促血管生成素-1对糖尿病大鼠肾脏色素上皮衍生因子和血小板反应蛋白-1基因表达的影响

目的 观察色素上皮衍生因子（PEDF）、血小板反应蛋白-1（TSP-1）在糖尿病大鼠肾脏的表达变化,探讨促血管生成素-1（Ang-1）对上述因子的影响. 方法 将雄性SD大鼠分正常对照（NC）组、DN组、空载处理（BV）组、Ang-1处理（AV）组.采用STZ腹腔注射诱导大鼠DN模型.成模8周后尾静脉注射Ang-1腺病毒载体.多时点检测24 hUAlb和肾组织PEDF、TSP-1蛋白及mRNA表达水平.结果 DN、BV、AV组24 hUAlb均升高,其中AV组于20周后降低（P＜0.05）.DN、BV、AV组肾组织PEDF蛋白及mRNA表达下调,TSP-1表达上调（P＜0.05）,其中AV组12周后肾组织PEDF和TSP-1mRNA及蛋白表达变化较DN、BV组改善明显（P＜0.05）. 结论 糖尿病大鼠肾脏PEDF、TSP-1异常表达参与DN发生发展,给予Ang-1可改善糖尿病大鼠肾脏PEDF、TSP-1异常表达.     

Evaluation of the efficacy and safety of anti-PD-1 and anti-PD-L1 antibody in the treatment of non-small cell lung cancer (NSCLC): a meta-analysis

Background

Currently, blockade of the programmed cell death 1 (PD-1)/PD-1 ligand 1 (PD-L1) signaling pathway has been proved one of the most promising immunotherapeutic strategies against cancer. Several antibodies have been developed to either block the PD-1 or its ligand PD-L1 are under development. So far, a series of phase I trials on PD-1/PD-L1 antibodies for non-small cell lung cancer (NSCLC) have been completed, without reports of results from phase II studies. Thus, we sought to perform a meta-analysis incorporating all available evidences to evaluate the efficacy and safety of PD-1 or PD-L1 inhibition therapy.

Methods

Electronic databases were searched for eligible literatures. Data of objective respond rate (ORR) and rate of adverse effects (AEs) with 95% confidence interval (CI) evaluated by immunohistochemistry (IHC) was extracted. The outcomes were synthesized based on random-effect model. Subgroup analyses were proposed.

Results

In overall, ORR in the whole population with PD-1 blockage treatment is 22.5% (95% CI: 17.6% to 28.2%). Additionally, the rate of Grade 3-4 AEs is 16.7% (95% CI: 6.5% to 36.8%) and drug-related death rate is 2.5% (95% CI: 1.3% to 4.6%). As for patients with PD-L1 inhibition therapy, an overall ORR is 19.5% (95% CI: 13.2% to 27.7%). A higher rate of Grade 3-4 AEs (31.7%, 95% CI: 14.2% to 56.5%) is observed with a lower drug-related death rate (1.8%, 95% CI: 0.4% to 8.3%). In exploratory analyses of anti-PD-1 agents, we observed that greater ORR was presented in the median-dose cohort (3 mg/kg) than that of both low-dose (1 mg/kg) and high-dose (10 mg/kg) cohort (low-dose vs. median-dose: OR =0.12, P=0.0002; median-dose vs. high-dose: OR =1.47, P=0.18).

Conclusions

Anti-PD-1 and anti PD-L1 antibodies showed objective responses in approximately one fourth NSCLC patients with a tolerable adverse-effect profile. In addition, median-dose (3 mg/kg) might be a preferential dosage of anti-PD-1 agents.     

肾上腺髓质素和内皮素-1在大鼠肝肺综合征发病机制中的作用

[目的]探讨肝肺综合征(HPS)的发病机制.[方法]采用胆总管结扎(CBDL)术制备大鼠HPS模型,观察肺组织肾上腺髓质素(ADM)、内皮素-1(ET-1)及其受体(ETRA和ETRB)的表达和分布.[结果]在大鼠HPS形成过程中,血浆和肺组织中ADM、ET-1水平动态升高,且与肺泡-动脉氧分压差(A-aDO2)正相关;HPS大鼠肺组织中ADM、内皮素前体原(ppET-1 mRNA)的表达较假手术组明显增强,差异均有统计学意义(P＜0.05).HPS大鼠肺血管ETRA的分布及染色强度与假手术组比较无明显变化,而ETRB在远端肺小动脉和小静脉内膜上表达明显增强.图像分析结果显示CBDL 5周(w)组大鼠ETRA染色面积、平均积分光密度值与假手术组比较差异无统计学意义(P＞0.05),而CBDL 5 w组大鼠ETRB染色面积和平均积分光密度值明显高于假手术组,差异均有统计学意义(P＜0.05).[结论]扩血管物质ADM和缩血管物质ET-1的共同作用可能参与HPS的发生,肺组织中升高的ET-1可能更多地通过与在肺血管表达增强的ETRB结合从而扩张肺血管.     

钙调素蛋白磷酸酶对Slingshot-1L的调控作用

目的 探讨钙调素依赖蛋白激酶(Calcinenurin/PP2B/CnA/Cn)对Slingshot-1L(SSH-1L)活性的调控作用.方法 用脂质体法将含YFP-SSH-1L的重组质粒转染至MG63细胞,经钙离子载体A23187诱导10 min,进行免疫细胞化学染色,观察细胞形态变化;体内及体外实验检测PP3B对SSH-1L的活性调控作用;应用免疫共沉实验检测PP2B与SSH-1L的相互结合情况.结果 Ca~(2+)信号诱导骨肉瘤细胞形成伪叶,同时SSH-1L与F-actin移位共聚集至细胞膜伪叶,但是被PP2B有效抑制剂Cypermethrin完全阻断;在体外,SSH-1L磷酸酶活性测定实验以及SSH-1L与PP2B结合实验证实SSH-1L与PP2B在细胞内是一对相互结合的蛋白质,同时PP2B具有促进SSH-1L酶活性的作用.结论 PP2B通路对细胞伪叶的形成及细胞运动具有重要调控作用,同时对SSH-1L酶具有促进其活性的作用.     

白细胞介素1与绝经后骨质疏松症相关性研究进展

绝经后骨质疏松症(PMOP)是一种绝经后妇女发病率日趋上升的全身骨性疾病,探讨其发病机制,并针对其机制找到能够预防甚至治疗PMOP的方法,是全球公共卫生亟待解决的重要问题。近年来研究发现,白细胞介素1(IL-1)在PMOP发生发展过程中有明显的作用。该文将通过对IL-1与PMOP的相关性研究进展进行总结,以期为PMOP防治及相关分子机制研究提供理论依据。     

内皮素-1在大鼠肝肺综合征发病机制中的作用

目的 探讨内皮素-1(ET-1)在大鼠肝肺综合征(HPS)发病机制中的作用.方法 应用放免法检测HPS大鼠血浆和肝、肺组织匀浆中ET-1的水平.结果 ①HPS大鼠血浆和肝组织、肺组织匀浆中ET-1水平动态升高.②各阶段血浆和肝、肺组织匀浆中ET-1水平与谷丙转氨酶(ALT)、总胆红素(TBIL)呈正相关.结论 在HPS形成过程中,血浆和肝、肺组织匀浆中ET-1水平持续升高,与肝功能损害有关,提示ET-1可能参与HPS的发生.肺组织匀浆中升高的ET-1可能更多地通过与在肺血管表达增强的内皮素受体B(ETRB)结合从而扩张肺血管.     

慢性胃炎患者胃黏膜三叶因子1与细胞间黏附分子1蛋白表达

[目的]在幽门螺杆菌(Hp)阴性慢性浅表性胃炎(CSG)中探讨脾胃湿热证与三叶因子1(TFF1)、细胞间黏附分子1(ICAM-1)蛋白表达的相关性。[方法]Hp阴性CSG患者(脾胃湿热组27例,脾虚组10例)及对照组10例,经临床检查、胃镜取标本、病理学及免疫组化SP法检测胃黏膜炎症程度及TFF1、ICAM-1的蛋白表达情况。[结果]胃镜下脾胃湿热组胃黏膜充血水肿较脾虚证明显。炎症程度:脾胃湿热组>对照组(P<0.01),脾虚组>对照组(P<0.05),脾胃湿热组稍重于脾虚组。TFF1蛋白表达:脾胃湿热组>脾虚组>对照组。ICAM-1蛋白表达:脾胃湿热组>脾虚组稍高于对照组。ICAM-1蛋白表达与炎症程度呈正相关(P<0.01)。TFF1与ICAM-1蛋白表达呈正相关(P<0.01)。[结论]脾胃湿热证时TFF1、ICAM-1蛋白均呈高表达。提示脾胃湿热证中TFF1可能与机体正气抗邪状态有关;ICAM-1可能参与湿邪致病的分子机制。     

Sequence heterogeneity of the merozoite surface protein-1 gene (MSP-1) of Plasmodium vivax wild isolates in southeastern Iran

The merozoite surface protein of Plasmodium vivax (PvMSP-1) has been considered as a vaccine candidate, which exhibits antigenic diversity among isolates. We investigated the extent of sequence variation in the polymorphic region 5 of PvMSP-1 in order to characterize the genetic structure and composition of P. vivax in clinical isolates from Iranshahr and Chahbahar districts of Sistan and Baluchistan province, Iran. The PvMSP-1 gene amplification revealed size variation among the isolates, ranging from 430 to 550 bp. Sequences were obtained for 15 Iranian and one Pakistani isolates and 14 different alleles were detected. Results also showed three distinct sequence types of the polymorphic region. Sequence analysis has shown several single nucleotide polymorphisms to occur in this block of PvMSP-1, creating different alleles in the progeny and also microheterogeneity in the region. Thus, this study provides preliminary evidence of sequence heterogeneity in the Iranian P. vivax population.     

Comparison of PD-L1 immunohistochemical assays and the significance of PD-L1 expression in thymoma

Thymoma is a relatively rare malignancy, which is categorized as thymic epithelial tumor but known as the most common pathology that is developed in the anterior mediastinum. Complete resection is recommended for localized tumors and usually favorable prognosis can be obtained. However, poor survival period has been reported in unresectable cases exhibiting extensive invasion or distant metastasis, as effective chemotherapeutic regimens are restrained. We previously assessed expression of programmed death ligand 1 (PD-L1) and programmed death 1 (PD-1) and discussed their prospective application in the immunotherapy of thymic epithelial tumors. After our publication, additional studies using reliable PD-L1 antibodies, which are currently administered to predict efficacy of PD-1/PD-L1 blockade therapy were performed and further characterized PD-L1 in thymoma. Herein, recent knowledge in relation to the significance of PD-L1 expression in thymoma is reviewed based on recent findings using qualified PD-L1 clones. Most studies coherently found high expression of PD-L1 on the cell membrane and cytoplasm of tumor epithelial cells in accordance with previous reports, which is a predictive marker for effectiveness of anti-PD-1/PD-L1 drugs, even when approved PD-L1 antibodies were employed. On the other hand, PD-L1 expression on tumor infiltrating immune cells remains to be sufficiently determined. High PD-L1 expression can be expected in cases with high grade histological subtypes, such as type B2/B3 thymomas, or those with advanced stages III or IV of the disease. Interestingly, the level of PD-L1 expression was found to be upregulated after chemotherapy compared with that before, which could be explained by immunogenic cell death. The prognostic impact of PD-L1 expression in thymoma might be found only when thymic carcinoma patients were excluded. Furthermore, it also could be identified when we analyzed thymomas completely resected, distinct from biopsy and incompletely resected cases.     

缺氧诱导因子-1与心肌对缺氧的适应

缺氧诱导因子 1是在体内广泛存在的核内转录因子 ,有两个亚基。HIF 1是细胞在缺氧条件下产生的核蛋白 ,它与靶基因结合后可调节多种基因如内皮素、血管内皮生长因子、诱导型一氧化氮合酶等的表达 ,促进机体对缺氧产生一系列的适应反应。其活性的维持对心脏的发育以及对心肌在缺血缺氧性疾病中的代偿起着重要作用。对HIF 1与心脏缺氧代偿关系的研究可为治疗心脏疾病提供新的途径     

他汀类药物对基质金属蛋白酶-1及组织型基质金属蛋白酶抑制剂-1的影响

目的观察阿托伐他汀(立普妥)、普伐他汀(普拉固)对大鼠腹腔巨噬细胞分泌基质金属蛋白酶-1(MMP-1)及组织型基质金属蛋白酶抑制剂-1(TIMP-1)的影响。方法培养的大鼠腹腔巨噬细胞中先加入10ng/ml的白介素-1β(IL-1β),促进MMP-1的分泌,24h后加入不同浓度的阿托伐他汀、普伐他汀(1×10-7mmol/L、1×10-6mmol/L、1×10-5mmol/L、1×10-4mmol/L),继续孵育24h后,采用酶联免疫吸附法(ELISA法)测培养上清液中的MMP-1及TIMP-1的浓度;取阿托伐他汀10-5mmol/L浓度,分别在6h、24h、48h测培养上清液中的MMP-1的浓度。结果随着药物浓度的增加(1×10-7mmol/L、1×10-6mmol/L、1×10-5mmol/L、1×10-4mmol/L),阿托伐他汀对大鼠腹腔巨噬细胞分泌MMP-1的抑制作用逐渐增强(加药组MMP-1分泌较对照组分别减少17.36%、19.40%、26.54%、33.70%),与对照组有显著统计学差异,而不同浓度的普伐他汀虽使大鼠腹腔巨噬细胞分泌MMP-1略有降低,但与对照组比较无统计学差异,且各组间也无统计学差异;两组他汀使大鼠腹腔巨噬细胞TIMP-1的分泌均略有降低,但与对照组比较,均无统计学意义;随着药物作用时间的延长(6h、24h、48h),阿托伐他汀(1×10-5mmol/L)对大鼠腹腔巨噬细胞分泌MMP-1的抑制作用逐渐增强(加药组MMP-1分泌较对照组分别减少11.96%、26.54%、32.77%),与对照组有显著统计学差异。结论阿托伐他汀呈时间剂量依赖性抑制IL-1β介导的大鼠腹腔巨噬细胞分泌MMP-1,而对TIMP-1的分泌无影响;普伐他汀对IL-1β介导的大鼠腹腔巨噬细胞分泌MMP-1无影响,对TIMP-1的分泌也无影响。     

The role of interleukin-1 receptor antagonist in the prevention and treatment of disease

Abstract

?Interleukin-1 (IL-1) and tumor necrosis factor α (TNF-α) play key proinflammatory roles in a variety of human diseases, including rheumatoid arthritis (RA). IL-1 receptor antagonist (IL-1Ra) is a naturally occurring structural variant of IL-1 that competitively inhibits receptor binding of IL-1. Four forms of IL-1Ra have been described: secretory IL-1Ra (sIL-1Ra) and three intracellular molecules (icIL-1Ra1, 2, and 3). Excess amounts of IL-1Ra are necessary to inhibit the biological effects of IL-1. The endogenous production of IL-1Ra plays an anti-inflammatory role, but the level of production of IL-1Ra in inflamed tissues may not be adequate to block IL-1 effectively. An allelic polymorphism in the IL-1Ra gene is associated with a variety of human diseases, largely of epithelial or endothelial cell origin. The disease associated allele IL1RN*2 may lead to a decreased production of icIL-1Ra1 by these cells, predisposing the patient to an imbalance in the IL-1 system. The therapeutic administration of IL-1Ra was found to be safe and efficacious in the treatment of RA. Intraarticular delivery of the IL-1Ra cDNA by ex vivo gene therapy in patients with RA was effective in enhancing local IL-1Ra production. This unique form of therapy is under further evaluation.     

血管紧张素Ⅱ受体1和二肽肌肽酶1基因多态性与糖尿病慢性肾脏疾病的相关性研究

目的 探讨ATⅡ受体1(AGTR1)和二肽肌肽酶1(CNDP1)基因多态性与糖尿病慢性肾脏疾病(CKD)的相关性. 方法 选取T2DM患者292例,采集外周血标本,全血用于提取基因组DNA,血清用于检测生化指标.利用聚合酶链反应-限制性片段长度多态性分析法(PCR-RFLP)测序分析AGTR1和CNDP1基因多态性. 结果 AGTR1的C等位基因是CKD的危险因素(P=0.028,OR=2.269,95％CI:1.134～6.837),AGTR1基因rs5186基因多态性可能为患CKD危险因素.CNDP1的C等位基因是CKD的危险因素(P=0.024,OR=2.571,95％CI:1.127～4.211),CNDP1基因rs4892247基因多态性可能为患CKD的危险因素. 结论 AGTRl的C等位基因和CNDP1的C等位基因与CKD相关.     

甲型H1N1与季节性H1N1流感病毒血凝素基因比较分析

目的分析泰安市2008～2009年度季节性流感与2009年度甲型H1N1流感病原学检测结果 ,比较季节性H1N1与甲型H1N1血凝素基因变异情况。方法选择国家级流感监测哨点医院以及暴发疫情的疫点,采集流感样病例的鼻咽拭子标本,通过RealtimePCR进行病毒检测,用MDCK细胞进行病毒分离,通过RT-PCR扩增血凝素HA1片段的基因并测序,利用生物信息学进行序列分析。结果 2008～2009年共检测鼻咽拭子标本283份,分离出流感病毒33株,分离阳性率为11.67%,其中季节性H1N1亚型31株。2009年5月1日～12月31日,检测鼻咽拭子标本996份,流感核酸检测阳性417份,阳性率为41.86%,其中甲型H1N1337份,季节性H1N1亚型1份。6株季节性H1N1病毒均在多个氨基酸位点上发生变异,与疫苗株A/Brisbane/59/2007(H1N1)比较,有11个位点发生了突变,其中5个位点位于抗原决定簇上;测序成功的6株甲型H1N1病毒在多个氨基酸位点发生变异,与疫苗株A/California/07/2009(H1N1)比较,有6个位点发生突变,其中1个位点位于抗原决定簇的B区。结论 2008～2009年度季节性H1N1为优势株,甲流暴发后,甲型H1N1成为绝对优势毒株。季节性H1N1分离株有多处氨基酸替换,抗原决定簇B区变异频繁;甲型H1N1病毒分离株的基因有变异,但关键位点第222位仍为D(天冬氨酸),与疫苗株相比抗原决定簇的关键位点变化不大。     

不同引物检测甲型H1N1流感病毒的比较研究

目的筛选灵敏、特异的甲型H1N1流感病毒核酸检测方法。方法采用国家流感中心推荐的甲型流感病毒(H1N1)核酸引物和1对自行设计的引物,同时选择市售荧光定量PCR试剂盒,分别对不同浓度的流感病毒进行RT-PCR或荧光定量PCR扩增,比较其检测的灵敏度和特异性。结果荧光定量PCR检测H1N1病毒核酸的灵敏度为10-5(病毒稀释度),高于普通RT-PCR的灵敏度10-3~10-4;RT-PCR扩增甲型流感病毒(H1N1)核酸时,自行设计引物的灵敏度为10-4,高于中国CDC推荐引物的灵敏度10-3。2种引物的特异性一致。结论对于甲型(H1N1)流感病毒疑似样品的检测,荧光定量PCR是较灵敏的方法,但从成本和灵敏度两方面考虑,自行设计的引物更适合基层疾控机构采用。     

纤溶酶原激活物抑制剂-1与急性心肌梗死关系的研究

目的探讨纤溶酶原激活物抑制剂-1(PAI-1)在急性心肌梗死(AMI)发病中的作用。方法应用发色底物法测定中国汉族AMI患者56例(男44,女12,平均年龄67±10岁)和正常对照组55例(男42,女13,年龄68±8岁)血浆PAI-1活性,并分析环境因素对PAI-1水平的影响。结果 (1)AMI组和正常对照组的血浆PAI-1水平分别为O.90±O.13Au/ml和O.72±O.13Au/ml,两组间比较有显著性差异(P<0.001)。(2)吸烟、高血压病史、既往血栓性疾病病史、冠心病家族史、体重指数(BMI)、三酰甘油(TG)、血糖水平均与血浆PAI-1水平呈正相关,多元逐步回归分析显示,高血压病史、冠心病家族史是血浆PAI-1水平的独立预测因素。结论血浆PAI-1水平增加是心肌梗死(MI)的危险因素;(2)高血压、冠心病家族史为PAI-1水平的独立决定因素。