI through activation of group III and IV afferents that act as nocioceptors to signal damage or potential damage to joint structures.^16–18 The firing of these afferents then may lead to facilitation of group Ib interneurons, the flexion reflex, or the gamma loop, ultimately resulting in quadriceps inhibition.²⁰ Thus, these models allow us to create symptoms that are associated with knee injury and have the added benefit of providing a way to examine their effects in isolation.Therefore, the purpose of our study was to determine the effects of pain on quadriceps strength and activation and to learn if simultaneous pain and knee joint effusion would affect the magnitude of quadriceps dysfunction. We hypothesized that pain alone would result in quadriceps inhibition and that the magnitude of inhibition would be greater when effusion and pain were present simultaneously.     

即早基因c-fos与脑血管病及学习记忆

即早基因c-fos是广泛存在于原核细胞和真核细胞的高度保守基因.在正常情况下,c-fos基因参与细胞生长、分化、信息传递、学习和记忆等生理过程,而在病理情况下c-fos基因表达及调控变化与多种疾病的发生和发展有关.C-fos在中枢神经系统的某些部位可有基础水平的表达,但表达很低,当受到如脑缺血、脑出血、痫性发作、应激等刺激后,其在数十分钟内做出反应,在对外界刺激-转录耦联的信忠传递过程中起着核内第三信使的重要作用.     

Opportunities and challenges in the prevention and control of cancer and other chronic diseases: children's diet and nutrition and weight and physical activity

OBJECTIVE: The purpose of this article is to review the role of behavioral research in disease prevention and control, with a particular emphasis on lifestyle- and behavior-related cancer and chronic disease risk factors--specifically, relationships among diet and nutrition and weight and physical activity with adult cancer, and tracking developmental origins of these health-promoting and health-compromising behaviors from childhood into adulthood. METHOD: After reviewing the background of the field of cancer prevention and control and establishing plausibility for the role of child health behavior in adult cancer risk, studies selected from the pediatric published literature are reviewed. Articles were retrieved, selected, and summarized to illustrate that results from separate but related fields of study are combinable to yield insights into the prevention and control of cancer and other chronic diseases in adulthood through the conduct of nonintervention and intervention research with children in clinical, public health, and other contexts. RESULTS: As illustrated by the evidence presented in this review, there are numerous reasons (biological, psychological, and social), opportunities (school and community, health care, and family settings), and approaches (nonintervention and intervention) to understand and impact behavior change in children's diet and nutrition and weight and physical activity. CONCLUSIONS: Further development and evaluation of behavioral science intervention protocols conducted with children are necessary to understand the efficacy of these approaches and their public health impact on proximal and distal cancer, cancer-related, and chronic disease outcomes before diffusion. It is clear that more attention should be paid to early life and early developmental phases in cancer prevention.