SLE患者外周血单个核细胞中IL-6 IL-10表达研究

目的 探讨系统性红斑狼疮（ＳＬＥ）患者中Ｔｈ２型细胞因子ｍＲＮＡ的表达。方法 用逆转录－多聚酶链反应（ＲＴ－ＰＣＲ）法检测了１０例正常人和１５例活动期ＳＬＥ患者外周血单个核细胞（ＰＢＭＣ）中白介素６（ＩＬ－６）和白介素１０（ＩＬ－１０）ｍＲＮＡ表达的水平。结果 与正常相比,活动期ＳＬＥ患者ＰＢＭＣ中ＩＬ－６和ＩＬ－１０ｍＲＮＡ的表达水平均增高（均Ｐ〈０．０１）。结论 ＳＬＥ患者中Ｔｈ２型细胞因子Ｉ     

SLE患者血清sIL－2R水平检测及其临床意义探讨

ＳＬＥ患者血清ｓＩＬ－２Ｒ水平检测及其临床意义探讨冯启仁，周玉贵，胡向阳，钱智萍我们用ＥＬＩＳＡ技术检测了４６例ＳＬＥ血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平，同时测定抗ＤＮＡ抗体（Ａｎｔｉ－ＤＮＡ），旨在通过检测对比探讨其临床意义。临床资料：...     

活动性系统性红斑狼疮患者外周血单个核细胞白介素6信使RNA（IL－6mRNA）表达水平的研究

应用反转录／聚合酶链反应（ＲＴ／ＰＣＲ）方法检测了２１例ＳＬＥ患者及１４例正常人外周血单个核细胞（ＰＢＭＣｓ）中白介素６信使ＲＮＡ（ＩＬ－６ｍＲＮＡ）表达水平，结果表明活动性ＳＬＥＰＢＭＣｓ中ＩＬ－６ｍＲＮＡ表达明显高于非活动性患者及正常对照，而非活动期ＳＬＥ与正常组比较无显著统计学差异，提示ＩＬ－６可能参与活动性ＳＬＥ的发病机制。     

用单克隆抗体检测SLE患者IL－2及IL－6分泌细胞量

ＩＬ－２和ＩＬ－６是机体重要的免疫调节因子。采用单克隆抗体以免疫酶标技术（ＡＰＡＡＰ法）对不同病期ＳＬＥ患者外周血单个核细胞中的ＩＬ－２、ＩＬ－６分泌细胞量进行了检测。结果表明：与正常人比较，活动期患者ＩＬ－２、ＩＬ－６分泌细胞量均升高（Ｐ＜０．０１），且二者间具相关性（ｒ＝０．８８，Ｐ＜０．０５）；非活动期患者ＩＬ－２分泌细胞量升高（Ｐ＜０．０１）而ＩＬ－６分泌细胞量与正常接近。     

SLE患者皮损ICAM－1的免疫组织化学研究

ＳＬＥ患者皮损ＩＣＡＭ－１的免疫组织化学研究马刚，卫藤光，西山茂夫白求恩医科大学第一临床医学院皮肤科（邮政编码１３００２１）细胞间粘附分子（ＩＣＡＭ－１）在扁平苔薛、银屑病皮损部表达增强”’。系统性红斑狼疮（ＳＬＥ）患者皮损表达如何，尚未见报道。我们...     

系统性红斑狼疮患者外周血单一核细胞中Th1型细胞因子的表达

目的 探讨系统性红斑狼疮（ＳＬＥ）患者中Ｔｈ１型细胞因子表达的情况。方法 用逆转录聚合酶链反应（ＲＴ－ＰＣＲ）法检测了ＳＬＥ患者外周血单一核细胞（ＰＢＭＣ）中白介素２（ＩＬ－２）ｍＲＮＡ表达（４１例）和γ干扰素（ＩＦＮ－γ）ｍＲＮＡ表达（３１例）的水平。结果 与正常人相比,活动期ＳＬＥ患者中ＩＬ－２表达水平降低者占７８．０％,ＩＦＮ－γ表达水平降低者占８３．９％。活动期ＳＬＥ组ＰＢＭＣ中ＩＬ－２和     

BXSB小鼠肝、肾、脾脏器中C－myc和N－ras原癌基因的表达

用同位素标记ｃＤＮＡ探针的斑点杂交方法观察了ＢＸＳＢ小鼠肝、肾、脾脏器中Ｃ－ｍｙｃ和Ｎ－ｒａｓ原癌基因的表达情况。结果表明ＳＬＥ发病较重的４～６月龄ＢＸＳＢ雄鼠脾脏和肾脏均表达Ｃ－ｍｙｃｍＲＮＡ，肝脏未见表达。ＳＬＥ发病较轻的４～６周龄ＢＸＳＢ雄鼠仅发现脾脏表达Ｃ－ｍｙｃｍＲＮＡ。ＢＸＳＢ小鼠肝、肾、脾各脏器均无Ｎ－ｒａｓｍＲＮＡ表达。本研究结果提示Ｃ－ｍｙｃ基因可能参与ＢＸＳＢ小鼠淋巴细胞异常活化和狼疮性肾炎的发生。     

SLE患者皮质类固醇治疗前后IL－2，sIL－2R及IL－6水平的比较

检测了１２例活动期ＳＬＥ病人皮质类固醇治疗前后血清中可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）及培养上清中ＩＬ－２的水平，并检测了其中９例病人血清Ｉ－Ｌ６水平。治疗前ＩＬ－２水平为１０．９±６．０Ｕ／ｍｌ，明显低于正常对照组（３８．３±１８．８Ｕ／ｍｌ），ｓＩＬ－２Ｒ水平为７０８±３６７Ｕ／ｍｌ，明显高于正常对照组（２１１±１３７Ｕ／ｍｌ），ＩＬ－６水平为７５．９±４２．５Ｕ／ｍ１，明显高于正常对照组（２１．３±５．８Ｕ／ｍｌ）。皮质类固醇治疗１～６个月后，ＩＬ－２，ｓＩＬ－２Ｒ及ＩＬ－６水平分别为３２．５±２５．６Ｕ／ｍｌ，３５２±１２０Ｕ／ｍｌ及５８±１９．３Ｕ／ｍｌ，均随着临床症状的好转而趋于正常。我们认为ＩＬ－２，ｓＩＬ－２Ｒ的检测可作为监测ＳＬＥ病情活动性的指标。ＩＬ－６的检测在ＳＬＥ病人中亦有一定意义。     

系统性红斑狼疮T细胞的TCR/CD_3信号转导

ＳＬＥ是一种病因未明 ,累及多系统的自身免疫性疾病 ,从过去 2 0年的研究中 ,我们认识到ＳＬＥ的细胞免疫失调是一个复杂的多细胞系的功能紊乱 ,Ｔ细胞被认为是ＳＬＥ发病机理之关键。Ｄａｙａｌ等[1] 提出 ,原发的Ｔ细胞异常 ,信号转导的生化途径失调 ,导致基因调节或表达的异常。使占主导地位的Ｔｈｏ细胞因子分泌方式转变为Ｔｈ2 方式 ,Ｔｈｏ细胞可产生Ｔｈ1ＣＫ (如 :ＩＬ 2、ＩＮＦ γ)和Ｔｈ2 ＣＫ (如ＩＬ 4、5、10 ) ,缺陷性Ｔ细胞的分泌细胞因子的转变 ,影响了Ｂ细胞克隆的免疫调节 ,导致多克隆Ｂ细胞的活化和无限制的致病自身抗…     

BXSB小鼠肝、肾、脾脏器中C－myc和N－ras原癌基因的表达

用同位素标记ｃＤＮＡ探针的斑点杂交方法观察了ＢＸＳＢ小鼠肝、肾、脾脏器中Ｃ－ｍｙｃ和Ｎ－ｒａｓ原癌基因的表达情况。结果表明ＳＬＥ发病较重的４～６月龄ＢＸＳＢ雄鼠脾脏和肾脏均表达Ｃ－ｍｙｃｍＲＮＡ，肝脏未见表达。ＳＬＥ发病较轻的４～６周龄ＢＸＳＢ雄鼠仅发现脾脏表达Ｃ－ｍｙｃｍＲＮＡ。ＢＸＳＢ小鼠肝、肾、脾各脏器均无Ｎ－ｒａｓｍＲＮＡ表达。本研究结果提示Ｃ－ｍｙｃ基因可能参与ＢＸＳＢ小鼠淋巴细胞异常活化和狼疮性肾炎的发生。     

Evaluation of polymerase chain reaction-based detection of Mycobacterium leprae for the diagnosis of leprosy

Because Mycobacterium leprae cannot be cultivated in vitro , laboratory diagnosis of leprosy is generally made by microscopic and histopathological examination. The objective of the present study was to evaluate the sensitivity and utility of polymerase chain reaction (PCR) to detect M. leprae in comparison with other conventional methods for diagnosis such as split skin smears, histopathology and serodiagnosis. PCR amplification of the M. leprae -specific 16S ribosomal RNA was compared to other methods. Samples included 37 multibacillary (MB) patients with a positive bacteriological index (BI), 32 newly diagnosed paucibacillary (PB) patients whose BI were negative and 30 plaque psoriasis patients not residing in leprosy endemic areas as controls. The sensitivity of PCR was 30 fg of M. leprae DNA, which is equivalent to the DNA from 8.3 bacilli. The detection rate in MB and PB were 100% and 50%, respectively; the specificity was 100%. Semiquantitative evaluation of PCR correlated well with BI, but not with the morphological index (MI) nor with the serum antibody against phenolic glycolipid-1 (PGL-1). PCR detection of M. leprae targeting 16S ribosomal RNA was specific and more sensitive than conventional methods, and can contribute to early and accurate diagnosis of leprosy.     

S-100蛋白染色和免疫酶组化技术在早期麻风诊断中的作用

目的 :　应用S- 10 0蛋白免疫组化染色 ,探讨其在早期麻风诊断中的作用。方法 :　将 4 6例临床诊断为少菌型麻风 ,病理检查为非特异性炎症 ,未发现神经枝或神经枝结构正常的石蜡包埋块 ,重新作连续切片进行HE染色与S - 10 0蛋白免疫组化染色 ,进行平行对比观察。结果 :　有 11例( 2 3.9% )显示神经内外炎性浸润。 4例 ( 8.7% )发现神经肉芽肿 ,两种方法具有显著性差异 (P <0 .0 5 )。结论 :　S 10 0蛋白免疫组化染色在显示神经枝及其病变程度方面优于HE染色 ,有助于早期麻风的诊断 ,尤其是结核样麻风     

Leprosy beyond MDT: study of follow-up of 100 released from treatment cases

Appearance of new skin and/or nerve lesions during or after fixed duration of multidrug therapy (MDT), in leprosy, is not uncommon. It could be a lesion due to leprosy reaction or relapse. Differentiation is easy in classical reactions both clinically and histopathologically. But, difficult in other situations especially when the relapse cases present with features of reaction at the onset. A study was done to find the reasons for released from treatment (RFT) cases to come to clinic and to follow in terms of clinical and neurological activity, leprosy reactions and deformity progression. Out of them, 14 cases and 86 cases had received paucibacillary (PB) and multibacillary (MB) multidrug therapy respectively. Skin lesions either old or new were noticed in 74% cases which might be due to inactivity or activity were noticed in 74% cases which might be due to inactivity or activity in forms of relapse and reaction. Relapse was seen in 26 cases. Out of these, 10 and 16 cases were previously diagnosed as PB and MB cases respectively. PB cases relapsed into MB cases while MB cases relapsed into MB cases. 46 cases presented with either type 1 or type 2 reaction. After declared as RFT, parasthesia in 34 cases, weakness in 18 cases, paresis and paralytic deformity in 6 cases were seen. So, all the RFT cases need regular follow-up, IEC and physiotherapy to prevent deformity and to diagnose relapse and reactions at the earliest.     

麻风固定疗程联合化疗后复发病例的分析

目的：评价麻风固定疗程联合化疗（FD MDT）后的远期复发率。方法：MB方案疗程24个月，PB方案疗程6个月，停药后定期随访患者的临床、病理、细菌变化，以观察FD MDT远期复发率。结果：4836例麻风患者采用FD MDT方案治疗，完成治疗4310例，其中MB方案3257例，复发12例，累积复发率为6．80／1000，平均复发潜伏期101．9个月；PB方案完成治疗1053例，复发2例，累积复发率为2．38／1000，平均复发潜伏期102．5个月。结论：凉山州、攀枝花两地20县FD MDT后复发率是低的，结果显示该方案疗程短、安全、疗效好，在边远山区和少数民族地区切实可行。     

A study of relapse after MDT in a district in West Bengal, India

A study was undertaken to estimate the magnitude of the problem of relapse and to identify factors responsible for relapse in leprosy units that were delivering MDT in Purulia District of West Bengal. From records patients were classified as "Relapse" or "Not relapse". "Not relapse" patients were selected by simple random sampling from the Surveillance Register and were matched according to age, sex, and the leprosy control unit. 128 cases ("Relapse") and 128 controls ("Not relapse") were interviewed in the clinic using a pre-tested questionnaire. Details of methods to identify and confirm relapse were circulated to all reporting units for ensuring uniformity and reliability. NGOs covered 42% of the population, while the State Government covered the remaining. The patients had been followed up after completion of treatment for a period of two years in PB leprosy and for five years in MB leprosy. The study revealed that the relapse rate was 1.71/1000 person-years for original PB cases and 0.76/1000 person-years for original MB cases. The study also showed that history of contact with an active leprosy patient and irregular treatment led more PB cases to relapse than control cases. All patients with an initial BI of 3+ relapsed with a BI of 1+ or 2+.     

五莲县1099例麻风愈后复发情况分析

五莲县1955～1989年累计治愈麻风1099例,复发60例次。我们用寿命表法计算其累积复发率为7.05%,并对影响复发的多种因素和复发后转型及转归进行了讨论,提出愈后随访观察MB和PB病人均不应少于10年,甚至应观察15年以上。     

A study on trend of relapse in leprosy and factors influencing relapse

A retrospective analysis of data pertaining to the rural field operation area of the Central Leprosy Teaching and Research Institute, Chengalpattu, Tamil Nadu, was carried out to determine the magnitude of relapse after MDT and its significance with other variables. The study included 3248 leprosy patients who have successfully completed treatment during 1987-2003, of whom 2892 were PB and 356 MB cases. A total of 58 cases of relapse was reported which gives a crude cumulative relapse rate of 1.78% for the 16-year period of follow-up and the rates for PB and MB were 1.9% and 0.84% respectively. With respect to PB cases, 68% of relapses were reported in the first 3 years of RFT. The person-year relapse rate was highly significant with regard to the number of skin lesions (p<0.0002) and nerve involvement (p<0.0002). The person-year relapse rate did not differ significantly between PB and MB leprosy, male and female, and child and adult cases. RFT year cohort relapse rate reveals that the introduction of MB-MDT regimen for PB leprosy had resulted in the reduction of relapses among PB cases after 1998. The relapse rate with reference to the time gap after RFT reveals that relapse declines with passage of time after RFT. The risk of relapse was very low in both PB and MB leprosy which fact emphasizes that proper counselling about signs and symptoms of relapse during RFT is adequate to combat the problem. A majority of relapses occurred in the first three years after RFT. The number of skin lesions and involvement of nerves were the main risk factors for relapse.     

Clinical, bacteriological and histopathological study of 62 referral relapse cases between Jan 2004 and Dec 2009 at the Foundation for Medical Research, Mumbai

Sixty two patients with relapsed leprosy seen between Jan 2004 and Dec 2009 were studied using clinical, bacteriological and histopathological parameters. The findings thus obtained were correlated to parameters such as trend and source of referral, clinical characteristics at diagnosis, treatment received, other events during or after RFT and duration between cessation of treatment and relapse. FINDINGS: Referrals per year have doubled since 2006. Most patients were referred by NGOs (58%), followed by Govt. hospitals (16%) and then by GPs (25%); 76% had received one of the WHO - MDT regimens including 16 treated with 24 months or more MB - MDT, 23 with 12 months MB - MDT and eight with 6 months PB - MDT. Of the remaining 14 cases, four had received DDS mono-therapy, seven had single dose of Rifampicin, Ofloxacin and Minocycline (ROM) and four Rifampicin and Ofloxacin (RO) daily for 28 days. The average incubation time of relapse, defined as duration between cessation of treatment and relapse was (SD) + 6-4 years. 59% of patients had positive slit skin smears on relapse. Relapse for the second time occurred in six BL cases including five from group 2 and one RO treated patient and 11/23 cases from group 2 conferred to BT-BB leprosy. Clinical features at diagnosis and on relapse were comparable in 47% of cases. CONCLUSION: All leprosy patients, regardless of their type and MDT regime, carry 'risk of relapse'. A shorter treatment duration reduces the incubation time to relapse. In group 2 (treated with 12 months MB-MDT regime) 11/23 were BT-BB cases and 5/23 (21%) were relapse for the second time, which further supports our earlier documented findings and maybe the efficacy of WHO-MDT regime is poor in a small subset of patients.     

Comparison of PCR mediated amplification of DNA and the classical methods for detection of Mycobacterium leprae in different types of clinical samples in leprosy patients and contacts

Traditional staining and microscopic examination techniques for the detection of Mycobacterium leprae, DNA amplification by polymerase chain reaction (PCR) of a 531-bp fragment of the M. leprae specific gene encoding the 36-kDa antigen, and serodiagnosis with M. leprae specific antigens (PGL-1 and D-BSA) were compared on different clinical specimens (serum samples, slit-skin smears, biopsies and swabs) from 60 leprosy patients attending the Sanatorium of Fontilles. Patients were divided into groups; (i) 20 multibacillary patients (MB) with positive bacteriological index (BI) by conventional methods and on WHO multidrug therapy (MDT); (ii) 30 MB patients with negative BI and completed minimum 2 years treatment MDT; (iii) 10 paucibacillary (PB) patients who had completed 6 months MDT at least 8 years ago. Control groups included four non-leprosy patients for PCR methods and 40 health control patients and 10 tuberculosis patients for serological methods. In the multibacillary BI positive group, there was a good correlation between all methods. All tests were negative in the paucibacillary group, although only a few patients were tested and all had been treated many years ago. One must be cautious concerning the diagnostic potential of these techniques in this type of leprosy. We also studied different combinations of leprosy diagnosis methods to determine the potential risk in a leprosy contact individuals group. The prevalence of antibodies to M. leprae antigens in serum was measured, together with the presence of M. leprae DNA in the nose and lepromin status in a group of 43 contacts of leprosy patients (12 household and 31 occupational) to evaluate the maintenance of infection reservoirs and transmission of the disease. Only two individuals were found to form a potential high risk group.     

Analysis of gene probes and gene amplification techniques for diagnosis and monitoring of treatment in childhood leprosy

Nucleic acid sequences of Mycobacterium leprae were detected using gene probes hybridizing with targeting ribosomal RNA (16S rRNA), ribosomal DNA (16S rDNA) and gene amplification techniques (PCR) in skin lesion of paediatric leprosy patients and the effect of treatment on the by these methods. Eighty paediatric leprosy patients were included in the study. Most cases (79%) were between 9 and 16 years of age. Cases were divided into three groups according to treatment status, viz. untreated (30), undergoing treatment (30), and at the end of treatment (20). Clinical and slit smear examination for acid fast bacilli (AFB) was performed and nucleic acids were extracted and fractionated from skin biopsies. M. leprae specific 16S rRNA and 16S rDNA was detected by hybridization with gene probes whereas the 36 kDa gene sequence was detected by a gene amplification assay (PCR). The cases were classified as paucibacillary (PB) and multibacillary (MB) by the standard criteria of WHO (1988). Positivity of 16S rRNA in PB cases decreased from 60% in untreated to 10.5% after 4-8 months of treatment whereas for 16S r DNA, it decreased from 50% to 21%, for PCR from 70% to 36.8% for the same specimen, and all became negative at 1 year. Similar trends were seen in MB cases where positivity in smear positive untreated cases decreased from 100% to 56.2% with 16S rRNA and 42.8% with 16S rDNA and PCR, respectively, after 9-12 months of treatment and all became negative at 2 years, except one case which remained positive with PCR. Similar results were observed in smear negative MB cases, 100% positivity detected by 16S r RNA and PCR, 75% detected by 16S rDNA decreased to zero after 9-12 months of therapy. This study suggests the potential usefulness of gene probes targeting 16S rRNA and 16S rDNA and PCR as supportive molecular tools for diagnosis of smear negative evolving MB disease and also monitoring the response to treatment, these observations however, needs to be validated in prospective follow up studies.