Analysis of tumor necrosis factor-α production and polymorphisms of the tumor necrosis factor-α gene in individuals with a history of Kawasaki disease

BACKGROUND: Tumor necrosis factor (TNF)-alpha plays a central role in the pathogenesis of vasculitis in Kawasaki disease (KD). To address the genetic background of KD, we investigated the level of TNF-alpha production and genetic polymorphisms in the 5' flanking region of the TNF-alpha gene in healthy children with a history of KD. METHODS: For TNF-alpha production, peripheral blood mononuclear cells (PBMC) of children with a history of KD (n = 61) and of non-KD children (n = 35) were stimulated with phorbol 12-myristate 13-acetate, toxic shock syndrome toxin-1 (TSST-1) and the culture supernatant of Staphylococcus aureus derived from a KD patient (S-6), which had several superantigenic activities. The genetic background of KD was addressed by studying polymorphisms in the 5' flanking region of the TNF-alpha gene at positions -1031 (thymine (T) to cytosine (C) change, termed -1031C), -863 (C to adenine (A), -863A), -857 (C to T, -857T), -308 (guanine (G) to A, -308A) and -238 (G to A, -238A) in KD, using dot-blot hybridization with sequence-specific oligonucleotide probes. RESULTS: The PBMC of KD patients with coronary artery lesions produced slightly higher levels of TNF-alpha in response to the bacterial products (such as TSST-1 and S-6). None of the polymorphisms in the 5' flanking region of the TNF-alpha gene were related to KD. CONCLUSIONS: These results suggest that a genetic disposition towards overproduction of TNF-alpha in response to bacterial products may be involved in the pathogenesis of KD.     

Expression of tumor necrosis factor-α protein in the myocardium in fatal myocarditis

BACKGROUND: Tumor necrosis factor (TNF)-alpha is the most studied cytokine in the failing human heart and in experimental murine myocarditis. We have investigated the expression of TNF-alpha in the myocardium in human myocarditis. METHODS: We examined endomyocardial biopsy (n = 4) and autopsy (n = 5) tissues obtained from nine patients diagnosed with myocarditis by the Dallas criteria. Expression of TNF-alpha in the hearts was immunohistochemically studied using monoclonal antibodies against human TNF-alpha. RESULTS: Tumor necrosis factor-alpha protein was expressed in the myocardium of six of the nine patients studied. Four of five fatal patients showed intense immunoreactivity for TNF-alpha compared with survivors. Furthermore, left ventricular systolic function was reduced in patients with TNF-alpha-positive hearts. CONCLUSIONS: These findings may support the suggestion that TNF-alpha plays an important role in cardiac dysfunction and myocytic damage in fatal human myocarditis.     

Association between cord blood IgE and genetic polymorphisms of interleukin-4, the β-subunit of the high-affinity receptor for IgE, lymphotoxin-α, and tumor Necrosis factor-α

High cord blood immunoglobulin E (cbIgE) is known to be associated with increased risks of atopic diseases in childhood. The relationship between genetic polymorphisms and high cbIgE has not been well documented. A cross-sectional study was conducted to assess the association between cbIgE and genetic polymorphisms of interleukin (IL)-4 -590C/T, the beta-subunit of the high-affinity receptor for IgE (FcepsilonRI-beta) E237G, lymphotoxin (LT)-alphaNcoI alleles, and tumor necrosis factor (TNF)-alpha -308G/A. A total of 320 mother-neonate pairs were recruited from four maternity hospitals from different locations of Taiwan. Cord blood was obtained and assayed for cbIgE. Polymerase chain reaction followed by restriction fragment length polymorphism was used to assess the genotypes. Three hundred pairs of mothers and neonates were included in the final analysis. Infants with IL-4 -590 C allele were found to have higher risk of elevated cbIgE (> or =0.35 IU/ml, 24.3%) (p = 0.004). After adjusting for gender, birth order, maternal age, and history of allergic disease in maternal and paternal families, odds ratios for CC and CT genotypes were 4.41 and 3.16 (95% confidence interval 0.78-22.67, and 1.66-6.13), respectively, using TT genotype as reference. The genotypes of FcepsilonRI-beta, LT-alpha, and TNF-alpha were not associated with cbIgE before or after the adjustment. Our finding suggested a significant association of cbIgE with genetic polymorphism of IL-4 -590C/T, but not with the genotypes of FcepsilonRI-beta, LT-alpha, and TNF-alpha.     

The regulatory function of umbilical cord blood CD4+ CD25+ T cells stimulated with anti-CD3/anti-CD28 and exogenous interleukin (IL)-2 or IL-15

The abundance of CD4⁺ CD25⁺ regulatory T cells in umbilical cord blood (UCB) might contribute to the decreased severity of graft-vs.-host disease (GVHD) for UCB transplantation. This study aims to characterize the phenotypes and suppressive function of UCB CD4⁺ CD25⁺ T cells under the influence of anti-CD3/anti-CD28 (CD3/CD28) and exogenous interleukin (IL)-2 or IL-15. Higher percentages of CD4⁺ CD25^high and FoxP3⁺ cells were detected in UCB compared to their adult counterparts. IL-15 was as effective as IL-2 in enhancing the proliferation of CD3/CD28 stimulated UCB CD4⁺ CD25⁺ T cells. Phenotypically, IL-2/IL-15-stimulated UCB CD4⁺ CD25⁺ T cells expressed higher level of CTLA-4, GITR, membrane bound transforming growth factor-β (mTGF-β), and especially Foxp-3 than controls. IL-2/IL-15-stimulated UCB CD4⁺ CD25⁺ T cells also produced much higher IL-10 and TGF-β than controls; while IL-2/IL-15-stimulated UCB CD4⁺ CD25⁻ T cells showed increased TGF-β, but not IL-10 production. IL-2/IL-15-cultured UCB CD4⁺ CD25⁺ T cells showed comparable suppressor activity on allogeneic adult CD4⁺ T-cell proliferation compared to controls, partly through a contact-dependent fashion. Taken together, IL-2/IL-15-stimulated UCB CD4⁺ CD25⁺ T cells show distinct regulatory T-cell phenotypic and functional features, and may be applied for the alleviation of GVHD severity following UCB transplantation.     

Fetal sensitization to cow''s milk protein and wheat: cow''s milk protein and wheat-specific TNF-α production by umbilical cord blood cells and subsequent decline of TNF-α production by peripheral blood mononuclear cells following dietary intervention

We present a case of fetal sensitization to cow's milk protein (CMP) and wheat, resulting in non-IgE mediated food allergy (NFA). Fetal sensitization was indicated by onset of NFA symptoms shortly after birth and CMP/wheat-specific tumor necrosis factor-alpha (TNF-alpha) production by cord blood mononuclear cells. Following dietary intervention, we observed a decline of TNF-alpha production by peripheral blood mononuclear cells with stimuli of these dietary proteins (DPs) but recurrence of reactivity was observed following viral gastroenteritis, while interleukin-10 production with these DPs persisted during his first 5 yr of life. This finding may indicate active suppressive mechanisms for maintaining oral tolerance.     

人脐血及脐带间充质干细胞的分离培养及表面标记分析

目的探讨从人脐带血及脐带分离和培养间充质干细胞(MSCs)的方法,并分析MSCs的表面标记。方法人脐带血按常规方法制备单个核细胞,利用MSCs贴壁生长的特性,经培养、换液、传代纯化MSCs;分离脐带华尔通胶(Wharton’s jelly),采用组织块贴壁法获得脐带MSCs并传代。将传代的MSCs冻存,1个月后再复苏,观察复苏后MSCs的生长情况。利用FACScan流式细胞仪检测脐带血及脐带细胞表面抗原。结果经过传代后,贴壁细胞形态趋于同一。人脐血及脐带MSCs体外生长形态相似,类似成纤维细胞,可以稳定增殖和传代。经冷冻保存,复苏后仍能较好生长。人脐血及脐带来源的MSCs表面标记CD29、CD44、CD59高表达,而表面标记CD14、CD33、CD34和CD45低表达。结论人脐带血及脐带均可分离出MSCs,在体外能扩增纯化及冻存复苏,为组织工程提供丰富的细胞来源。     

Interleukin-15 enhances CD4+ CD45RA+ expression on umbilical cord blood mononuclear cells

The reduced incidence of graft‐vs.‐host disease following umbilical cord blood (CB) transplantation may be related to the functional immaturity of newborn T cells expressing mainly the naive CD45RA phenotype. Expansion of CD4⁺ CD45RA⁺ T cells using cytokines may benefit neonates and infants with human immunodeficiency virus (HIV) infection, as a preferential decline in CD4⁺ CD45RA⁺ cells has been noted as HIV disease progresses. The aim of the study was to investigate the effect of interleukin (IL)‐15, a novel cytokine similar to IL‐2 in biological activities, on CD45RA/RO expression and apoptosis in umbilical cord blood (CB) and adult peripheral blood (APB) mononuclear cells (MNCs). Prior to culture, CB MNCs contained a greater number of CD4⁺ CD45RA⁺ cells and fewer CD4⁺ CD45RO⁺ cells than did APB MNCs. When incubated with RPMI‐1640 containing 10% fetal calf serum for 7 days, the percentage of CD45RA⁺ cells within CD4⁺ T cells (%CD45RA⁺/CD4⁺) significantly decreased compared to that of fresh CB MNCs. IL‐15 exerted a dose‐dependent increase of %CD45RA⁺/CD4⁺ and a corresponding decrease of %CD45RO⁺/CD4⁺ in CB MNCs, an effect not observed with APB MNCs treated with IL‐15. The percentages of CD45RA⁺ and CD45RO⁺ expression within CD8⁺ cells, however, were not influenced by IL‐15, in either CB or APB MNCs. A greater number of CB MNCs underwent apoptosis than did APB MNCs after 7 days of culture in RPMI‐1640 containing 10% fetal calf serum. IL‐15 did not inhibit apoptosis but induced proliferation comparable to that achieved in APB MNCs. The ability of IL‐15 to preferentially enhance the proliferation of CD4⁺ CD45RA⁺ cells in CB MNCs suggests a role for immunomodulative therapy in HIV‐infected newborns and infants.     

Cardiac troponin I, cardiac troponin T and creatine kinase MB concentrations in umbilical cord blood of healthy term neonates

AIMS: To measure and compare cardiac troponin I, cardiac troponin T and creatine kinase MB concentrations in the umbilical cord blood of healthy term infants and to investigate the relationship between maternal and neonatal troponin values at birth. METHODS: Troponin I, troponin T and creatine kinase MB concentrations were measured from the umbilical cord samples of 85 healthy term neonates and in the blood samples of their respective mothers at birth. RESULTS: Median (interquartile range) umbilical cord concentrations were 0 microg/L (0-0) for troponin I, 0 microg/L (0-0.019) for troponin T and 4.90 microg/L (3.90-6.61) for creatine kinase MB. Troponin I and T concentrations were higher than the detection limit for the assay in 2 (2.3%) and 41 (48.2%) neonates, respectively. Two mothers (2.3%) had cTnT levels above the detection limit; none of them had increased levels of cTnI. CONCLUSION: Probably owing to differences in expression and assay detection limits, cord blood troponin T concentrations are frequently over the detection limit at birth, while troponin I is mostly undetectable and comparable with that in healthy pregnant women. These cardiac regulatory proteins are of neonatal origin and are not influenced by maternal levels.     

Evaluation of cytotoxic function and apoptosis in interleukin (IL)-12/IL-15-treated umbilical cord or adult peripheral blood natural killer cells by a propidium-iodide based flow cytometry

Both deficient natural killer (NK) cell effector function and increased propensity to apoptosis of neonatal NK cells contribute to the increased susceptibility to infection in the neonates. Interleukin (IL)-12 and IL-15 are two immunoregulatory cytokines known to enhance cytolytic function of neonatal NK cells. The present study aims to simultaneously investigate the effect of IL-12/IL-15 on K562 cytotoxicity as well as NK cells apoptosis of enriched umbilical cord blood (CB) and adult peripheral blood (APB) NK cells, using flow cytometric cytotoxicity assays. The results indicated that (i) prior to cytotoxicity assays, CB NK cells underwent greater degree of spontaneous apoptosis than did APB NK cells; (ii) both IL-12 and IL-15 inhibited the spontaneous apoptosis of CB NK cells, while IL-15 promoted the apoptosis in APB NK cells; (iii) the deficient K562 cytotoxicity of CB NK cells could be enhanced to levels comparable with that of APB NK cells by IL-15; (iv) IL-15 increased the percentages of apoptosis in NK–K562 conjugates in a dose-dependant manner in both CB and APB with a greater effect seen with APB NK cells; (v) target-induced apoptosis was observed with APB NK cells which were further enhanced with IL-15. However, CB NK cells, unstimulated or IL-15-activated, were resistant to K562-induced apoptosis. Thus, the multi-parameter flow cytometry analysis not only demonstrates better for the deficient CB NK function but also provides greater details for cytotoxic mechanisms of NK cells.     

Phenotypic changes of T-lymphocyte subsets induced by interleukin-12 and interleukin-15 in umbilical cord vs. adult peripheral blood mononuclear cells

The decreased incidence of graft-vs.-host disease found following umbilical cord blood (CB) transplantation, and the increased susceptibility of newborns to infections, have been attributed, in part, to functional and phenotypic immaturity of neonatal T cells. We investigated the phenotypic changes of CB T cells induced by two immunoregulary cytokines, interleukin (IL)-12 and IL-15, alone or in combination. Adult peripheral blood (APB) mononuclear cells (MNCs) were also tested for comparison. Prior to culture, the percentages of CD3⁺ CD8⁺, CD3⁺ CD25⁺, and CD3⁺ CD56⁺ cells were significantly lower in CB MNCs than in APB MNCs. IL-15, but not IL-12, significantly increased CD3⁺ CD8⁺ expression among the CB MNCs after 1 week of culture. Combining IL-12 and IL-15, however, resulted in decreased CB CD3⁺ CD8⁺ expression compared with IL-15 alone. The percentage of CD3⁺ CD25⁺ cells in CB MNCs spontaneously increased in the absence of cytokines, while that of CD3⁺ CD56⁺ cells in CB MNCs could not be enhanced with cytokines. In contrast, the percentages of CD3⁺ CD25⁺ and CD3⁺ CD56⁺ cells among the APB MNCs could be increased with IL-12, IL-15, and further with IL-12 and IL-15 combined. Thus, different patterns of T-cell subset changes were demonstrated between CB MNCs and APB MNCs in response to IL-12 and/or IL-15. These data may serve as a foundation for using cytokine therapy in newborns and children receiving CB transplants.     

脐血间充质干细胞对T淋巴细胞增殖和激活影响的实验研究

目的研究脐血源间充质干细胞(UCB-MSCs)对T淋巴细胞激活和增殖的影响。方法2006—2007年广西壮族自治区人民医院从脐血中分离和培养间充质干细胞,流式细胞术检测其表面标志以鉴定纯度;用B r-du法测定细胞增殖率,观察UCB-MSCs对异体T淋巴细胞增殖的影响;流式细胞仪检测共培养体系中CD6 9细胞水平。结果从脐血获得的MSCs免疫表型分析显示,其不表达HLA-II抗原。对PHA刺激的脐带血T淋巴细胞,UCB-MSCs对其的增殖反应具有抑制作用,呈细胞数量剂量依赖性;UCB-MSCs与脐带血单个核细胞共培养体系中,CD 69细胞比例降低,与对照组比较差异有统计学意义(P<0.01)。结论UCB-MSCs抑制PHA刺激的T淋巴的增殖及激活,这种抑制特性表明,UCB-MSCs对免疫反应具负调节作用,可能为GVHD的防治提供一条新途径。     

Influence of perinatal risk factors on CD3+/TCR αβ and CD3+/TCR γδ lymphocytes in cord blood of preterm neonates

Abstract Background : The aim of the study was the evaluation of CD3+/TCR αβ and CD3+/TCR γδ lymphocytes in the cord blood of the preterm neonates. Methods : The study included 26 term neonates as a control group delivered both by spontaneous labor and by cesarean section and 41 preterm neonates: (i) by cesarean section due to abruptio placentae, (ii) by cesarean section due to the danger of intrauterine asphyxia, (iii) by cesarean section due to preterm rupture of membrane (PROM), and (iv) by spontaneous labor. Immunological analysis was performed in the flow cytometer FACScan, using anti‐CD3, anti‐TCR αβ and anti‐TCR γδ monoclonal antibodies from Becton Dickinson (San Jose, California USA). Results : It was shown that the way of delivery does not influence the value of CD3+/TCR αβ lymphocytes. A decrease of the percentage and number of CD3+/TCR γδ lymphocytes was found in neonates delivered by elective cesarean section. However, the danger of intrauterine fetal asphyxia, as a reason for preterm delivery, influenced a considerable increase of the number of CD3+/TCR αβ and CD3+/TCR γδ lymphocytes. Perinatal risk factors (abruptio placentae, PROM) were related to the lowest number of CD3+/TCR γδ lymphocytes in the blood of the preterm neonates. Conclusion : The obtained results suggest that in spite of considerable immaturity, both a term and preterm neonate is prepared for the immune response and is able to activate cell mechanisms. The precise mechanism that links CD3+/TCR αβ and CD3+/TCR γδ lymphocytes and pathological condition of preterm birth remains unclear.     

母婴因素对脐血CD34+造血干/祖细胞的影响

目的 比较不同母婴因素与脐血有核细胞总数及CD34⁺造血干/祖细胞数量的关系,为脐血库合理选择脐血提供参考。方法 前瞻性收集130例2019年6月至2020年1月期间于大连市妇女儿童医疗中心分娩的新生儿脐血标本,男女比例为1：1。收集围生期相关信息：孕母年龄及血型,有/无妊娠糖尿病、妊娠高血压,妊娠方式、分娩方式、单胎/双胎,新生儿体重、性别、生后Apgar评分,以及胎盘、羊水、脐带情况。结果 根据孕母血型、妊娠糖尿病、妊娠高血压、妊娠方式、分娩方式、单胎/双胎,新生儿性别、生后Apgar评分,胎盘形态、羊水胎粪污染、脐带绕颈等情况进行分组,组间比较脐血有核细胞总数及CD34⁺细胞计数差异均无统计学意义（P > 0.05）。孕母年龄、新生儿体重与脐血有核细胞总数无相关性（P > 0.05）,新生儿体重与CD34⁺细胞计数无相关性（P > 0.05）,孕母年龄与CD34⁺细胞计数呈正相关（P < 0.05）。结论 脐血中CD34⁺细胞数量随孕母年龄增大而增多,故脐血库在筛选脐血时,同等条件下可以选择年龄偏大的孕妇。     

Effects and long‐term follow‐up of using umbilical cord blood–derived mesenchymal stromal cells in pediatric patients with severe BK virus‐associated late‐onset hemorrhagic cystitis after unrelated cord blood transplantation

This is a retrospective study to evaluate the efficacy and safety of umbilical cord blood–derived mesenchymal stromal cells (MSCs) for the treatment of pediatric patients with severe BK virus–associated late‐onset hemorrhagic cystitis (BKV‐HC) after unrelated cord blood transplantation (UCBT). Thirteen pediatric patients with severe BKV‐HC from December 2013 to December 2015 were treated with MSCs. The number of MSCs transfused in each session was 1 × 10⁶/kg once a week until the symptoms improved. The median follow‐up time was 1432 (89‐2080) days. The median frequency of MSC infusion was 2 (1‐3), with eight cured cases and five effective cases; the total efficacy rate was 100%. The copy number of urine BKV DNA was 4.43 (0.36‐56.9) ×10⁸/mL before MSC infusion and 2.67 (0‐56.3) ×10⁸/mL after MSC infusion; the difference was not significant (P = .219). There were no significant differences in the overall survival, disease‐free survival, and the incidence of relapse and acute and chronic graft‐versus‐host disease between the MSC infusion group and non‐MSC infusion group. There was also no significant difference in the cytomegalovirus, Epstein‐Barr virus (EBV), and fungal and bacterial infection rates between the two groups. Although umbilical cord blood–derived MSCs do not reduce the number of BKV DNA copies in the urine, the cells have a high efficacy rate and minimal side effects in treating severe BKV‐HC after UCBT among pediatric patients. MSCs do not affect the rates of relapse, long‐term infection, or survival of patients with leukemia.     

脐血单个核细胞侧脑室移植对HIBD新生大鼠脑神经元凋亡及Bax、Bcl-2蛋白的影响

目的 探讨脐血单个核细胞移植对缺氧缺血性脑损伤 （HIBD）新生大鼠脑神经元凋亡及Bax、Bcl-2蛋白的影响。方法 7日龄Sprague-Dawley新生大鼠制备缺氧缺血性脑损伤 （HIBD）模型,随机分为正常对照 （N）+生理盐水 （NS）、HIBD+NS、N+脐血单个核细胞 （UCBMC）及HIBD+UCBMC组。N+UCBMC与HIBD+UCBMC组侧脑室注入3×106个UCBMC,N+NS与HIBD+NS组注入等体积NS。移植后7 d采用NeuN/活性Caspase-3免疫荧光双标染色法、TUNEL法观察大脑皮层神经元凋亡,Western blot观察脑组织Bax、Bcl-2蛋白表达。结果 HIBD+NS组的NeuN+活性Caspase-3+DAPI+细胞及TUNEL+DAPI+细胞均多于N+NS和N+UCBMC组 （P < 0.01）;HIBD+UCBMC组的NeuN+活性Caspase-3+DAPI+细胞及TUNEL+DAPI+细胞均少于HIBD+NS组 （P < 0.01）。HIBD+NS组的Bax蛋白表达高于N+NS与N+UCBMC组,Bcl-2蛋白低于N+NS与N+UCBMC组 （P < 0.01）;而HIBD+UCBMC组的Bax蛋白较HIBD+NS组降低 （P < 0.01）,Bcl-2蛋白则高于HIBD+NS组、N+NS和N+UCBMC组 （P < 0.05）。结论 HIBD新生大鼠侧脑室移植UCBMC可以减轻神经元凋亡,其机制可能与Bcl-2蛋白表达上调,Bax蛋白表达下调有关。