可溶性血管细胞粘附分子1、白细胞介素6及肿瘤坏死因子α在妊高征发病中的作用

目的：研究可溶性血管细胞粘附分子1(soluble vaseular cell adhesion molecule-1，sVCAM-1)、白细胞介素6(interleukin-6，IL-6)及肿瘤坏死因子α(tumor necrosis factor-α，TNF-α)在妊高征发病中的作用。方法：测定67例孕妇血清中sVCAM-1、IL-6、TNF-α水平，其中正常妊娠组15例，妊高征组52例，包括轻度14例、中度18例、重度20例。用酶联免疫吸附法(EUSA)测定sVCAM-1，用放射免疫法(RIA)测定IL-6及TNF-α。结果：中、重度妊高征患者血中sVCAM-1、IL-6、TNF-α水平均显著高于正常妊娠组(P<0．01)，轻度妊高征患者与正常妊娠组相比，虽无统计学差异，但有升高趋势。妊高征组产后各项指标下降与正常妊娠组差异无显著性(P>0．05)。sVCAM-1与平均动脉压呈正相关(r=0．542，P<0．01)，IL-6、TNF-α与sVCAM-1也呈正相关(r=0．435，P<0．01及r=0．532．P<0．01)。结论：妊高征患者血中sVCAM-1水平升高表明内皮细胞损伤在妊高征的发病中起重要作用。IL-6、TNF-α可诱导sVCAM-1的表达。     

Longitudinal analysis of soluble intercellular adhesion molecule 1 in retinal vasculitis patients

Abstract. Increased levels of soluble intercellular adhesion molecule 1 (sICAM-1) in serum have been demonstrated in several human disease conditions. We have previously shown, in a point-prevalence study, a positive correlation between sICAM-1 levels and disease relapse in patients with idiopathic retinal vasculitis. We now report a longitudinal study over 1 year in which sICAM-1 levels were compared with clinical disease status in order to determine this relationship further. Serum samples from 11 patients with idiopathic retinal vasculitis were tested for the presence of sICAM-1 by enzyme linked immunosorbent assay. Eight control subjects were also tested. Five out of 11 patients presented with relapse and had raised sICAM-1 levels compared with quiescent periods of their disease. Five out of 11 patients showed no relapse over 1 year and also no increase in sICAM-1 levels. One patient showed increased levels of sICAM-1, but no clinical signs of relapse. These results indicate that sICAM-1 is associated with disease activity in retinal vasculitis patients and could indicate dysfunction of the blood-retina barrier.     

鼻内应用肾上腺皮质激素治疗鼻息肉后ICAM-1及sICAM-1的表达及意义

目的:检测鼻内应用肾上腺皮质激素(激素)治疗鼻息肉前后鼻息肉组织中的细胞间黏附分子-1(intercellular adhesion molecule-1,ICAM-1)和鼻分泌物中的可溶性细胞间黏附分子-1(soluble intercellular adhesion molecule-1,sICAM-1)表达水平的变化,探讨ICAM-1、sICAM-1两者间关系及其在鼻息肉发展过程中的作用及鼻内应用激素治疗鼻息肉的可能机制.方法:选择19例未用药的鼻息肉患者(未用药组)、14例经鼻内应用激素(氟替卡松)治疗后的鼻息肉患者(激素治疗组)、12名正常人(正常对照组),取其鼻息肉或鼻黏膜组织及鼻分泌物,用ELISA法检测其鼻息肉或鼻黏膜组织匀浆中ICAM-1和鼻分泌物中sICAM-1的含量并作比较.结果:未用药组鼻息肉组织匀浆中ICAM-1的含量及鼻分泌物中sICAM-1的含量,较激素治疗组及正常对照组为高(均为P＜0.01),而激素治疗组与正常对照组鼻黏膜组织匀浆中ICAM-1的含量和鼻分泌物中sICAM-1的含量比较差异无统计学意义(P＞0.05).未用药组鼻息肉组织匀浆中ICAM-1及鼻分泌物sICAM-1含量呈线性相关(r=0.843,P=0.000).结论:鼻内应用激素的治疗效果可能与其抑制ICAM-1的表达有关.在未受药物干扰的情况下,鼻分泌物中 sICAM-1的含量也能很好的反映鼻息肉组织中ICAM-1的表达情况.     

Cytokine profiles in bronchoalveolar lavage fluid and blood in HIV-seropositive patients with Pneumocystis carinii pneumonia

Concentrations and ex vivo production of interleukin 1β (IL-1), tumour necrosis α (TNF), interleukin 6 (IL-6), interleukin-1 receptor antagonist (IL-1RA) and TNF soluble receptors (sTNF-receptors, P55 and P75) were measured in bronchoalveolar lavage (BAL) fluid and blood in 23 HIV-seropositive (HIV+) patients with Pneumocystis carinii pneumonia (PCP) and compared with values found in healthy HIV-seronegative (HIV−) controls and asymptomatic HIV+ subjects. Concentrations of the proinflammatory cytokine IL-1β were increased in BAL fluid of HIV+ patients with PCP (184 ± 47 pg mL⁻¹) compared with undetectable levels in healthy control subjects ( P  = 0.0001). In plasma of these patients higher concentrations of the anti-inflammatory cytokine IL-1RA were found during acute PCP than after recovery (2.1 ± 0.7 vs. 0.5 ± 0.2 ng mL⁻¹, P  = 0.01). No correlations could be found between cytokine concentrations and clinical severity of the infection. Corticosteroid treatment did not influence cytokine concentrations in BAL or blood, nor did it suppress the production in alveolar cells. In whole-blood cultures, however, lipopolysaccharide (LPS)-stimulated production was significantly suppressed for IL-1 (1.3 vs. 5.5 ng mL⁻¹, P  = 0.009) and for IL-6 (0.6 vs. 2.5 ng mL⁻¹, P  = 0.01). The overall data show that in HIV+ patients with PCP (similar to what we had found previously in HIV− patients with PCP) proinflammatory cytokines are more prominently present in BAL, whereas anti-inflammatory reaction is predominant in the circulation.     

Acute-phase response patterns in isolated hepatic perfusion with tumour necrosis factor α (TNF-α) and melphalan in patients with colorectal liver metastases

BACKGROUND: In this study, we have evaluated hepatotoxicity, secondary cytokine production and hepatic acute-phase response (APR) in patients who underwent isolated hepatic perfusion (IHP) with tumour necrosis factor (TNF) alpha and melphalan for irresectable colorectal liver metastases. DESIGN: An extracorporeal veno-venous bypass was used to shunt blood from the lower body and intestines to the heart. Inflow catheters were placed in the hepatic artery and portal vein, and an outflow catheter in the inferior caval vein. The liver was perfused for 60 min with 0.4 mg of TNF-alpha plus 1 mg kg-1 melphalan (IHPTM group, n = 6) or 1 mg kg-1 melphalan (IHPM group, n = 3). The liver was washed with macrodex before restoring vascular continuity. RESULTS: After the washout procedure, a TNF-alpha peak (169 +/- 38 pg mL-1) was demonstrated in the IHPTM group only. Both groups demonstrated peak levels of interleukin 6 (IL-6) in the perfusate as well as systemically. These were significantly higher in the IHPTM group. Acute-phase protein (APP) levels followed a similar pattern as has been demonstrated after major surgery, with no significant differences between both groups. The addition of TNF-alpha to the perfusate did not lead to a significant difference in APP levels and the time course between groups. CONCLUSIONS: IHP with TNF and melphalan is followed by a transient systemic peak of TNF directly after liver washout. Secondary IL-6 induction was seen in the present study after IHP with and without TNF, which was highest when TNF was added. This phenomenon cannot be extrapolated to APP induction, which appeared unaffected by the addition of TNF, presumably because the surgical procedure itself already causes maximal stimulation of APP production.     

Elevated cell-associated levels of interleukin 1β and interleukin 6 in inflamed mucosa of inflammatory bowel disease

The aim of this study was to investigate the involvement of the monocyte-derived cytokines interleukin 1β (IL-1β), interleukin 6 (IL-6) and tumour necrosis factor-α (TNF-α) in idiopathic inflammatory bowel disease. Endoscopic biopsies of normal and inflamed intestinal mucosa were obtained from patients with ulcerative colitis ( n  = 11) and with Crohn's disease ( n  = 10). Intestinal mucosal cells were isolated by collagenase digestion. Cell viability, morphology and CD14 expression were determined. To measure cell-associated cytokine levels, cells were lysed and analysed for IL-1β and TNF-α in specific radioimmunoassays and for IL-6 using a biological assay. Compared with mucosal cells from control patients without inflammatory bowel disease the inflamed intestine in ulcerative colitis and Crohn's disease displayed markedly enhanced levels of IL-1β (median 245 pg 10⁻⁶ cells, range 30–1275) and IL-6 (median 22 U 10⁻⁶ cells, range 1–298). Non-inflamed mucosa in patients with ulcerative colitis and Crohn's disease did not shown elevated levels of IL-1β (median 50 pg 10⁻⁶ cells, range 33–90) or IL-6 (mean below detection limit of assay, i.e. 1 U 10⁻⁶ cells). In contrast, no clear cut difference between inflamed and non-inflamed mucosa could be detected for TNF-α. High tissue levels of IL-6 were associated with a high endoscopic grade of local inflammation. These results suggest that the monocyte-derived cytokines IL-1β and IL-6 are mediators of inflammation in inflammatory bowel disease.     

Comparison of soluble ICAM-1, VCAM-1 and E-selectin levels in patients with episodic cluster headache and giant cell arteritis

The pathophysiology of cluster headache (CH) is supposed to involve the lower posterior part of the hypothalamus, the trigeminal nerve, autonomic nerves and vessels in the orbital/retro-orbital region. The exact connection of this hypothalamic–trigemino–autonomic–vascular axis is not fully understood. The presence of inflammation in the perivascular tissue of the retro-orbital region has been presented as a possible mechanism behind the pain and the sympatheticoplegia sometimes observed during headache attacks. In a previous study we found neither increased levels of erythrocyte sedimentation rate, C-reactive protein or acute-phase reactants nor clinical signs of a generalized inflammatory disorder. However, these tests may not be sensitive enough to detect a focal inflammatory process in the retro-orbital region. In the present study, we analysed serum levels of three soluble adhesion molecules; soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular cell adhesion molecule-1 (sVCAM-1) and soluble E-selectin (sE-selectin) in patients with episodic CH and in patients with biopsy-positive giant cell arteritis (GCA), a known vasculitic disorder of large and medium-sized arteries. A control group of healthy volunteers was also included. Within the CH group, sICAM-1, sVCAM-1 and sE-selectin showed an increasing trend in remission compared with the active CH period, but the difference was statistically significant for sE-selectin only. The mean sICAM-1 value was higher in patients with active GCA than in CH patients during the active cluster period. Compared with the healthy control group, the mean levels of soluble adhesion molecules in CH patients also tended to be higher, but statistically significantly so only for sVCAM-1. We hypothesize that CH is not a vasculitic disorder of the medium-sized arteries, but CH patients may have an immune response that reacts differently from that of healthy volunteers.     

Circulating soluble adhesion molecules ICAM-1 and VCAM-1 and their association with clinical outcome, troponin T and C-reactive protein in patients with acute coronary syndromes

OBJECTIVES: The aim of this study was to compare concentrations of soluble intercellular adhesion molecule (ICAM-1) and vascular cell adhesion molecule (VCAM-1) in patients with coronary artery disease and healthy control and to evaluate the usefulness of the inflammatory markers as predictors of adverse prognosis in patients with acute coronary syndromes (ACS). DESIGN AND METHODS: ELISA was used to measure sICAM-1 and sVCAM-1 levels in 75 patients with ACS, 36 patients with stable angina pectoris (SAP) and 25 healthy subjects. hsCRP was measured with immunoturbidimetric assay, cardiac troponin T-with electrochemiluminescence immunoassay. RESULTS: All soluble ICAM-1 and VCAM-1 significantly discriminated between patients with ACS and SAP (p=0.014 and 0.05, respectively) and control subjects (p<0.001 and 0.05). During the 6-month follow-up of the patients with ACS, there were 28 major cardiac events (37.3%). The odds ratio associated with the highest value of sVCAM-1 was 4.62 (95% CI 1.8-11.4, p=0.0009) without adjustment and remained significantly elevated after adjustment for cTnT (RR 3.93, 1.5-10, p=0.04) and hsCRP (RR 2.22, 0.8-5.7, p=0.05). In contrast, an elevated level of sICAM-1 was not associated with future coronary risk after adjustment for cTnT and hsCRP. CONCLUSIONS: In patients with acute coronary syndromes, VCAM-1 serum levels powerfully predict an increased risk for subsequent cardiovascular events and extend the prognostic information gained from traditional biochemical markers.     

Effects of angiotensin II-receptor blockers on soluble cell adhesion molecule levels in uncomplicated systemic hypertension: An observational, controlled pilot study in Taiwanese adults

Background:

Controversy exists as to whether individuals with hypertension without risk factors for atherosclerosis (eg, diabetes mellitus, dyslipidemia,

Objective:

The aim of this study was to determine whether (1) levels of solubleCAMs (sCAMs) (soluble E-selectin [sE-selectin], soluble intercellular adhesion molecule-1 [sICAM-1 ], soluble vascular cell adhesion molecule-1 [sVCAM-1 ], and von Willebrand factor [vWF]) are elevated in Taiwanese adults with uncomplicated essential hypertension without other risk factors; (2) CAM levels increase with severity (stage) of hypertension; and (3) monotherapy with the angiotensin II-receptor blocker (ARB) irbesartan modulates CAM expression in a subgroup of these patients.

Methods:

This observational, controlled pilot study was conducted at the Hypertension Clinic, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan. Adult patients with uncomplicated essential hypertension without other risk factors (eg, diabetes mellitus, dyslipidemia, obesity) and normotensive controls were eligible. Blood pressure (BP) was determined using 24-hour ambulatory BP monitoring (ABPM) in all participants, and the staging of hypertension was classified based on criteria in The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (normotensive, prehypertension, stage I hypertension, and stage II hypertension). The SCAM levels and 24-hour ABPM were measured before and after 8 weeks of open-label irbesartan monotherapy in a subgroup of the patients with hypertension. Patients who had difficulty achieving the target BP values on irbesartan monotherapy were treated with combination therapy (2 or 3 antihypertensive agents); levels of sCAMs were not measured in these patients. Plasma levels of sE-selectin, the sCAMs, and vWF were measured using enzyme-linked immunosorbent assay.

Results:

The study comprised 61 patients with uncomplicated essentialhypertension (33 men and 28 women; mean [SD] age, 51 [12] years) and 17 normotensive controls (11 men, 6 women; mean [SD] age, 52 [ 11 ] years). The mean (SD) dose of irbesartan was 243 (63) mg. Hypertensive patients had significantly higher circulating levels of sICAM-1 compared with normotensive controls (P = 0.009). No significant differences in levels of sVCAM-1, sE-selectin, or vWF were found between hypertensive patients and controls. The mean sICAM-1 level was significantly higher in the prehypertensive patients compared with normotensive controls (P = 0.03). The mean sE-selectin level was significantly higher in the patients with stage I hypertension compared with the prehypertensive group (P = 0.01). The 18 patients given 8 weeks of irbesartan monotherapy showed a significant decrease from baseline in systolic and diastolic BP (both, P = 0.001) and sE-selectin (P= 0.006), but not in sVCAM-1 or sICAM. Forty-three patients did not reach target BP on irbesartan monotherapy and thus were treated with combination therapy.

Conclusions:

Based on the results of this observational, controlled pilotstudy in Taiwanese patients, we suggest that ARB therapy, in addition to reducing BP, has the potential to suppress CAM expression and to improve endothelial dysfunction in hypertension.     

血液透析对慢性肾功能衰竭患者血清SIL2R、IL6和TNFα的影响

目的：探讨慢性肾功能不全（ＣＲＦ）患者细胞免疫功能状况,以及血液透析（血透）的影响。方法：应用酶联免疫吸附（ＥＬＩＳＡ）双抗体夹心法检测３０例ＣＲＦ未透析患者和６２例血透患者血透前后及对照组血清可溶性白介素－α受体（ＳＩＬ－２Ｒ）、白介素－６（ＩＬ－６）和肿瘤坏死因子－α（ＴＮＦ－α）水平。结果：与对照组相比,ＣＲＦ未透析患者和血透患者血清ＳＩＬ－２Ｒ、ＩＬ－６和ＴＮＦ－α水平无显著差异。血清ＳＩＬ－２Ｒ较透前显著增高。结论：ＣＲＦ患者均存在显著的细胞免疫功能紊乱,单次透析对细胞免疫功能无显著影响。     

The effects of three different LDL-apheresis methods on the plasma concentrations of E-selectin, VCAM-1, and ICAM-1

Plasma concentrations of cellular adhesion molecules are associated with atherosclerotic diseases and major cardiovascular risk factors. It was shown that LDL-apheresis with dextran sulfate lowers the levels of E-selectin and ICAM-1 in patients with familial hypercholesterolemia. The effects of different LDL-apheresis methods have not been studied yet. Cholesterol, triglycerides, LDL cholesterol, HDL cholesterol, fibrinogen, and the adhesion molecules E-selectin, VCAM-1, and ICAM-1 were measured in 20 patients with coronary heart disease and severe hyperlipoproteinemia immediately before and after regular LDL-apheresis. Treatment was performed by different apheresis methods (direct absorption, DA, n = 6; dextran sulfate adsorption, DS, n = 7; heparin precipitation, HP, n = 7). Rebound data of adhesion molecule levels were obtained from 2 patients of each group. Lipids were reduced similarly in all groups. The concentrations of all adhesion molecules were lowered during apheresis. The reduction of E-selectin (-31 +/- 7 vs. -6 +/- 5 and -6 +/- 5%, respectively, P < 0.001) was most prominent in the patients treated by heparin precipitation. Depending on the method of LDL-apheresis, the concentrations of VCAM-1 and E-selectin in the outlets of the LDL-apheresis columns were significantly lower compared to the concentration in the inlets. Plasma concentrations of adhesion molecules increased to their pre-apheresis values within 2 to 4 days following LDL-apheresis. The reductions of adhesion molecule levels observed during LDL-apheresis are at least partly due to adsorption to the LDL-apheresis column. The extent of absorption depends on the principle of extracorporeal LDL elimination.     

VCAM-1和E选择素在血栓闭塞性脉管炎患者血管壁中的表达及其临床意义

目的探讨血管内皮细胞黏附分子-1(VCAM-1)和E选择素(E-selectin)在血栓闭塞性脉管炎(TAO)患者血管壁中的表达及其临床意义。方法取因血栓闭塞性脉管炎行截肢手术的18例患者和因非血管疾病行截肢手术的16例患者的血管组织,采用免疫组织化学法检测组织中VCAM-1和E选择素的表达并与临床资料进行相关性分析。结果TAO患者血管壁中VCAM-1阳性表达率为77.8%(14/18),E选择素阳性表达率为72.2%(13/18),明显高于对照组的6.3%(1/16)和6.3%(1/16),差异均有统计学意义(P0.01)。VCAM-1和E选择素的阳性率与患者年龄、吸烟量、吸烟时间、药物使用情况没有相关性(P0.05)。结论 VCAM-1和E选择素的表达与TAO的发生、发展关系密切,检测VCAM-1和E选择素表达可以作为TAO的诊断指标。     

Serum homocysteine is weakly associated with von Willebrand factor and soluble vascular cell adhesion molecule 1, but not with C-reactive protein in type 2 diabetic and non-diabetic subjects - The Hoorn Study

BACKGROUND: Hyperhomocysteinaemia may constitute an independent risk factor for cardiovascular disease, but it is still unclear by which pathophysiological mechanisms homocysteine (tHcy) may promote atherothrombosis. The aim of this study was firstly to examine whether tHcy is associated with endothelial dysfunction, increased adherence of leukocytes, and/or chronic low-grade inflammation, as estimated from plasma levels of von Willebrand factor (vWf), soluble vascular cell adhesion molecule 1 (sVCAM-1) and C-reactive protein (CRP), respectively. Secondly we investigated whether the presence of type 2 diabetes modifies these associations. MATERIALS AND METHODS: Six hundred and ten subjects of a general population of middle-aged and elderly subjects, 170 of whom had type 2 diabetes, participated in this cross-sectional study. Linear regression analyses were used to study whether tHcy was associated with vWf, sVCAM-1 and CRP, and whether the presence of diabetes modified these associations. RESULTS: After adjustment for confounders, tHcy was significantly but weakly associated with vWf (beta = 0.15, P = 0.05) and sVCAM-1 (beta = 0.082, P = 0.04). tHcy was not significantly associated with CRP (beta = 0.02, P = 0.91). The presence of diabetes did not significantly modify these associations. CONCLUSIONS: This study provides evidence that tHcy is, at most, weakly associated with endothelial dysfunction as estimated from plasma vWf, and with leukocyte adhesion as estimated from plasma sVCAM-1. tHcy was not significantly associated with chronic low-grade inflammation as estimated from plasma CRP. Our data thus suggest that the link between tHcy and atherothrombosis cannot be explained by associations of tHcy with vWf, sVCAM-1 or CRP.     

黏附分子和细胞因子在支气管哮喘中的变化及意义

目的探讨支气管哮喘患者外周血黏附分子和细胞因子的变化及其临床意义。方法将本院收治并诊断为支气管哮喘发作期的患者38例作为研究组,同时选取本院门诊体检的健康志愿者38例作为健康对照组,采用流式细胞仪检测两组外周血清细胞间黏附分子-1(sICAM-1)水平,并应用酶联免疫吸附试验检测血液中内皮细胞黏附分子-1(VCAM-1)、白细胞介素-6(IL-6)、IL-8及肿瘤坏死因子-α(TNF-α)水平。结果 (1)与健康对照组相比,研究组患者外周血sICAM-1、VCAM-1表达显著增高,两组数据间差异有统计学意义(P<0.01);(2)研究组患者血清IL-6、IL-8及TNF-α水平显著高于健康对照组,两组数据间差异有统计学意义(P<0.05)。结论支气管哮喘发作患者外周血sICAM-1、VCAM-1、IL-6、IL-8及TNF-α水平显著提高,提示黏附分子和细胞因子异常是参与支气管哮喘发病的重要机制之一。     

贝前列素钠对早期糖尿病肾病患者血清可溶性细胞间黏附分子1、C反应蛋白及尿微量白蛋白排泄率影响的临床观察

目的 观察贝前列素钠对早期糖尿病肾病(DN)患者的临床疗效.方法 测定27例糖尿病无肾病患者(糖尿病无肾病组)、48例早期DN(DN组)患者血清可溶性细胞间黏附分子1(sICAM-1)浓度,并将48例早期DN患者随机分为两组,常规治疗组和贝前列素钠治疗组,各24例,测定两组治疗前后sICAM-1、C反应蛋白(CRP)及尿微量白蛋白排泄率(UAER)的变化.结果 早期DN患者血清sICAM-1浓度[(1385±171) g/L与(943±167) g/L;t=1.034,P=0.002]明显高于糖尿病无肾病组.贝前列素钠治疗组与常规治疗组治疗前血浆sICAM-1、CRP及UAER浓度比较差异均无统计学意义(P均＞0.05),治疗后均较治疗前改善,差异均有统计学意义(P＜0.05或P＜0.01),且贝前列素钠治疗组较常规治疗组改善明显,差异均有统计学意义(P＜0.05或P＜0.01).结论 早期DN患者即存在血清sICAM-1浓度升高,贝前列素钠治疗显著降低早期DN患者血清sICAM-1、CRP及UAER浓度,对早期DN有保护作用.     

血清VCAM-1、FGF2等炎症因子与难愈性糖尿病足的相关性研究

目的探讨血管细胞黏附分子-1(VCAM-1)和成纤维细胞生长因子2(FGF2)等炎症因子与难愈性糖尿病足(DF)发生、发展的关系。方法收集145例难愈性DF患者(DF组)和65例无足部溃疡的2型糖尿病(T2DM)患者(T2DM组)的基本临床资料,采集空腹血检测VCAM-1、FGF2、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、血糖(FBG)、餐后2 h血糖(2 hPG)、糖化血红蛋白(HbA1c)、糖化白蛋白(GA)、C反应蛋白(CRP)、纤维蛋白原(FIB)、白细胞计数(WBC)和中性粒细胞比率(Neu%),并对结果进行统计分析。将DF组参照Wagner分级方法分为WagnerⅢ级(37例)、WagnerⅣ级(92例)和WagnerⅤ级(16例)。结果 DF组和T2DM组之间性别构成、体重指数(BMI)、FBG、2 hPG、HbA1c和GA差异均无统计学意义(P0.05)。DF组VCAM-1、FGF2、TNF-α、IL-6、WBC、Neu%、FIB、CRP、年龄、糖尿病病程和心率均高于T2DM组(P0.01)。TNF-α与VCAM-1呈正相关(r=0.284,P=0.000)。单因素Logistic回归分析表明VCAM-1、FGF2、TNF-α、IL-6、年龄、糖尿病病程、心率、WBC、Neu%、FIB和CRP是DF发生的危险因素。多因素Logistic回归分析显示VCAM-1、TNF-α、FIB和Neu%为DF发生的独立风险因素。WagnerⅤ级组年龄低于WagnerⅢ级组和WagnerⅣ级组(P0.01),而IL-6、CRP、FIB、WBC、Neu%均高于WagnerⅢ级组和WagnerⅣ级组(P0.05、P0.01)。WagnerⅤ级组FGF2和HbA1c高于WagnerⅢ级组(P0.05)。结论血清VCAM-1、FGF2等炎症因子水平升高在DF发生、发展过程中起到重要作用。DF治疗中应注重抗炎治疗。     

Interleukin 1, tumour necrosis factor-alpha (cachectin) and the pathogenesis of cancer cachexia

Summary. Soluble proteins synthesized and released by phagocytic cells may be responsible for the protein and energy wasting frequently observed during catabolic states, including cancer cachexia. This hypothesis is based upon the observation that many of the hosts's metabolic responses to infection, inflammation, accidental trauma and some forms of cancer are remarkably similar. Anorexia and degradation of skeletal and connective tissue protein, as well as increases in hepatic protein synthesis and energy expenditure, can all be reproduced by the administration of activated macrophage products. During inflammatory states, including active tumour growth, increased production of some cytokines, including interleukin 1 and tumour necrosis factor-alpha (cachectin), have been observed. If these monokines serve as metabolic inducers, then efforts to block therapeutically the actions of macrophage-secreted substances may play a role in slowing the progression of tissue-wasting associated with catabolic states, particularly due to malignant tumours.     

Pro- and anti-inflammatory cytokines in healthy volunteers fed various doses of fish oil for 1 year

Dietary supplementation with n -3 fatty acids from fish oil alleviates inflammation in various chronic inflammatory disease states. Reductions in the production of pro-inflammatory cytokines interleukin 1β (IL-1β), tumour necrosis factor alpha (TNF-α), and interleukin 6 (IL-6) have been seen in humans after short-term n -3 fatty acid supplementation. We investigated long-term effects of dietary n -3 fatty acids on circulating cytokine concentrations and on ex vivo stimulated whole-blood production of IL-1β, TNF-α and interleukin 1 receptor antagonist (IL-1Ra), the naturally occurring antagonist of IL-1. A total of 58 monks with a mean age of 56 years were randomized into four groups and their diets were supplemented with 0, 3, 6, or 9 g of fish oil, providing 0, 1.06, 2.13 or 3.19 g of n -3 fatty acids per day. Subjects received equal amounts of saturated fatty acids, vitamin E and cholesterol. Compliance was excellent and erythrocyte fatty acid profiles closely reflected the amounts of n -3 fatty acids ingested. In the group receiving 9 g of fish oil per day, no influence of n -3 fatty acids on circulating cytokine concentrations was observed relative to placebo. Endotoxin-stimulated whole-blood cytokine production was measured at 26 and 52 weeks after the start and at 4, 8 and 26 weeks after cessation of supplementation. In all groups, the production of IL-1β and IL-1Ra was higher during supplementation than afterwards. However, no differences in cytokine production were noted between the placebo group and the various treatment groups at any point in time. Our results suggest that long-term supplementation of fish oil does not affect ex vivo cytokine production in man.     

可溶性细胞间黏附分子与急性期脑梗死体积的关系

目的 检测急性脑梗死(ACI)患者可溶性细胞间黏附分子(sICAM)的水平,评价其与急性期梗死体积的相关性.方法 采用双抗体夹心酶联免疫吸附法测定165例ACI患者血清sICAM～1水平,并与58例脑出血患者和87例健康体检者对照比较.结果 ACI组24h血清slCAM-1水平C(4.73+0.26)mg/L)]明显高于脑出血组((2.81士0.18)mg/L]和健康对照组[(2.64士0.25)mg/L],直至发病后14 d仍高于脑出血组和健康对照组(P均＜0.01).大梗死组(梗死灶＞10 cm3)血清sICAM-1水平[(5.14±0.34)mg/L]明显高于中梗死组[梗死灶4～10 cm3,(4.47±0.20)mg/L)和小梗死组[梗死灶＜4 cm3,(4.12士0.28)mg/L,P均＜0.01].ACI后伴感染组在14 d内血清slCAM-1水平均明显高于不伴感染组(P＜0.05或P＜0.01).结论 血清siCAM水平的变化与ACI梗死灶的大小密切相关.     

The study on change of serum cytokines levels and its correlation with function rehabilitation in patients with cerebral infarction

TO explore the relationship between CK and pathologic process of CI as well as its clinical signific ance,we measured the serum IL －６,TNF and sIL －２R levels in ４６CI patie nts as well as ２２recovery phase patients of ４６．１Materials and Methods １．１Clinical Materials CI group：There were forty －six pa－tients ,２５were men,２１women ,aged ４２to ８６year,averaging（６２．９２±１４．６７）year old．They were selected from those consec－tively from hospitalized in Depar…