Comparision of the apoptotic effects on lymphoblasts and on increase of myeloid lineage cells of a short-time, high-dose methylprednisolone and the conventional-dose prednisolone treatments in children with acute lymphoblastic leukemia

The authors compare the apoptotic effect on the lymphoblasts and the proliferative effect on the myeloid lineage cells of a short-course high-dose methylprednisolone (HDMP) and the conventional-dose prednisolone treatments in children with acute lymphoblastic leukemia (ALL). The patients were divided into 2 groups. Group I (n = 10) received HDMP (30 mg/kg/day for 7 days) in a single dose before 6 a.m. perorally. Group II (n = 10) received prednisolone (2 mg/kg/day for 7 days) in 3 doses. The apoptotic percentages of lymphpblasts and the percentages of blasts and myeloid lineage cells were determined after performing the bone marrow aspiration (BMA) at diagnosis on the 0th, 3rd, and 7th days of the treatments in all patients. The mean apoptotic percentages of the lymphoblasts on the 3rd day were significantly higher than those on the 0th and 7th days in both groups (p < .05). The highest apoptosis was determined on the 3rd day in group I. The mean percentages of the blast cells on the 7th day were significantly lower than those on the 0th and the 3rd days in both groups (p < .05). The lowest lymphoblast percentage was determined on the 7th day in group I. The mean percentages of the CD13+ and CD33+ cells on the 7th day were significantly higher than those on the 0th and the 3rd days in both groups (p < .05). The highest percentages of the CD13+ and CD33+ cells were found on the 7th day in group I. Prednisolone and HDMP showed no proliferative effect on the CD14+ cells. These findings indicate that a short-course HDMP treatment shows a more effective apoptosis on the lymphoblasts and on the increase of the myeloid lineage cells when compared to the prednisolone treatment. The authors suggest that HDMP may be used in the treatment of patients with ALL instead of prednisolone.     

Proliferation of myeloid lineage cells and apoptosis of lymphoblastic leukemic cells induced by short-course high-dose methylprednisolone in patients with acute lymphoblastic leukemia

In this paper, we investigated the effects of short-course high-dose methylprednisolone (HDMP) treatment on the proliferation of myeloid lineage cells and on apoptosis of blast cells in eight children with acute lymphoblastic leukemia (ALL). The patients were given the HDMP treatment (30 mg/kg/d, perorally) before 9:00 a.m. for seven days. Bone marrow (BM) aspiration was done at days 0 and 3 of the HDMP treatment in all patients and at the 7th day of the HDMP treatment in six patients. Bone marrow blast cells had gradually decreased after the HDMP treatment by the 7th day. There were statistically significant differences between the mean percentages of BM blast cells at days 0 and 3, days 0 and 7, and at days 3 and 7 (p<0.05). The mean percentages of blast cell apoptosis at the 3rd day was significantly higher than at days 0 and 7, and apoptosis at day 0 was significantly lower than at the 7th day (p<0.05). The mean percentages of BM myeloid lineage cells at the 7th day was significantly higher than at days 0 and 3 (p<0.05), and the mean percentage at day 0 was significantly lower than at the 3rd day (p<0.05). These findings indicate that short-course HDMP treatment causes apoptosis on lymphoblasts and increases the proliferation of myeloid lineage cells in children with ALL.     

Expression of T subsets and mIL-2R in peripheral blood of newborns with hypoxic ischemic encephalopathy

Background  Infantile and undifferentiated immune cells in the pathogenesis of neonates with HIE have been studied in recent years. This study was undertaken to observe the expression level of T subsets and membrane interleukin-2 receptor (mIL-2R) in the peripheral blood of newborns with hypoxic ischemic encephalopathy (HIE) and its clinical manifestations. Methods  The peripheral blood mononuclear cells (PBMCs) of newborns with HIE and normal controls were isolated by the routine Ficoll-Hypaque method, and the rates of CD₃ ⁺, CD₄ ⁺, CD₈ ⁺, CD₄ ⁺/CD₈ ⁺ and mIL-2R induced and not induced by phytohemagglutinin (PHA) were detected by biotin-streptavidin (BSA) at the first, third and seventh day after birth. Results  At the first day after birth, the positive rates of CD₃ ⁺, CD₄ ⁺, CD₈ ⁺, CD₄ ⁺/CD₈ ⁺ and mIL-2R induced and not induced by PHA were (37.4±6.7)%, (29.4±6.9)%, (16.7±3.3)%, 1.8±0.5, (3.6±1.1)% and (20.9±4.8)%, respectively. Significant differences were observed between the HIE group and the normal controls (P<0.01-P<0.05). At the third day after birth, the positive rates of CD₃ ⁺, CD₄ ⁺, CD₈ ⁺, CD₄ ⁺/CD₈ ⁺ and mIL-2R induced and not induced by PHA were (41.0±7.4)%, (35.8±6.9)%, (22.6±4.5)%, (1.7±0.5), (3.9±1.2)%, and (22.8±5.1)%, respectively. There were significant differences between the HIE group and the normal controls (P<0.05). At the seventh day after birth, the positive rates of CD₃ ⁺, CD₄ ⁺, CD₈ ⁺ were (41.8±6.1)%, (36.4±5.1)% and (25.6±4.3)%, respectively. There was significant difference between the HIE group and the normal controls (P<0.05). The ratio of CD₄ ⁺/CD₈ ⁺ and the expression level of mIL-2R induced and not induced by PHA were 1.5±0.3, (4.1±1.2)% and (23.8±5.2)%, respectively. There was no significant difference between the HIE group and the normal controls (P>0.05). Conclusions  Peripheral blood mononuclear cells of newborns are immature and undifferentiated with a very low expression level of surface markers. The changes of cell immunity involve in the pathogenesis of HIE. The disorder of cellular immune function exists in newborns with HIE. Cell immunity and immune regulative response in newborns are gradually improved or mature during the period of growing, facilitating the recovery from brain injury caused by HIE.     

TREATMENT OF KASABACH-MERRITT SYNDROME BY MEGADOSE METHYLPREDNISOLONE

The authors have previously demonstrated a favorable effect of high-dose methylprednisolone (HDMP), which can induce differentiation and apoptosis of leukemic cells in children with acute myeloblastic leukemia (AML). Here, they evaluate the effect of short-course HDMP in 2 children with acute myeloblastic leukemia (AML-M2) presented with myeloid tumor (MT). Methylprednisolone (20 or 30 mg/kg/day) was given orally, in a single dose, without using other antileukemic agents. Rapid cytoreduction in MT, peripheral blood, and bone marrow blasts was observed in both children following short-course (4 or 7 days) HDMP treatment, possibly due to HDMP-induced differentiation and apoptosis of leukemic cells. The effects of HDMP should be explored in patients with other subtypes of AML who present with MT.     

High dose methylprednisolone therapy in nephrotic syndrome

This study was done to determine the efficacy of oral high dose methylprednisolone (HDMP) therapy in the treatment of childhood nephrotic syndrome (NS). Fifteen patients were enrolled in the study. Patients were arbitrarily divided into two groups. Group I received prednisolone (daily 60 mg/m² for 4 weeks, 45, 30, 20, 10, 5 mg/m² on alternate days for 4 weeks) and group II received HDMP (30 mg/kg/d for 3 days, 20 mg/kg/d for 4 days, 10 mg/kg/for a week, before 9 am, orally). The patients were followed-up for a duration of 38.0±5.5 months (range 24–68 months) in group I and 42.1±5.5 months (range 16–72 months) in group II. No significant difference was obtained in the duration of remission between both groups (p>0.05), while HDMP induced early remission than prednisolone (p<0.05). The mean relapse rate was 0.8/year in group I and 0.8/year in group II (p>0.05). Although, the number of the patients were limited in the study it can be recommended that patients with NS can be treated with oral HDMP therapy as an alternative to standard oral prednisolone therapy.     

EFFECT OF TWO-ROUND FICOLL-HYPAQUE DENSITY GRADIENT CENTRIFUGATION ON LYMPHOCYTE SUBSETS AND NATURAL KILLER ACTIVITY OF UMBILICAL CORD BLOOD MONONUCLEAR CELLS

Umbilical cord blood (CB) mononuclear cells (MNCs) obtained from Ficoll-Hypaque density gradient centrifugation (FDGC) are frequently contaminated with erythrocytes and nucleated erythroid precursors. The authors investigated the effect of two-round (2-r) FDGC on lymphocyte subsets and natural killer activity of CB and adult peripheral blood (APB) MNCs, in comparison with those obtained from conventional one-round (1-r) separation. The percentage of CD45-expressing CB MNCs was greatly increased after the second density step (p &lt; .01), indicating the efficacy in purification. The percentages of CD3/CD4, CD3/CD8, and CD16/56 double-positive staining CB MNCs were significantly increased after 2-r FDGC, as compared to those after 1-r separation. However, the percentages of CD34⁺ stemcells and CD19⁺ B cells were not affected by 2-r FDGC. MNCs obtained from 2-r FDGC had higher natural killer (NK) activity than did MNCs obtained from 1-r separation (p &lt; .01). In contrast, 2-r FDGC did not affect lymphocyte subsets and NK activity of APB MNCs as compared to 1-r FDGC. Thus, 2-r FDGC are recommended to obtain CB MNCs for flow cytometric analysis and NK cytotoxicity assays.     

EFFECT OF SHORT-COURSE, HIGH-DOSE STEROID THERAPY IN A CHILD WITH MYELODYSPLASTIC SYNDROME

High-dose methylprednisolone (HDMP) has been shown to induce differentiation of myeloid leukemic cells with a remarkable antileukemic effect in children with various subtypes of acute myeloblastic leukemia (AML). Here the beneficial effect of short-course HDMP therapy in a child with myelodysplastic syndrome (MDS) is reported. Oral methylprednisolone sodium succinate (Prednol-L) was administered at a single daily dose of 30 mg/kg for 5 days to a 4-year-old girl with refractory anemia with excess of blasts and hypocellular bone marrow before the initiation of chemotherapy. In addition to dramatic clinical improvement, the patient's white blood cell count increased from 2.3 ×10 9 /L to 5.0 ×10 9 /L, and peripheral blood blast cells disappeared 4 days after HDMP treatment. Repeated bone marrow aspirate 1 week after the initiation of HDMP disclosed increased cellularity with no blasts. Furthermore, short-course HDMP treatment stimulated the increase in the number of peripheral blood lymphocytes and CD3 + , CD4 + , CD8 + , CD19 + , CD34 + , and NK cells. Results obtained with HDMP from the previous studies and the present case suggest that high-dose methylprednisoloneis a promising agent in the treatment of MDS and it is recommended as an initial treatment especially for MDS children with hypocellular bone marrow at presentation.     

The role of short course of high-dose methylprednisolone in children with acute myeloblastic leukemia (FAB M2) presented with myeloid tumor

The authors have previously demonstrated a favorable effect of high-dose methylprednisolone (HDMP), which can induce differentiation and apoptosis of leukemic cells in children with acute myeloblastic leukemia (AML). Here, they evaluate the effect of short-course HDMP in 2 children with acute myeloblastic leukemia (AML-M2) presented with myeloid tumor (MT). Methylprednisolone (20 or 30 mg/kg/day) was given orally, in a single dose, without using other antileukemic agents. Rapid cytoreduction in MT, peripheral blood, and bone marrow blasts was observed in both children following short-course (4 or 7 days) HDMP treatment, possibly due to HDMP-induced differentiation and apoptosis of leukemic cells. The effects of HDMP should be explored in patients with other subtypes of AML who present with MT.     

EFFECT OF SHORT-COURSE,HIGH-DOSE STEROID THERAPY IN A CHILD WITH MYELODYSPLASTIC SYNDROME

High-dose methylprednisolone (HDMP) has been shown to induce differentiation of myeloid leukemic cells with a remarkable antileukemic effect in children with various subtypes of acute myeloblastic leukemia (AML). Here the beneficial effect of short-course HDMP therapy in a child with myelodysplastic syndrome (MDS) is reported. Oral methylprednisolone sodium succinate (Prednol-L) was administered at a single daily dose of 30 mg/kg for 5 days to a 4-year-old girl with refractory anemia with excess of blasts and hypocellular bone marrow before the initiation of chemotherapy. In addition to dramatic clinical improvement, the patient's white blood cell count increased from 2.3 &#50 10 9 /L to 5.0 &#50 10 9 /L, and peripheral blood blast cells disappeared 4 days after HDMP treatment. Repeated bone marrow aspirate 1 week after the initiation of HDMP disclosed increased cellularity with no blasts. Furthermore, short-course HDMP treatment stimulated the increase in the number of peripheral blood lymphocytes and CD3 + , CD4 + , CD8 + , CD19 + , CD34 + , and NK cells. Results obtained with HDMP from the previous studies and the present case suggest that high-dose methylprednisoloneis a promising agent in the treatment of MDS and it is recommended as an initial treatment especially for MDS children with hypocellular bone marrow at presentation.     

THE EFFECT OF FEEDING ON OXYGEN CONSUMPTION, RQ AND PLASMA LEVELS OF GLUCOSE, FFA, AND D-β-HYDROXYBUTYRATE IN NEWBORN INFANTS OF DIABETIC MOTHERS AND SMALL FOR GESTATIONAL AGE INFANTS

Abstract. Eight infants of strictly controlled diabetic mothers (IDM), 8 infants of gestational diabetic mothers (IGDM) and 6 small for gestational age infants (SGA) were studied before the first feeding and during an early feeding regimen. In IDMs and IGDMs continuous monitoring from 2 hours up to 7 1/2 hours after birth before feeding revealed no consistent changes of Vo₂ and RQ. The groups of infants were studied on 4 different occasions: (I) 2 to 16 hours, (II) 1 to 2 days, (III) 3 to 4 days, and (IV) 7 to 11 days. Prefeeding Vo₂-values were not significantly different between each of the groups, but mean RQ was higher in IGDMs than in IDMs. Age of the infant and prefeeding RQ were inversely correlated (r=-0.537, p<0.02). With increasing age and milk intake Vo₂ increased significantly in all groups. RQ decreased during the first 24 to 48 hours in all groups and rose thereafter with highest values at 7 to 11 days. Plasma levels of glucose, FFA, and D-β-hydroxybutyrate were not significantly different between each of the groups. The highest values for D-β-hydroxybutyrate were found at 1–2 days when the lowest RQ values were also recorded. D-β-hydroxybutyrate concentrations and RQ values (r= -0.648, p<0.001) were inversely correlated suggesting increasing oxidation of fat. Feeding resulted in a marked rise in RQ to values around unity, which preceded a distinct increase in Vo₂ that reached a maximum at 1 to 1 1/2 hours after the feed, then slowly returned to pretest values. The rise in Vo₂ was accompanied by an increase in rectal temperature (0.4 to 1.5°C). Vo₂, RQ, and plasma levels of glucose, FFA, and D-β-hydroxybutyrate, were almost identical for each of the groups. We suggest: 1) That differences in feeding practice is the most likely explanation for the discrepancy between reported values for Vo₂, RQ, and circulating substrates in normal and low birth weight newborns. 2) That the rise in Vo₂ during the neonatal period, caused by feeding, reflects the cost of growth.     

SAFETY PROFILES OF Fe2+ AND Fe3+ ORAL PREPARATIONS IN THE TREATMENT OF IRON DEFICIENCY ANEMIA IN CHILDREN

The major purpose of this study was to compare the oxidant-related toxicities of the different oral iron preparations in children with iron deficiency anemia (IDA); the second aim was to investigate the side effects of iron preparations. Seventy-two children with IDA were randomly included in the Fe²⁺ group (= 39) or the Fe³⁺ group (= 33). Some oxidizable substrates (erythrocytes malondialdehyde (MDA), urine 8-isoprostane, and basal and Cu-stimulated-oxidized LDL and antioxidant enzyme (superoxide dismutase (SOD), catalase and glutathione peroxidase) activities were evaluated at the beginning and at the 1st, 3rd, and 6th months of therapy. Side effects due to medication were recorded. While at the end of the 1st month SOD levels were significantly increased in Fe³⁺ group, at the 6th month evaluation, basal-oxidized LDL levels were significantly increased in the Fe³⁺ group, as was urine 8-isoprostane in the Fe²⁺ group. No other difference was found between two groups. In conclusion, there were minimal differences between children treated with ferric or ferrous iron in antioxidant system activities, the status of oxidizable substrates, and clinical toxicities.     

Lack of CD4+CD25+FOXP3+ regulatory T cells is associated with resistance to intravenous immunoglobulin therapy in patients with Kawasaki disease

The aim of this study was to investigate changes in CD4⁺CD25⁺FOXP3⁺ regulatory T cells (Tregs) throughout the clinical course of Kawasaki disease (KD) and correlations with response to intravenous immunoglobulin (IVIg) therapy. Participants comprised 18 patients who fulfilled the diagnostic criteria for KD and 20 healthy subjects. Expressions of CD25 and FOXP3 among all CD4⁺ T cells in peripheral blood mononuclear cells were analyzed by flow cytometry before and 7 and 30 days after IVIg therapy. Before treatment, percentages of CD4⁺CD25⁺FOXP3⁺ Tregs among total CD4⁺ Tregs were significantly lower among KD patients (4.19 %; range, 0.16–8.11 %) than among healthy subjects (7.32 %; 4.18–13.42 %; P?=?0.0001). Both percentages and absolute numbers of CD4⁺CD25⁺FOXP3⁺ Tregs on day?7 after IVIg therapy were significantly increased compared with values before treatment (8.02 % (range, 0.51–12.6 %) vs. 4.19 % (range, 0.16–8.11 %), P?=?0.0005; 93.25/?μL (range, 6.67–258.05) vs. 41.85/?μL (range, 0.44–160.62), P?<?0.0001, respectively). Moreover, percentages and absolute numbers of CD4⁺CD25⁺FOXP3⁺ Tregs before treatment were significantly lower in the IVIg-resistant group than in the IVIg-sensitive group (0.18 % (range, 0.16–3.34 %) vs. 4.52 % (range, 2.8–8.11 %), P?=?0.0022; 0.68/μL (range, 0.44–53.81) vs. 51.66/μL (range, 2.88–160.62), P?=?0.0098, respectively). The frequency of CD4⁺CD25⁺FOXP3⁺ Tregs in four of the five IVIg-resistant patients at diagnosis was more than 3 standard deviations below that in healthy subjects. Two of these four patients displayed coronary abnormalities, and one of these two patients developed coronary aneurysm. Conclusion: Lack of CD4⁺CD25⁺FOXP3⁺ Tregs before treatment may predict resistance to IVIg therapy in patients with KD.     

母乳喂养对人巨细胞病毒感染婴儿免疫功能的影响

目的 探究母乳喂养对人巨细胞病毒(human cytomegalovirus,HCMV)感染患儿免疫功能的影响。方法 回顾性分析2021年1月—2022年5月郑州大学附属儿童医院收治的135例喂养方式为母乳喂养的HCMV感染患儿的病例资料,根据母乳HCMV-DNA检测结果分为母乳阳性组(78例)和母乳阴性组(57例),再根据母乳HCMV-DNA载量中位数,将母乳阳性组患儿分为母乳高病毒载量亚组(39例)和母乳低病毒载量亚组(39例),分别比较母乳阳性组和母乳阴性组、母乳高病毒载量亚组和母乳低病毒载量亚组患儿外周血淋巴细胞亚群CD3⁺T、CD3⁺CD4⁺T、CD3⁺CD8⁺T、CD19⁺B百分率,CD4⁺T/CD8⁺T比值,IgG、IgM、IgA及尿液HCMV-DNA载量。结果 母乳阳性组和母乳阴性组、母乳高病毒载量亚组和母乳低病毒载量亚组患儿在CD3⁺T、CD3⁺CD4...     

脐血移植治疗37例儿童恶性血液病的临床研究-单中心经验

目的 探讨脐血造血干细胞移植（UCBT）治疗儿童恶性血液病的疗效。方法 回顾性分析接受UCBT 的37 例恶性血液病患儿的临床资料，包括急性淋巴细胞性白血病14 例，急性髓细胞性白血病9 例，幼年粒单细胞白血病5 例，慢性粒细胞白血病和骨髓增生异常综合征各3 例，急性混合型白血病2 例，淋巴肉瘤性白血病1 例。其中34 例非血缘相关，3 例血缘相关。HLA 配型6/6 相合5 例，5/6 相合12 例，4/6 相合11 例，3/6 相合9 例。移植中位年龄5.7 岁，中位体重20 kg。结果 中性粒细胞和血小板植入中位天数分别是12 d 和25 d，植入率分别为95% 和78%。中性粒细胞植入率与CD34+ 细胞数呈正相关（P=0.011）。血小板植入率与CD34+ 细胞数和有核细胞数均有关（分别P=0.001、0.014）。急性移植物抗宿主病（GVHD）的发生率为49%，慢性GVHD 为11%。随访中位时间54 个月，5 年移植相关病死率、总生存率和无病生存率分别为27%、57%和41%。结论 脐血移植是快速获得的造血干细胞来源之一，为恶性疾病患儿争取了治疗时间。     

A NOVEL APPROACH TO TREATMENT WITH HIGH-DOSE STEROID AS A DIFFERENTIATION INDUCER IN CHILDREN WITH ACUTE MYELOBLASTIC LEUKEMIA

Several experimental studies have demonstrated that certain steroid hormones can induce differentiation of mouse myeloid leukemic cells to macrophages and granulocytes. We have shown that high-dose methylprednisolone treatment (HDMP, 20-30 mg/kg/day) can induce differentiation of leukemic cells to mature granulocytes in children with different morphological subtypes of acute myeloblastic leukemia (FAB AML M1, M2, M3, M4). In addition, apoptosis can also be induced in vivo and in vitro in AML blast by HDMP treatment. Short-course (3 to 5 days) HDMP treatment increases the hematopoietic CD34- positive progenitor cells in both bone marrow and peripheral blood in children with AML. Acceleration of leukocyte and neutrophil recovery has been obtained by the administration of short-course HDMP in chemotherapy-induced neutropenic children with AML. The addition of HDMP to anti leukemic chemotherapy increased the complete remission rate and prolonged the duration of remission in children with AML and significantly improved the outcome of AML children who presented with extramedullary infiltration. We suggest that the possibility of HDMP-induced differentiation and apoptosis should be evaluated in patients with other malignant diseases.     

ALLOGENEIC CORD BLOOD TRANSPLANTATION IN CHILDREN WITH HEMATOLOGICAL MALIGNANCIES: A Long-Term Follow-Up Single-Center Study

Forty-two consecutive pediatric patients with high-risk leukemia who received cord blood (CB) transplantation at the authors’ institution from January 1996 and December 2007 were included in this study. Age ranged from 6 months to 18 years and body weight from 7 to 73 kg. Twenty-nine patients had ALL and 13 AML. Twenty-seven out of 42 patients were transplanted in advanced phase of disease (beyond 2nd CR). For 13 patients the CB transplantation was their second transplant. The median follow-up for survivors was 60 months (range, 6–120 months). The probability of myeloid engraftment was 95 ± 5% and the median time to neutrophil >500/μL was 20 days (range, 12–54). The median time to platelet engraftment was 60 days (range, 37–200). The probability of relapse was 33 ± 9%. The nonrelapse mortality at day +100 after transplantation was 30 ± 7%. The probability of disease-free survival was 34 ± 7%. The CD34⁺ cell dose had a significant impact on DFS (HR, 3.28; 95% CI: 1.49–7.23; p =. 003). The results from a long-term follow-up study suggest that cord blood transplantation should be performed in the early phase of disease whenever possible. The cord blood unit for transplantation in pediatric patients with hematological malignancies should be chosen based on cell dose, especially a CD34⁺ cell dose.     

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.     

The effect of short-course high-dose methylprednisolone on peripheral blood CD34+ progenitor cells of children with acute leukemia during remission induction therapy

This study was undertaken to determine the effect of short-course high-dose methylprednisolone (HDMP) treatment on peripheral blood (PB) CD34+ progenitor cells during remission induction treatment in 11 children with newly diagnosed acute leukemia (7 with ALL, 4 with AML) whose bone marrow (BM) cells expressed fewer than 5% CD34 at the time of diagnosis. All children who had no infection were given HDMP as a single daily oral dose of 30 mg/kg for the first four days of induction therapy. The number of CD34+ progenitor cells were determined by flow cytometry before and after four days of HDMP treatment. While the number of PB blast cells significantly decreased after only a four-day course of HDMP treatment, the number of PB CD34+ progenitor cells increased in all patients. In addition, after four days of HDMP treatment polymorphonuclear leukocytes (PMN) and mononuclear cells (MNC) increased significantly (p < 0.05). We suggest that the potential beneficial effects of HDMP in the induction treatment of acute leukemia may occur partly by the stimulation of PB CD34+ hematopoietic progenitor cells in a short period of time.     

Interleukin-2 receptor positive T and B cells in children with acute severe asthmatic attack

Subpopulations of interleukin-2 receptor (IL-2R)-positive CD4 and CD8 T cells and IL-2R⁺ CD20 B cells in the peripheral blood lymphocytes as well as serum concentrations of soluble IL-2R (sIL2R) were measured in children aged 1–7 years who suffered acute severe asthmatic attack. Subpopulations of CD4⁺ IL-2R⁺ cells, CD8⁺ IL-2R⁺ cells and CD20⁺ IL-2R⁺ cells in the peripheral blood lymphocytes at acute severe asthmatic attack phase were significantly higher than those at non-asthmatic attack phase (P < 0.02, P < 0.03 and P < 0.02, respectively). Subpopulations of CD20⁺ IL-2R⁺ cells in the peripheral blood lymphocytes significantly decreased 5–10 days after acute severe asthmatic attack (at recovery phase, P < 0.02) and were significantly correlated with clinical severity of asthmatic attack (P < 0.05). These results indicated that activation of both T cells and B cells was important in the pathogenesis of acute asthmatic attack in young children.     

草分枝杆菌对哮喘小鼠CD4+CD25+调节性T细胞和Th17细胞平衡的影响

目的：评估早期应用草分枝杆菌F.U.36注射液干预治疗对哮喘小鼠CD4+CD25+调节性T细胞（Treg）和Th17细胞平衡的影响,探讨草分枝杆菌的免疫调节作用。方法：将30只雌性BALB/c小鼠随机分为对照组、哮喘组和草分枝杆菌治疗组（治疗组）,每组10只。通过注射和雾化吸入鸡卵蛋白（OVA）制备哮喘模型;治疗组于第1次致敏前2周腹腔注射草分枝杆菌F.U.36注射液0.57?μg,隔日1次,共3次;对照组以生理盐水代替致敏液。所有小鼠于末次激发后24 h处死,取小鼠左肺组织作病理切片观察炎症改变;同时利用流式细胞仪检测各组小鼠脾单个核细胞CD4+CD25+ Treg细胞、Th17细胞占CD4+T细胞的百分比;酶联免疫吸附试验（ELISA）检测各组小鼠血清和支气管肺泡灌洗液中细胞因子IL-10、IL-17的表达水平。结果：哮喘小鼠脾单个核细胞CD4+CD25+ Treg细胞百分比及IL-10的表达水平较对照组明显降低（P<0.05）,Th17细胞的百分比及IL-17表达水平较对照组明显增高（P<0.05）;治疗组小鼠CD4+CD25+ Treg细胞百分比及IL-10表达水平较哮喘组明显升高（P<0.05）,而Th17细胞百分比及IL-17表达水平较哮喘组明显降低（P<0.05）。结论：早期应用草分枝杆菌F.U.36干预性治疗哮喘小鼠,可增加CD4+CD25+ Treg细胞的数目并促进IL-10的产生,同时抑制Th17细胞的表达及IL-17的产生。