系统性红斑狼疮患者外周血CD4+CD25+T细胞亚群的表达及临床意义

目的研究系统性红斑狼疮(SLE)患者外周血CD4~ 、CD25~ 、CD4~ CD25~ 淋巴细胞亚群的变化及临床意义。方法采用二色荧光抗体标记法,以流式细胞仪对34例SLE患者和18名正常人外周血CD4~ 、CD25~ 、CD4~ CD25~ 淋巴细胞亚群进行了检测,以CD25抗原荧光强度≥10的细胞定义为CD25~(high)细胞,分析其百分率和荧光强度,并结合临床资料进行相关分析。结果活动组SLE患者外周血CD4~ CD25~ 细胞、CD4~ CD25~(high)细胞占总淋巴细胞的百分率[(4．80±1．21)%和(0．25±0．10)%]均低于正常对照组[(8．92±3．21)%和(0．44±0．22)%],亦低于稳定组SLE患者[(11．28±2．09)%和(0．59±0．34)%](P均＜0．05),而稳定组SLE患者与正常对照组差异无统计学意义(P＞0．05)；但CD4~ CD25~ 细胞占CD4~ 细胞的比例在三组之间差异无统计学意义(P均＞0．05)；外周血CD4~ CD25~ 、CD4~ CD25h~(high)细胞数与系统性红斑狼疮疾病活动指数(SLEDAI)积分呈负相关(r=-0．74,P=0．004和r=-0．614,P=0．026),与其他临床指标如补体、抗核抗体(ANA)滴度等无相关性；活动组SLE患者外周血CD4~ 和CD25~ 细胞亦均低于正常对照组[(23±7)vs(34±7)和(7．4±1．8)vs(13．9±3．4),P＜0．05]；SLE患者CD25抗原的荧光强度高于正常对照组(P＜0．05),而CD4抗原的荧光强度差异无统计学意义(P＞0．05)。结论活动性SLE患者外周血CD4~ CD25~ 细胞数是减少的,并与CD4~ 细胞的减少有关,提示在SLE的发病及病情活动中可能起一定作用。     

系统性红斑狼疮患者CD4+CD25+调节性T细胞的变化

目的检测系统性红斑狼疮(SLE)患者外周血CD4 CD25 T细胞和CD4 CD25highT细胞占CD4 T细胞的比率,探讨其在SLE发病中的意义。方法采用流式细胞术检测93例SLE患者及47 名正常对照外周血CD4 CD25 调节性T细胞和CD4 CD25highT细胞占CD4 T细胞的比率,分析其与SLE 临床及实验室指标的关系。结果活动性SLE患者CD4 CD25 调节性T细胞及CD4 CD25highT细胞比例较正常人降低;CD4 CD25highT细胞水平与系统性红斑狼疮疾病活动指数(SLEDAI)呈负相关;CD4 CD25 调节性T细胞与抗核抗原抗体(ANA)、抗可提取的核抗原(ENA)抗体、抗dsDNA抗体、免疫球蛋白、补体C3、C4无相关。结论CD4 CD25 T细胞和CD4 CD25highT细胞可能参与SLE的发病机制。     

系统性红斑狼疮患者外周血CD5+B细胞亚群的意义

目的通过检测系统性红斑狼疮(SLE)患者外周血中CD5+B细胞亚群水平,以探讨CD5+B细胞亚群在SLE疾病活动中的作用.方法利用双色流式细胞分析法对44例SLE患者和19名正常人群外周血CD5+CD19+,CD5-CD19+细胞亚群进行检测,同时检测患者抗dsDNA抗体,C3和C4水平.结果活动期系统性红斑狼疮患者CD5+B细胞水平较正常人群明显升高(P＜0.01);静止期系统性红斑狼疮患者CD5+B细胞较正常人群明显下降(P＜0.05),系统性红斑狼疮患者CD5+B细胞水平与疾病活动指数明显正相关(P＜0.01).结论研究证实,活动期系统性红斑狼疮患者外周血CD5+B细胞水平明显升高,与SLE疾病活动有着一定的关系.     

外周血CD+4CD+25T细胞表达在系统性红斑狼疮患者中的意义

目的了解系统性红斑狼疮(SLE)患者外周血CD4 CD2 5T细胞表达及其临床意义。方法用流式细胞仪检测53例SLE患者外周血CD4 CD2 5T细胞表达,根据CD25表达荧光强度>100者为CD4 CD25brightT细胞,并与SLE活动指数评分(SLEDAI)、血清补体C3水平、抗双链DNA抗体、抗核抗体滴度进行相关分析。结果SLE患者外周血CD4 CD2 5T细胞表达率为(7·84±1·85)%,显著低于对照组(9·18±2·01)%(P<0·05),且活动期组[(6·72±1·16)%]较稳定期组更低[(8·57±1·91)%,P<0·01]。外周血CD4 CD25brightT细胞表达率在活动期组[(0·85±0·24)%]和稳定期组[(0·91±0·25)%]之间相比差异无统计学意义(P=0·686),但均低于对照组[(1·43±1·08)%,P<0·01]。随治疗后SLEDAI评分的下降,活动期组SLE患者外周血CD4 CD25brightT细胞表达率无明显变化。进一步分析外周血CD4 CD25brightT细胞表达率与SLEDAI评分、抗核抗体、抗双链DNA抗体滴度和血清C3水平的相关性,分别为ρ=-0·188,P=0·178;ρ=-0·216,P=0·121;ρ=0·082,P=0·560;ρ=0·010,P=0·944,差异均无统计学意义(P>0·05)。结论外周血CD4 CD2 5T细胞的减少可能与SLE的发病有关。     

外周血单核细胞CD69/CD3比值在评估系统性红斑狼疮疾病活动性中的作用

目的　通过检测系统性红斑狼疮 (SLE)患者外周血中T细胞CD6 9表达 ,以探讨CD6 9/CD3比值在评估SLE疾病活动指数中的作用。方法　利用流式细胞分析法对 5 4例SLE患者和 18名健康志愿者外周血T细胞上CD6 9表达进行分析 ,同时检测患者抗dsDNA抗体、C3和C4水平。结果　SLE患者CD6 9/CD3的比值显著高于正常人群 (P <0 0 1) ,当抗dsDNA抗体、C3和C4水平与疾病活动性缺乏相关关系时 ,CD6 9/CD3仍与SLE活动指数 (SLEDAI)有明显相关性 (P <0 0 5 )。结论　T细胞活化 (CD6 9/CD3)程度与SLEDAI指数有明显的相关性 ,可用于评估SLE疾病活动性     

系统性红斑狼疮患者T淋巴细胞PTA1表达的研究

目的：研究血小板和T细胞活化抗原1（PTA1）在系统性红斑狼疮（SLE）外周血T淋巴细胞的表达及其与SLE活动相关性，探索活化T细胞在SLE发病中的作用。方法：应用双色直接荧光标记，流式细胞仪分析27例（其中活动期13例，非活动期14例）SLE患者和30名健康志愿者的CD3，CD4，CD8淋巴细胞，在植物血凝素（PHA）刺激下PTA1（CD226）表达，同时检测SLE患者抗dsDNA抗体，C3和C4补体，疾病活动度用SLEDAI记分，结果：SLE患者组CD3，CD4，CD8淋巴细胞上PTA1表达率均高于正常对照组，CD3上PTA1表达两组差异有显著性（P＜0．01），活动期SLE组CD3，CD4，CD8细胞上PTA1表达均高于正常对照组和非活动期SLE组（P＜0．01），而非活动期SLE组与正常对照组差异无显著性（P＞0．05），SLE患者CD3，CD8细胞PTA1表达与SLEDAI，抗dsDNA抗体之间呈正相关，与C3，C4补体水平呈负相关，CD8细胞PTA1表达与SLEDAI，抗dsDNA抗体，C3，C4补体水平呈直线相关（P＜0．05），结论：SLE患者存在T细胞亚群异常活化，活动期SLE淋巴细胞PTA1表达增高，SLE患者CD8细胞PTA1表达异常与SLEDAI，抗dsDNA抗体，C2和C4补体之间有明显相关，CD8细胞活化程度与SLE疾病程度有关，PTA1可能参与了SLE的免疫发病机制。     

系统性红斑狼疮患者外周血CD4+CD25highFoxp3+调节性T细胞数量和Foxp3mRNA的表达水平与疾病活动性的相关性

目的 研究系统性红斑狼疮(SEE)患者CD4+CD25highFoxp3+调节性T细胞的数量及其功能基因Foxp3 mRNA的表达水平与SLE疾病活动性和肾脏损伤的相关性.方法 采用四色流式细胞术以Foxp3-异硫氰酸荧光素(FITC )/CD25-藻红蛋白/CD4-多甲藻叶绿素蛋白(PerCP)/CD3-藻蓝蛋白7抗体组合检测40名健康对照者及42例SLE患者外周血CD4+CD25highFoxp3+调节性T细胞的数量,实时荧光定量聚合酶链反应(PCR)检测特异性转录因子Foxp3 mRNA的表达水平,并分析其与SLE患者疾病活动指数(SLEDAI)、补体C3及血清抗双链DNA(dsDNA)抗体的关系.统计学方法采用t检验和Spearman相关分析.结果 活动期SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量显著低于健康对照组[(4±3)％与(7±4)％,P＜0.05],稳定期与健康对照组差异无统计学意义(P＞0.05);活动期SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量及CD4+CD25highFoxp3+调节性T细胞/CD4+比值显著低于稳定期患者[(4±3)％,(9±6)％与(5±4)％,(10±6)％,P均＜0.05];活动期SLE患者外周血Foxp3 mRNA的表达水平明显低于稳定期和对照组(P＜0.01,P＜0.05);SLE患者并发肾病组外周血CD4+CD25highFoxp3+调节性T细胞数量及CD4+CD25highFoxp3+调节性T细胞/CD4+比值显著低于SLE非肾病组(P＜0.05).相关分析显示,SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量与SLEDAI呈负相关(r=-0.5782,P＜0.05);CD4+CD25highFoxp3+调节性T细胞/CD4+比值与SLEDAI呈负相关(r=-0.4913,P＜0.05),与补体C3呈正相关(r=0.3687,P＜0.05);SLE患者外周血CD4+CD25highFoxp3+调节性T细胞数量与Foxp3 mRNA的表达水平呈正相关(r=0.6142,P＜0.0l).结论 SLE患者外周血CD4+CD25highFoxp3+调节性T细胞和Foxp3 mRNA的变化可能是导致SLE疾病发生和发展的关键因素之一,与疾病的活动性有密切关系.     

系统性红斑狼疮患者CD1的表达与疾病活动性的相关性

目的研究系统性红斑狼疮(SLE)患者外周血CD1的表达与疾病活动性之间的关系。方法用流式细胞仪检测了47例SLE患者外周血单个核细胞CD1c及CD1d的表达及淋巴细胞亚群百分数。结果SLE活动组病人CD1c+及CD1d+细胞百分率显著增高(P<0.05),CD4+细胞百分率显著降低(P<0.01),CD3+、CD8+细胞百分率正常,CD20+细胞数增高(P<0.01)。稳定期病人CD1c+及CD1d+细胞百分率正常,CD4+、CD8+、CD20+细胞百分率均正常。SLE患者CD1c+、CD1d+细胞阳性率与患者SLEDAI的评分有显著的相关性(r=0.68与r=0.66,P<0.01),与抗dsDNA抗体的表达有显著相关性(r=0.36与r=0.41,P<0.05);SLE患者CD1c+细胞阳性率与抗磷脂抗体(ACA)的表达有显著的相关性(r=0.68,P<0.01),与血清C3水平有显著相关性(r=-0.35,P<0.05)。经治疗后CD1c及CD1d的表达明显下降。结论系统性红斑狼疮患者外周血CD1c与CD1d的表达与疾病的活动性明显相关,CD1c、CD1d可能在SLE脂类抗原及核酸类抗原的递呈及抗dsDNA抗体、抗磷脂抗体的产生中起重要作用。     

糖皮质激素受体α在系统性红斑狼疮发病机制中的作用研究

目的探讨系统性红斑狼疮(SLE)患者外周血单个核细胞(PBMCs)糖皮质激素受体!(GR!)mRNA表达及其与免疫指标[抗核抗体(ANA)、抗dsDNA抗体]的变化、疾病活动性的关系,分析GR!在SLE发病机制中的作用。方法采用反转录聚合酶链反应(RT-PCR)检测活动期和缓解期SLE患者和正常人PBMCs中GR!mRNA的表达,并将其与ANA、抗dsDNA抗体及疾病活动性作相关分析。结果SLE患者PBMCs中GR!mRNA表达较正常人明显减少(P<0.05),但活动期患者表达高于缓解期患者(P<0.05),且与抗dsDNA抗体及疾病活动性呈负相关。结论SLE患者外周血PBMCs存在GR!的表达缺陷,从而引起对自身反应性T、B淋巴细胞的活化缺乏抑制效应,导致自身免疫耐受丧失,产生炎症性细胞因子和自身抗体。GR!在SLE的发病机制中可能发挥重要作用。     

抗核小体抗体诊断系统性红斑狼疮的价值

280份血清,取自健康体检者50例,类风湿关节炎（RA）74例,系统性红斑狼疮（SLE）106例．其他结缔组织病50例．分别检测其抗核抗体（ANA）,抗双链DNA（dsDNA）,抗史密斯（Sm）,抗组蛋白（His）及抗核小体抗体（AnuA）抗体。结果5种抗体诊断SLE的敏感性和特异性为;ANA96．2%、31％,AnuA80．1％、93％,dsDNA56．6%、92％,Sm49．7％、90％,His54．7％、85%。ANA、AnuA敏感性明显高于其他3种抗体（P〈0．001）．AnuA、dsDNA、HiS、Sm的特异性明显高于ANA（P〈0．001）。AnuA是SLE的又一种特异性抗体,其与ANA、dsDNA抗体及Sm抗体、His抗体联合检测对SLE的诊断有重要意义。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.