严重烧伤病人PMN CD11b/CD18受体表达及特异性iRNA对其调节作用

本文探讨了严重烧伤对病人外周血中性粒细胞 (PMN)CD11b/CD18受体表达的影响及特异性免疫核糖核酸 (iRNA)对其调节作用。结果发现 :(1)严重烧伤病人PMNCD11b/CD18受体表达率明显下降 ,至伤后第 10天时 ,分别只有正常的6 7 1%和 6 8 9% ,且其下降程度与烧伤面积成正比 ;(2 )伤后早期应用特异性iRNA可明显提高烧伤病人PMNCD11b/CD18受体表达率 ;(3)临床观察发现 ,治疗组伤后创面细菌培养阳性率 ,创面脓毒症及菌血症的发生率明显低于对照组 (P均 <0 0 5 ) ,创面愈合时间明显短于对照组 (P <0 0 1)。该结果为临床应用特异性iRNA防治烧伤后感染提供了实验依据。     

Increased CD11b expression on polymorphonuclear leucocytes and cytokine profiles in patients with Kawasaki disease

Clinical evidence implicates polymorphonuclear leucocytes in the pathogenesis of vasculitis in Kawasaki disease. We examined modulation of expression of adhesion molecules (CD11b and CD62L) on polymorphonuclear leucocytes and how this expression is related to serum cytokine concentrations. In 18 patients with Kawasaki disease and 15 control subjects, adhesion molecule expression was determined by two-colour immunofluorescence staining of blood leucocytes and flow cytometry. Eight cytokines and chemokines were also measured. In patients with Kawasaki disease, mean fluorescence intensity for CD11b before giving intravenous immunoglobulin was significantly higher than in normal subjects (P<0 x 005). After intravenous immunoglobulin, mean fluorescence intensity for CD11b decreased significantly. With coronary artery lesions present, mean CD11b fluorescence intensity was significantly higher than without coronary artery lesions (P=0 x 005 before intravenous immunoglobulin; P=0 x 024 after intravenous immunoglobulin). No differences were seen in CD62L expression on polymorphonuclear leucocytes between patients with Kawasaki disease and normal subjects. CD11b expression on polymorphonuclear leucocytes correlated positively with serum interleukin (IL)-6, IL-10, granulocyte colony-stimulating factor, percentage of neutrophils among white cells and C-reactive protein. Polymorphonuclear leucocytes from patients with Kawasaki disease showed increased CD11b expression, which was associated with increased serum cytokines and appeared to be related to coronary artery lesions.     

Increased serum levels of soluble L-selectin (CD62L) in patients with active systemic lupus erythematosus (SLE)

The adhesion molecule L-selectin (CD62L) mediates lymphocyte recirculation and leucocyte rolling on vascular endothelium at sites of inflammation. Serum levels of soluble L-selectin (sL-selectin) were measured in patients with SLE in order to relate these levels to clinical activity and immunological parameters. An ELISA was used to detect the soluble form of human L-selectin (CD62L) in 42 patients with SLE and in 33 healthy individuals. The mean +/- s.e.m. values of sL-selectin were 1285 +/- 121 ng/ml for patients with SLE and 986 +/- 180 ng/ml for healthy blood donors, but there was no significant difference. When patients with active SLE were analysed, higher levels of circulating sL-selectin were found when compared with patients without activity (1497 +/- 167 ng/ml versus 941 +/- 150 ng/ml; P = 0.028). We found a significant correlation between the levels of sL-selectin and of dsDNA antibodies (r = 0.36, P = 0. 044) and between levels of sL-selectin and SLE Disease Activity Index (SLEDAI) score (r = 0.42, P = 0.003). Patients with active SLE studied cross-sectionally showed significant elevations of sL-selectin (CD62L) compared with controls. Thus, the levels of this soluble adhesion molecule correlated with active disease and levels of anti-dsDNA antibodies.     

Expression of CD62L on Donor CD4<Superscript>+</Superscript> T Cells in Allografts: Correlation with Graft-Versus-Host Disease after Unmanipulated Allogeneic Blood and Marrow Transplantation

Introduction  The aim of this study was to investigate the association of donor CD4⁺ T cells expressing CD62L with transplant outcomes. Materials and Methods  We report a prospective analysis of 31 patients who were treated with a Bu/Cy regimen, followed by unmanipulated blood and marrow transplantation. Results  Median number (range) of CD4⁺CD62L⁺, CD4⁺CD45RA⁺CD62L⁺, and CD4⁺CD45RO⁺CD62L⁺ cells infused were 0.31(0.05–1.10)×10⁸/kg, 0.22(0.03–0.95)× 10⁸/kg, and 0.17(0.01–0.81)×10⁸/kg, respectively. The incidence of grades II to IV aGVHD was 36%. In a multivariate analysis, infusion of >0.22 × 10⁸ CD4⁺CD45RA⁺CD62L⁺ cells infused/kg increased the risk of grades II to IV aGVHD (HR = 4.741, 95% CI = 1.037–21.662, P = 0.045). Thirteen of 31 patients experienced cGVHD, the risk of cGVHD was increased in patients receiving >0.45 × 10⁸ CD4⁺CD45RA⁺ cells infused/kg (HR = 4.614, 95% CI = 1.265–16.829, P = 0.021). Conclusion  Our results suggest that a high cell dose of CD4⁺CD45RA⁺CD62L⁺ cells increase the incidence of grades II–IV aGVHD. A high number of CD4⁺CD45RA⁺ cells infused were associated with increased risk of cGVHD in our transplant settings. Ying-Jun Chang: performed research, analysis and interpretation of data, and drafting of the article, and gave final approval of the version to be published; Xiang-Yu Zhao: performed research, analysis and interpretation of data, and drafting of the article and gave final approval of the version to be published; Ming-Rui Huo: performed research, analysis and interpretation of data, and drafting of the article and gave final approval of the version to be published; Xiao-Jun Huang: involved in conception and design, revising the article critically, and final approval of the version to be published.     

COPD加重期患者肺功能、血气指标及 炎症指标的变化分析

目的 研究慢性阻塞性肺疾病急性加重期患者的肺功能指标、血气以及炎性指标的变化,为临床制定诊疗方案提供参考依据。方法 将我院2014年1月~2016年10月呼吸内科收治的42例慢阻肺急性加重期患者纳入A组,对其采用相应的治疗措施,另选取42例同期收治的慢阻肺稳定期患者纳入B组,并选取同期42例正常体检者为对照组。对三组患者的肺功能指标、血气分析以及炎性指标进行分析对比。结果 A组、B组三项指标均比正常体检者低,差异有统计学意义（P＜0.05）;A组三项指标均低于B组,差异有统计学意义（P＜0.05）;血气指标、炎性因子表达变化与急性加重期患者肺功能改变均具有相关性（P＜0.05）。结论 急性加重期患者肺功能、血气及炎性指标与其他分期或健康者有较大的差异,在临床上需要对病情进行详尽分析,确定合适的治疗方案。     

Effect of cysteinyl leukotriene receptor antagonist on CD11b and CD23 expression in asthmatic children

BACKGROUND: Cysteinyl leukotrienes are potent pro-inflammatory mediators that contribute to the pathophysiologic features observed in allergic asthma. Inhibitors of leukotriene receptors represent novel therapy in asthma treatment. In addition to the protection from early asthmatic responses, these drugs have recently been shown to protect from late airway responses too. METHODS: We studied the effect of treatment with an oral antagonist of cysteinyl leukotriene receptors on the increased expression of the low-affinity IgE receptor, CD23, on B cells, and of its ligands, CD11b and CD11c, on CD4(+) T cells and monocytes in peripheral blood of patients with allergic asthma. In this uncontrolled open-label study, 14 children with allergic asthma received montelukast, a cysteinyl leukotrine receptor antagonist, for a period of 6 weeks after demonstrating forced expiratory volume in 1 s (FEV(1)) of less than 80% of the predicted value. Samples of peripheral heparinized blood and sera were obtained before and after therapy completion. Three-colour immunofluorescence analysis was performed, and expression of CD11b and CD11c on CD4(+) T lymphocytes and monocytes as well as the expression of CD21 and CD23 on B cells were determined (n=12). Peripheral blood eosinophil count, changes in FEV(1) and peak expiratory flow rate (PEFR), asthma exacerbations, and as-needed use of beta-agonist were also monitored. RESULTS: Montelukast improved FEV(1) and PEFR, and decreased peripheral eosinophil counts in all study patients. There was no significant change in the expression of CD21 and CD23 on B cells. The expression of CD11c on CD4(+) T cells and of both CD11b and CD11c on monocytes remained similar to the pretreatment expression. However, the percentage of CD11b(+)CD4(+) T lymphocytes significantly decreased after treatment with montelukast. This was accompanied by a significant decrease in the levels of total IgE. CONCLUSION: The capacity of 6-week montelukast therapy to reduce the percentage of CD11b CD4(+) T cells might be a mechanism leading to the immune response modulation on this T cell subset interaction with CD23-expressing B cells and subsequent down-regulation of IgE synthesis.     

CD44和CD62P在IgA肾病中变化的临床意义

目的　观察IgA肾病患者外周血粘附分子CD44 (细胞表面糖蛋白 )和CD6 2P (P选择素 )表达水平的变化 ,并探讨CD44和CD6 2P在IgA肾病发病中的作用及临床意义。方法　采用流式细胞术 ,对 40例IgA肾病患者外周血CD44和CD6 2P表达进行研究 ,以 36例正常人作为对照。结果　IgA肾病患者外周血CD44、CD6 2P的表达分别为 33.89%± 13.2 9%、8.5 8%± 5 .17%明显高于正常对照组 19.73 %± 6 .82 %、3.2 6 %± 1.76 % ,差异有显著性 (P <0 .0 1) ;其中在IgA肾病Ⅳ级和Ⅴ级患者CD44、CD6 2P的表达水平亦明显高于Ⅱ级和Ⅲ级 ;相关性检验结果显示 :IgA肾病患者外周血CD44表达水平与CD6 2P的表达水平呈显著正相关 (r=0 .39,P <0 .0 5 )。结论　CD44和CD6 2P在IgA肾病患者外周血表达增强 ,在IgA肾病的发病机制中起重要作用 ,可能参与了IgA肾病的病理发展过程。     

信必可都保联合噻托溴铵治疗对COPD合并支气管哮喘患者肺功能、免疫功能及气道阻力的影响

目的研究信必可都保联合噻托溴铵治疗对慢性阻塞性肺疾病(COPD)合并支气管哮喘患者肺功能、免疫功能及气道阻力的影响。方法选取88例COPD合并支气管哮喘患者,随机分成两组,每组各44例,对照组噻托溴铵治疗,观察组信必可都保+噻托溴铵治疗,两组疗程均为2周,比较两组肺功能、免疫功能及气道阻力。结果治疗后,观察组总有效率为93.18%,明显高于对照组的77.26%(P<0.05);两组哮喘控制测试(ACT)评分较治疗前明显升高(P<0.05),且观察组升高幅度大于对照组(P <0.05);两组第1秒最大呼气量(FEV1.0)、第1秒最大呼气率(FEV1.0%)、最大呼气流速峰值(PEFR)、肺活量(FVC)较治疗前明显升高(P<0.05),两组肺动脉收缩压(PASP)、肺动脉舒张压(PADP)、平均肺动脉压(MPAP)较治疗前明显降低(P <0.05),且观察组变化幅度大于对照组(P <0.05);两组CD4^+、CD4^+/CD8^+、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)较治疗前明显升高(P<0.05),两组CD8^+较治疗前明显降低(P<0.05),且观察组变化幅度大于对照组(P <0.05);两组气道总阻抗(Z5)、气道总粘性阻力(R5)、近端气道粘性阻力(R20)、周边弹性阻力(X5)较治疗前明显降低(P<0.05),且观察组降低幅度大于对照组(P <0.05);两组血管内皮生长因子(VEGF)、细胞间黏附分子(ICAM-1)、白细胞介素-13(IL-13)、白细胞介素-17(IL-17)较治疗前明显降低(P<0.05),且观察组降低幅度大于对照组(P<0.05);两组在治疗期间未出现明显不良反应。结论信必可都保联合噻托溴铵治疗COPD合并支气管哮喘疗效显著,有效改善肺功能和哮喘情况,调节免疫功能、降低气道阻力和诱导痰细胞因子水平,安全性好,值得临床推广。     

CD11b单核苷酸多态性与中国汉族系统性红斑狼疮的研究

目的 分析CD11b基因rs1143679的单核苷酸多态性(SNP)在中国汉族系统性红斑狼疮(SLE)患者中的表达,并阐明该SNP与SLE临床表型的相关性.方法 采用病例对照的研究方法,应用PCR-PFLP以及直接测序技术对中国汉族人群中584例系统性红斑狼疮患者和624例健康对照者进行多态性检测,分析基因型和等位基因频率的分布差异,并与临床表型进行相关性分析.结果 (1)SLE患者中CD11b rs1143679 GA基因型频率为1.89％,大大低于欧美国家的基因型频率,与香港及泰国地区接近.(2) CD11b rs1143679 GA基因型与狼疮肾炎有相关性(P=0.01),而与发病时间、关节炎、血液系统、神经系统损害没有统计学差异(P＞0.05).结论 CD11b rs1143679 SNP与中国汉族人群系统性红斑狼疮易感性有关,并可能参与了狼疮肾炎的发生发展.     

髓过氧化物酶、CD11b和IL-8在哮喘大鼠模型中表达增加

目的观察哮喘模型大鼠中性粒细胞(PMN)CD11bI、L-8和髓过氧化物酶(MPO)的表达,探讨PMN在哮喘中的作用及其可能的机制。方法复制哮喘大鼠模型,随机分成哮喘组和对照组,分离纯化血PMN;免疫组化法检测MPO表达,ELISA法测定IL-8蛋白,流式细胞术测定血PMN CD11b表达,支气管肺泡灌洗液(BALF)行细胞计数。结果哮喘组肺组织和血PMN中MPO、CD11b及血PMN和BALF中IL-8的水平显著高于对照组(P<0.01)。哮喘组BALF中PMN和嗜酸性粒细胞计数显著高于对照组(P<0.01)。结论BALF中PMN数量增加及血中PMN和肺组织中CD11bI、L-8和MPO在哮喘时表达增加,他们可能参与了哮喘的炎症过程。     

Exogenous Melatonin Up-Regulates Expression of CD62L by Lymphocytes in Aged Mice under Inflammatory and Non-Inflammatory Conditions

It is well documented that age-related impaired functioning of immunocompetent cells is associated with an increase in the rates of chronic inflammatory diseases. Recently, an ability of melatonin to modulate inflammatory processes by regulating leucocyte recruitment has been demonstrated. However, to date, no studies have attempted to determine the impact of melatonin on the expression of CD62L by lymphocytes. CD62L, also known as L-selectin, is required for the entry of lymphocytes into secondary lymphoid organs, sites of tumor growth and chronic inflammation through high endothelial venules. Here, we investigated the effect of melatonin at physiological concentrations on the expression of CD62L by T and NK cells in vivo and in vitro. We demonstrated that NK and CD3⁺ T cells obtained from the spleen of aged mice were characterized by decreased expression of CD62L compared to young mice. Melatonin administration up-regulated the levels of surface CD62L on NK and T cell populations in aged mice under non-inflammatory conditions and on CD8⁺ T cells in aged mice with chronic inflammation. Pre-incubation with melatonin prevented the reduction in CD62L expression by CD8⁺ T cells induced by the co-cultivation of peripheral blood mononuclear cells with human pancreatic adenocarcinoma cell line (MiaPaCa-2). The obtained results suggest that melatonin can modulate lymphocyte homing into lymph nodes and sites of chronic inflammation and, therefore, can stimulate immune responses in chronic inflammatory conditions associated with aging.     

Seasonal dynamics of chemokine receptors and CD62L in subjects with asymptomatic skin sensitization to birch and grass pollen

BACKGROUND: Asymptomatic skin sensitization (AS) has been shown to be a risk factor for respiratory allergic disease. CCR4, CXCR1 and CD62L have all been assigned a role in the immunopathogenesis of allergy. Memory T-cell expression of CCR4, CXCR1 and CD62L has not hitherto been investigated in subjects with AS. METHODS: We investigated seasonal CD4 memory T-cell expression of the chemokine receptors CCR4, CXCR1 as well as L-selectin (CD62L) in fresh cultures derived from symptomatic atopics (SAs), subjects with AS and healthy controls (HCs). Peripheral blood mononuclear cells from all three groups were isolated during birch and grass pollination as well as in the following winter. CD4 memory T-cell expression of CCR4, CXCR1 and CD62L was determined by flow-cytometry. RESULTS: During spring and summer, a significantly increased proportion of memory T cells expressed CCR4, CXCR1 and CD62L in SAs when compared with subjects with AS and HCs. Only SAs exhibited seasonal fluctuations in numbers of CCR4, CXCR1 and CD62L positive memory T cells. CONCLUSION: Although clearly IgE sensitized, subjects with AS have significant diminished numbers of CCR4, CXCR1 and CD62L positive memory T cells, during pollination, when compared with SAs. In contrast to SAs, cultures derived from subjects with AS did not display seasonal variation. Our findings explain the lack of clinical symptoms, during pollination, in subjects with AS.     

CD64感染指数、BODE指数与降钙素原在慢阻肺患者中的水平变化

目的 分析慢阻肺患者的CD64感染指数、BODE指数与降钙素原的水平变化并探究其临床意义。方法 收集2016年1月~2017年3月我院收治的慢阻肺患者80例作为研究组,同时将同期在医院进行检查的稳定期慢阻肺患者作为对照组。分别检测CD64感染指数、BODE指数与降钙素原的水平,分析其临床意义。结果 对照组CD64感染指数为（3.28±0.75）,BODE指数为（1.65±0.39）,降钙素原水平为（0.15±0.09）ng/ml。治疗前,研究组CD64感染指数（5.28±1.99）、BODE指数（3.21±0.63）、降钙素原水平[（0.28±0.13）ng/ml]均高于对照组,差异有统计学意义（P＜0.05）。治疗后,研究组CD64感染指数（3.97±0.81）、BODE指数（1.98±0.41）、降钙素原水平[（0.12±0.12）ng/ml]均下降,与对照组相比,差异无统计学意义（P＞0.05）。结论 CD64感染指数、降钙素原可能是监测慢阻肺住院患者的早期指标,若能在早期进行检测,为用药进行指导,可降低患者住院风险;同时也有利于临床合理应用抗菌药物。而BODE指数则可作为评估患者病情程度及预后的指标。     

Efficacy and Safety of Roflumilast in Korean Patients with COPD

PurposeRoflumilast is the only oral phosphodiesterase 4 inhibitor approved to treat chronic obstructive pulmonary disease (COPD) patients [post-bronchodilator forced expiratory volume in 1 second (FEV₁) <50% predicted] with chronic bronchitis and a history of frequent exacerbations. This study evaluated the efficacy and safety of roflumilast in Korean patients with COPD and compared the efficacy based on the severity of airflow limitation.ResultsA total of 260 Korean COPD patients were recruited, of which 207 were randomized to roflumilast (n=102) or placebo (n=105) treatment. After 12 weeks, LSMean post-bronchodilator FEV₁ increased by 43 mL for patients receiving roflumilast and decreased by 60 mL for those taking placebo. Adverse events were more common in the roflumilast group than in the placebo group; however, the types and frequency of AEs were comparable to those reported in previous studies.ConclusionRoflumilast significantly improved lung function with a tolerable safety profile in Korean COPD patients irrespective of the severity of airflow limitation.     

Pretreatment with simvastatin upregulates expression of BK-2R and CD11b in the ischemic penumbra of rats

Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A reductases, collectively known as statins, have been shown to minimize cerebral ischemic events in patients. We assessed the mechanisms of simvastatin pretreatment in preventing cerebral ischemia/reperfusion injury in rats using a model of middle cerebral artery occlusion (MCAO). Rats were pretreated with simvastatin 14 days prior to MCAO induction. At 3, 24, and 48 hours after reperfusion, bradykinin levels in the ischemic penumbra were assayed by ELISA, mRNA levels of bradykinin B2 receptors (BK-2Rs) and CD11b were measured by fluorescent quantitative real-time PCR (RT-PCR), and co-expression of microglia and BK-2Rs was determined by immunofluorescence. Simvastatin had no effect on bradykinin expression in the ischemic penumbra at any time point. However, the levels of BK-2R and CD11b mRNA in the ischemic penumbra, which were significantly decreased 3 hours after ischemia-reperfusion, were increased in simvastatin-pretreated rats. Moreover, the co-expression of BK-2Rs and microglia was confirmed by immunofluorescence analysis. These results suggest that the beneficial effects of simvastatin pretreatment before cerebral ischemia/reperfusion injury in rats may be partially due to increased expression of BK-2R and CD11b in the ischemic penumbra.     

中西医结合治疗慢性阻塞性肺疾病并高黏血症的临床疗效分析

目的:观察银杏达莫注射液联合内服外敷中药治疗慢性阻塞性肺疾病(简称慢阻肺,COPD)合并高黏血症的临床疗效。方法:88例COPD合并高黏血症患者分为治疗组(n=44)与对照组(n=44),对照组给予西医常规治疗,治疗组在对照组治疗的基础上,给予静脉滴注银杏达莫注射液,并予以中药内服和穴位贴敷。14天后观察两组临床疗效及血液流变学指标变化。结果:连续治疗14天后,治疗组临床痊愈率明显高于对照组(45.45%vs25.00%,P0.05),无效率显著低于对照组(6.82%vs22.73%,P0.05)。治疗组高切表观黏度、低切表观黏度、红细胞压积、血浆黏度、血浆纤维蛋白原含量和红细胞聚集指数等指标均较治疗前明显改善(P0.01);治疗组与对照组治疗后比较,除红细胞聚集指数外,其它指标均显著降低,差异有统计学意义(P0.05)。结论:银杏达莫注射液联合内服外敷中药治疗COPD合并高黏血症,可明显提高临床痊愈率并显著改善血液流变状态。     

Bone marrow-derived progenitors are greatly reduced in patients with severe COPD and low-BMI

Chronic obstructive pulmonary disease (COPD) patients have reduced circulating hemopoietic progenitors. We hypothesized that severity of COPD parallels the decrease in progenitors and that the reduction in body mass index (BMI) could be associated with more severe bone marrow dysfunction.     

高敏CRP、vWF和CD62P联合检测在冠心病患者的应用

探讨超敏C反应蛋白(hs-CRP)、血管性血友病因子(von Willebrand factor,vWF)、血小板表面P选择素(CD62P)的变化与冠心病患者的关系及其临床价值。对40例冠心病患者(不稳定性心绞痛)及30名正常人采用乳胶增强免疫比浊法测定hs-CRP,ELISA测血浆vWF,流式细胞仪(FCM)测定血小板膜CD62P阳性百分率(%)。结果显示,冠心病组的hs-CRP显著高于对照组(P<0.01),血浆vWF显著高于对照组(P<0.01),CD62P阳性率显著高于对照组(P<0.01)。联合检测hs-CRP、vWF和CD62P对冠心病患者的辅助诊断、疗效和预后观察有一定价值。     

慢性阻塞性肺疾病急性加重期患者外周血Th17细胞的表达及临床意义

目的 探讨外周血Th17细胞在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的表达及临床意义.方法 以260例慢性阻塞性肺疾病(COPD)患者为研究对象,按临床表现分为COPD稳定期组(130例)和AECOPD组(130例),同时选取50例健康体检者为对照组.采用流式细胞术检测外周血Th17细胞水平,酶联免疫吸附法检测外周血细胞因子IL-17水平,同时检测C-反应蛋白(CRP)及白细胞计数(WBC)水平,记录COPD评估测试(CAT)评分.结果 AECOPD组患者外周血Th17细胞、IL-17、CRP及WBC水平显著高于COPD稳定期组和正常对照组(P＜0.05);经过相应治疗后,AECOPD组患者外周血Th17细胞、IL-17、CRP、WBC水平及CAT评分均较治疗前明显降低,差异具有统计学意义(P＜0.05).相关性分析显示,AECOPD组患者外周血Th17细胞水平与CAT评分呈显著正相关(r=0.91,P＜0.01).外周血Th17细胞水平与炎性因子IL-17也呈正相关(r=0.89,P＜0.01),而AECOPD组患者外周血Th17细胞水平与CRP(r =0.084,P＞0.05)、WBC(r=0.063,P＞0.05)水平无显著相关性.ROC曲线分析显示,外周血Th17细胞水平的曲线下面积(AUC)为0.868(95％ CI0.774～0.918),以外周血Th17细胞水平3.72作为临界值时,其诊断AECOPD的敏感性为88.6％,特异性为86.4％,其显著优于CRP和WBC指标.结论 外周血Th17细胞在AECOPD患者中高表达,其可作为预测COPD急性加重期的有效指标,具有一定的临床运用价值.     

IL-18 produced by thymic epithelial cells induces development of dendritic cells with CD11b in the fetal thymus

Thymic dendritic cells (DCs) are suggested to be involved in T cell selection; however, their exact origin and function remain to be established. Although DCs in the adult thymus are mostly CD8alpha(+)CD11b(-), we found that CD8alpha(-)CD11b(+) DCs were abundantly present in the fetal thymus and they possessed antigen-presenting activity. Interestingly, these CD11b(+) DCs were significantly decreased in mice deficient for TNFR-associated factor 6 (TRAF6), a key signaling molecule downstream of IL-1 and tumor necrosis factor-alpha that have been known to induce DCs from intra-thymic precursor cells. CD11b(+) DCs were induced from CD4(-)CD8(-) thymocytes by fetal thymic epithelial cells (TECs). Analysis of cytokine expression in TECs revealed that none of the cytokines previously shown to induce DCs were expressed. Instead, we found strong expression of IL-18 that transmits signals through TRAF6. IL-18 induced CD11b(+) DCs from CD4(-)CD8(-) thymocytes in vitro, which exhibited strong antigen-presenting activity and formed conjugates with CD4(+)CD8(+) T cells efficiently. Taken together, these results strongly suggest that CD11b(+) DCs are differentiated from CD4(-)CD8(-) thymocytes by IL-18 produced from TECs and that they are involved in T cell selection in the fetal thymus.