慢性活动性乙型肝炎患者细胞免疫功能检测及其临床意义

测定了例慢性活动乙型肝炎患者外周血单个核细胞（ＰＢＭＣ）产生的白细胞介素２（ＩＬ－２）活性，其中部分病人检测了血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平，膜白细胞介素２受体（ｍＩＬ－２Ｒ）表达，ＬＡＫ活性及外周血Ｔ淋巴细胞亚群，并分析了它们之间的相关性，结果表明：ＩＬ－２活性，ｍＩＬ－２Ｒ表达，ＬＡＫ活性，ＣＤ４／ＣＤ８比值显著低于正常对照组（Ｐ〈０．００１），而ｓＩＬ－２Ｒ水平，ＣＤ８细胞显     

可溶性IL－2R在选择性IgA缺乏症发病机理中的意义

白细胞介素２（ＩＬ－２）及其受体（ＩＬ－２Ｒ）系统在机体免疫调节中发挥着重要作用。本研究首先以间接免疫荧光技术检测了选择性ＩｇＡ缺乏症（ＳＩｇＡＤ）患儿活化淋巴细胞膜表面白细胞介素２受体（ｍＩＬ－２Ｒα）的表达情况及其Ｔ细胞亚类水平，继而采用双抗体夹心ＥＬＩＳＡ法检测了ＳＩｇＡＤ患儿血清可溶性白细胞介素２受体（ＳＩＬ－２Ｒα）的含量。结果表明：ＳＩｇＡＤ患儿组的Ｔａｃ阳性细胞百分率（ｍＩＬ－２Ｒα）明显高于正常对照组，其ＣＤ４＋细胞百分率明显低于正常对照组、ＣＤ８＋细胞百分率明显高于正常对照组。而其血清ＳＩＬ－２Ｒα含量亦明显高于正常对照组。研究显示：ＳＩｇＡＤ患儿ｍＩＬ－２Ｒα的表达虽高于正常对照组，但因其Ｔ细胞亚类的显著异常既有体内存在着明显的细胞免疫功能的损害，导致ＩＬ－２的生成不足，使高水平的ＳＩＬ－２Ｒα大量脱落成为ＳＩＬ－２Ｒα，而ＳＩＬ－２Ｒα又可与ＳＩＬ－２Ｒα竞争结合ＩＬ－２，从而使机体细胞免疫功能的损害进一步加剧。     

可溶性白细胞介素2受体在轮状病毒胃肠炎中价值的初探

动态观察轮状病毒胃肠炎患儿血浆中可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）水平的变化，以及轮状病毒（ＲＶ）浓度与ＳＩＬ－２Ｒ，ＩＬ－２与ＳＩＬ－２Ｒ水平之间的关系。结果显示：急性期患儿血浆中ＳＩＬ－２Ｒ明显升高，恢复期患儿血浆中ＳＩＬ－２Ｒ接近正常；在ＲＶ抗原诱导下末梢血中单个核细胞可释放ＳＩＬ－２Ｒ；ＲＶ浓度与ＳＩＬ－２Ｒ水平呈负相关，ＩＬ－２水平与ＳＩＬ－２Ｒ亦呈负相关。提示：ＳＩＬ－２Ｒ分泌增高     

新生儿脐血T细胞IL－2R表达和血清sIL－2R水平的研究

对新生儿脐血Ｔ细胞ＩＬ－２Ｒ表达率和血清ｓＩＬ－２Ｒ水平进行检测，结果显示：①早产儿脐血Ｔ细胞ＩＬ－２Ｒ自然表达率明显低于足月新生儿和正常儿童组，而后两者间无差异；②经ＰＨＡ活化后足月新生儿和早产儿Ｔ细胞ＩＬ－２Ｒ表达率皆显著低于正常儿童组，早产儿组也明显低于足月新生儿组；③足月新生儿和早产儿脐血血清ｓＩＬ－２Ｒ水平均明显高于正常儿童组，但前两者间无明显差异；④新生儿组（包括足月和早产儿）脐血Ｔ细胞ＩＬ－２Ｒ自然表达率与血清ｓＩＬ－２Ｒ水平呈直线负相关，而正常儿童组二者间呈直线正相关。     

42例肝癌患者外周血T淋巴细胞亚群变化与sIL—2R水平关系的研究

本文对４２例肝癌患者及正常人外周血Ｔ淋巴细胞亚群，可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）水平进行了检测。结果表明肝癌患者Ｔ淋巴细胞亚群变化与ｓＩＬ－２Ｒ水平有一定关系。     

智能低下患儿外周血T淋巴细胞亚群与sIL－2R水平的变化

本文检测５５例智能低下（ＭＲ）患儿及正常人外周血Ｔ淋巴细胞亚群及血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）的水平，结果表明ＭＲ患儿ＣＤ３＋、ＣＤ４＋细胞显著低于对照组，ＣＤ８＋细胞明显高于对照组，ＣＤ４＋／ＣＤ８＋比值下降。ｓＩＬ－２Ｒ活性明显高于对照组。     

呼吸道合胞病毒感染患儿免疫功能变化及PBL体外表达IL－2R的动态观察

探讨７２例确诊呼吸道合胞病毒（ＲＳＶ）特异性血清抗体及鼻咽分泌物脱落细胞中ＲＳＶ抗原阳性患儿急性期及恢复期Ｔ淋巴细胞亚群，血清ＩｇＧ、ＩｓＭ、ＩｇＡ及ＩＬ－２Ｒ的活性表达，动态观察了呼吸道合胞病毒感染患儿急性期、恢复期和正常对照组外周血淋巴细胞经ＰＨＡ刺激后，于不同时间（２４ｈ、４８ｈ、７２ｈ）细胞膜上ＩＬ－２Ｒ的活性表达。结果表明，抗体效价恢复期较急性期升高４～１２８倍，病例组急性期ＣＤ３、ＣＤ１６、Ｂ细胞升高，ＣＤ４／ＣＤ８的比值下降，ＩｇＧ、ＩｇＡ均降低，而ＩＬ－２Ｒ的活性表达呈下降趋势。此结果有助于探讨ＲＳＶ感染患儿的免疫紊乱发生机制。     

慢性肺心病患者辅以免疫因子治疗前后免疫状态变化观察

对２４例慢性肺原性心脏病急性加重期患者在常规抗感染的同时辅以白细胞介素２（ＩＬ－２）与α－干扰素（ＩＦＮ－α）等免疫因子治疗前后机体免疫状态，包括ＮＫ细胞活性，ＩＬ－２Ｒ阳性细胞比例，可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）的动态变化进行了观察，结果表明，肺心病急性加重期患者ＮＫ细胞活性，ＩＬ－２Ｒ表达的阳性细胞比例均明显低于正常对照组，ｓＩＬ－２Ｒ受体水平明显高于正常对照组（Ｐ〈０．０１）。治疗后     

SLE患者T细胞和IL－2／IL－2R系统变化的临床意义

本文检测３７例（４１份）ＳＬＥ患者ＩＬ－２的产生、ｍＩＬ－２Ｒ的表达、ｓＩＬ－２Ｒ水平、淋巴细胞转化及Ｔ细胞亚群。结果表明：ＳＬＥ患者ｓＩＬ－２Ｒ水平升高，而ＩＬ－２的产生、ｍＩＬ－２Ｒ的表达、淋转率、ＣＤ４＋百分率和ＣＤ４＋／ＣＤ８＋比值均下降，由于其中仅有ｓＩＬ－２Ｒ水平与疾病活动性有关，因而ｓＩＬ－２Ｒ可作为疾病活动的一个指标。免疫指标的变化与激素治疗无关。本文认为Ｔ细胞功能及ＩＬ－２释放紊乱主要是由疾病本身的免疫调节紊乱引起。     

甲状腺疾病患者血清可溶性白细胞介素2受体测定的临床意义

某些甲状腺疾病时血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平及其与游离甲状腺素（ＦＴ＿４）、游离三碘甲腺原氨酸（ＦＴ＿３）和促甲状腺素（ＴＳＨ）水平的相关性比较。结果发现甲状腺机能亢进症（甲亢）未治疗组（Ａ）及甲亢未治疗伴突眼组（Ｄ）血清ｓＩＬ－２Ｒ明显升高；甲状腺机能减退症（甲减）经治疗甲状腺功能灭常组（Ｇ）ｓＩＬ－２Ｒ明显高于甲减未治疗组（Ｆ）；１０例毒性弥漫性甲状腺肿（Ｇｒａｖｅｓ病）患者经抗甲状腺药物治疗后ｓＩＬ－２Ｒ明显降低；Ｇｒａｖｅｓ病及甲减患者血清ｓＩＬ－２Ｒ均与ＦＴ＿３呈正相关。提示除自身免疫外，甲状腺素水平也是甲状腺疾病患者血清ｓＩＬ－２Ｒ水平的重要调节因素。     

幽门螺杆菌相关的消化性溃疡患儿细胞免疫功能研究

目的检测42例幽门螺杆菌（HP）感染相关的消化性溃疡外周血白细胞介素-2（IL-2）、可溶性白细胞介素2受体（sIL-2R）、白细胞介素6和8（IL-6和IL-8）和T淋巴细胞亚群,以探讨其免疫学发病机制。方法IL-2、sIL-2R、IL-6、IL-8和T淋巴细胞亚群检测,分别采用ELISA、双抗体夹心ELISA和APAAP法进行。结果CD3＋、CD4＋细胞百分率、CD4＋/CD8＋比值和IL-2水平均显著低于对照组（P均〈0.01）,而CD8＋细胞百分率、sIL-2R、IL-6、IL-8水平均显著高于对照组（P均〈0.01）。结论HP感染相关的消化性溃疡患儿细胞免疫功能低下且紊乱,该患儿机体的免疫功能障碍在该病的发生中起一定作用。     

Soluble and cellular markers of immune activation in patients with systemic sclerosis

The peripheral blood lymphocyte pattern, the lymphocyte responses in vitro, as well as the soluble markers of immune activation were studied in 24 patients with systemic sclerosis (SSc patients). The proportions of total T cells (CD3), their CD4 subset, as well as B lymphocytes were within the normal range. The relative proportion of CD8 lymphocytes, however, was significantly reduced. Patients with SSc had a slightly lower percentage of CD4/4B4+ cells, whereas their proportion of CD4/2H4+ cells was elevated as compared to healthy controls. The proportion of lymphocytes expressing the interleukin-2 receptor (IL-2R) was significantly higher in SSc patients. The proliferative responses of peripheral blood mononuclear cells to PHA stimulation were reduced in the patient group, while expression of IL-2R on lymphocytes after such in vitro stimulation was comparable to that of controls. Expression of IL-2R on patient but not control lymphocytes was increased after in vitro exposure to laminin. Such exposure failed to induce IL-2 production or cell proliferative responses. Soluble plasma IL-2R level (sIL-2R) and soluble CD8 (sCD8) molecule levels in SSc patients were significantly elevated. These results indicate the presence of an ongoing lymphocyte activation in this disease process.     

Does immune activation continue during an attack‐free period in familial Mediterranean fever?

Although some information is available regarding immune activation in familial Mediterranean fever (FMF), little is known about either peripheral blood T cell activation marker expression or the T cell proliferative response to phytohaemagglutinin (PHA). In the present study, we aimed to investigate the percentages of peripheral blood lymphocyte subsets, T cell expression of cellular activation markers (CD25, CD69, HLA-DR), the T cell response to PHA and serum levels of soluble interleukin-2 receptor (sIL-2R) and interleukin (IL)-10 in patients with FMF. Forty patients with FMF were enrolled into the study. Control groups were sex- and age-matched and consisted of 20 healthy blood donors and 15 patients with inactive Behcet's disease. The patients with FMF in an attack period had higher levels of sIL-2R than those in an attack-free period, and also in comparison with both control groups. The levels of sIL-2R were also found to be higher in patients with FMF in an attack-free period than those in both control groups. The mean levels of IL-10 were found to be lower in patients with FMF in an attack-free period than those in an attack period and were also lower than those in the healthy controls. In an acute attack period, the absolute counts of CD3+HLA-DR+, CD4+CD69+, CD8+CD25+ and CD8+CD69+ T cells in peripheral blood samples were also higher than those in both control groups. Both the percentages and absolute counts of CD4+CD69+ T cells in peripheral blood samples of patients with FMF in an attack-free period were slightly but significantly higher than those in the healthy controls. In conclusion, our study indicates that the T cell system is abnormally activated in patients with FMF in both the attack and attack-free period and that decreased IL-10 levels may create a tendency to perpetuate subclinical immune activation in the attack-free period.     

PHA-LAK细胞激活培养过程中多项免疫学指标的动态分析

本文用APAAP、ELISA、MTT等方法检测了PHA—LAK细胞激活培养过程中某些免疫学指标的动态变化,结果表明:(1)在PHA-LAK细胞预刺激阶段,CD3~+、CD4~+、CD8~+及mIL-2Ra~+细胞百分率均持续升高(P均<0.01);上清液中sIL-2R水平和IL-2活性也升高,且前者与MIL-2Ra~+细胞百分率呈正相关(r=0.84,P<0.05);(2)在rIL2激活培养阶段,CD3~+、mIL-2Ra~+细胞百分率居高不下,CD4~+细胞百分率逐渐降低,而CD8~+细胞百分率则逐渐升高,培养上清液中sIL-2R水平增加和IL-2活性降低的幅度以激活培养的初期(0～3d)为最大.从而提示PBMC经预刺激后可迅速被外源性的rIL-2激活,这不仅可以提高rIL-2的利用率,也可能是PHA-LAK细胞具有较高增殖能力和细胞毒活性的原因.     

Gammadelta T cells and interleukin-6 levels could provide information regarding the progression of human renal allograft

We have determined the percentage of alphabeta and gammadelta T cells by flow cytometry as well as serum interleukin-6 (IL-6) and soluble interleukin-6 receptor (sIL-6R) levels by enzyme-linked immunosorbent assay in kidney allograft recipients with acute, chronic or stable graft evolution. The percentage of CD4 and CD8 T cells in transplanted patients was lower than in the control group (P < 0.001) with the exception of CD8 gammadelta T cells from patients with stable evolution (P > 0.05). The serum levels of IL-6 and sIL-6R in acute and chronic rejection were higher than in the controls (P < 0.05). No differences in IL-6 levels were observed between the stable evolution and the control groups (P > 0.05). The levels of sIL-6R were higher in stable evolution patients than in the controls (P < 0.05) and no differences were observed between the chronic and stable evolution patients (P > 0.05). IL-6 decreased in patients with a favourable evolution, increased in those with an increased renal dysfunction and was maintained when the renal dysfunction was not modified. These results suggest that gammadelta T cells could participate in renal allograft maintenance and that IL-6 but not sIL-6R serum levels may provide a prognostic marker for measuring the evolution of kidney allograft.     

Soluble Interleukin-2 Receptor Levels and Immune Activation in Patients with Schistosomiasis and Carcinoma of the Urinary Bladder

Soluble interleukin-2 receptor (sIL-2R) level in serum is a marker of immune regulation and lymphocyte activation. Highly elevated levels of sIL-2R in serum were observed in patients of schistosomiasis with carcinoma of the bladder (SCB) and carcinoma of the bladder without schistosomiasis (CB) compared with patients with carcinoma of the prostate with or without schistosomiasis and normal healthy controls. Patients with SCB, who had an elevated percentage of cells expressing CD38+ activation antigen and CD71+ transferrin receptors in circulation, also had elevated levels of sIL-2R in serum. There were few interleukin-2 receptor (CD25+) positive cells in circulation in some patients with SCB. Despite this, the sIL-2R levels were extremely elevated. Our data suggest that in SCB, CD38+ and CD71+ cells may be the source of secretion of sIL-2R in serum. This relationship was confirmed by phenotypic characterizations of mononuclear cells and sIL-2R levels in individual patients. Measurements of sIL-2R levels in serum may provide a sensitive method of immune activation in patients with SCB.     

Expression of IL-2R, IL-4R, IL-6R on peripheral blood lymphocytes in systemic lupus erythematosus and correlation with disease activity: a prospective study.

AIMS: To study the expression of interleukin-2 receptor (IL-2R), interleukin-4 receptor (IL-4R) and interleukin-6 receptor (IL-6R) on peripheral blood lymphocytes (PBL) in patients with systemic lupus erythematosus (SLE); to correlate the level of expression of these receptors with SLE disease activity. METHODS: Peripheral blood lymphocytes were studied by a high sensitivity flow cytometry technique using monoclonal antibodies directed against CD25 (IL-2R alpha chain), CD122 (IL-2R beta chain), CD124 (IL-4R), and CD126 (IL-6R). SLE disease activity was scored using the SLE Disease Activity Index, C3 and C4 concentrations, anti-dsDNA level, and absolute lymphocyte count. RESULTS: Compared with normal controls, PBL from patients with SLE had a higher percentage of CD25+ cells (median 20.8% v 16.5%) and a lower percentage of CD122+ cells (median 13.1% v 22.4%). The difference in CD122+ cells was greater in the CD122weak population than the CD122strong (natural killer cell) population. The percentages of CD124+ and CD126+ PBLs in patients with SLE and controls were similar. On CD25+ cells, the relative antigenic level of the IL-2R alpha chain was significantly higher in patients with SLE (median 2.01 v 1.81). The relative antigenic levels of CD122+, CD124+ and CD126+ cells were similar in patients and controls. Neither the percentages nor the relative antigenic levels of all of these cytokine receptors were correlated with any of the parameters of disease activity. CONCLUSION: Lymphocyte activation in patients with SLE was evident from the increase in CD25 expression on PBL, with a reciprocal decrease in CD122 expression. As the expression of IL-2R, IL-4R, IL-6R did not correlate with disease activity, it seems that these cytokine/receptor systems do not play a direct role in disease activation in SLE.     

The role of interleukin 2 (IL-2) and serum-soluble IL-2 receptor cells in idiopathic IgA nephropathy.

Interleukin 2 (IL-2) plays a central role in the immune response and may be involved in the derangement of cellular immunoregulation of idiopathic IgA nephropathy (IgAN). The aim of this study was to investigate the serum levels and production of IL-2 from peripheral blood mononuclear cells (PBMC) and the distribution of IL-2 receptor cells and serum-soluble IL-2 receptor cells (sIL-2R) in patients with IgAN. Twenty-four patients with IgA nephropathy and 11 healthy controls (age and sex matched) were studied during an infection-free period without signs of clinical activity at the moment of the study. Serum IL-2 concentrations did not differ between patients and controls. The supernatant levels of IL-2 taken from 24-hr cultures of PBMC stimulated with phytohemagglutinin or tumor necrosis factor increased significantly in the patients but not in the controls. The percentage of IL-2R positive cells (CD25+) was increased in patients compared with controls. Moreover, IgAN patients had increased activated CD4+ lymphocytes when compared with the controls. Serum levels of sIL-2R were significantly higher in patients than in controls. There were no correlations among renal function, serum IgA levels, and urinary findings with cellular subsets or with IL-2 levels. However, sIL-2R was higher in the subgroup of patients with episodic macrohematuria and was closely related with the presence of red blood cells in the urinary sediment. We conclude that PBMC of IgA nephropathy patients have an overproduction of IL-2 after mitogenic stimulation, an increased helper T cell activity, increased IL-2R+ cells, and elevated serum levels of sIL-2R. These alterations are present in periods of apparent clinical inactivity. Finally, sIL-2R is closely related with hematuria, providing a good marker for disease activity. Our results suggest a pivotal role of IL-2 in cellular immune responses with regard to T cell activation in patients with IgAN.     

In Vivo CD3+CD25+ Lymphocyte Subpopulation Is Down-regulated Without Increased Serum-Soluble Interleukin-2 Receptor (sIL-2R) by Gonadotropin Releasing Hormone Agonist (GnRH-a)

PROBLEM: To test further whether the suppression of the CD3⁺CD25⁺ lymphocyte sub-population by gonadotropin-releasing hormone agonist (GnRH-a) is related to the change in levels of cytokines and soluble interleukin-2 receptor (sIL-2R). METHOD: Twenty-seven infertile patients were enrolled under the long protocol of GnRH-a agonist (buserelin acetate) and superovulation with gonadotropin from our IVF-ET program. Peripheral B cells, NK cells, CD4⁺ and CD8⁺ T cells and the expression of CD69, CD25, HLA-DR, and CD71 antigens on the T cells were serially examined by dual-color flow cytometry. Serum levels of cytokines and sIL-2R were measured. RESULTS: The B cells, NK cells, T cells, CD4⁺, CD8⁺ T cells, CD3⁺DR⁺, and CD3⁺CD71⁺ lymphocyte subpopulations were not changed after the use of GnRH-a. The CD25⁺ T cell subpopulation was significantly down-regulated, but the CD69⁺ T cell subpopulation was increased when the GnRH-a was used for approximately 2 wk. The serum levels of interleukin-lp (IL-1β), interleukin-2 (IL-2), interleukin-4 (IL-4), interferon-γ (IFN-γ), and sIL-2R were not changed. CONCLUSION: The GnRH-a had a transiently suppressive effect on CD25⁺ T cells, but a stimulatory effect on CD69⁺ T cells. However, the serum level of cytokines or sIL-2R did not change. These immunological modulations seems to be the result of interaction between GnRH-a and estrogen.     

反复呼吸道感染儿sIL－2R和T细胞亚群的测定

本文采用双抗体夹心ＥＬＩＳＡ法分别测定了２１例反复呼吸道感染儿，３０例正常儿童，１０例新生儿脐血的血清可溶性白细胞介素２受体（ｓＩＬ＝２Ｒ）水平。结果患儿组ｓＩＬ－２Ｒ为７１６．６０±３０．１０Ｕ／ｍｌ；正常儿童组为３８４．４７±８８．０３Ｕ／ｍｌ（ｐ＜０．０１）；新生儿脐血为４４６．２０±５５．６８Ｕ／ｍｌ，与正常儿童比较Ｐ＞０．０５。同时采用间接免疫荧光技术测定了患儿Ｔ细胞亚群水平，结果ＣＤ８细胞数升高，ＣＤ３细胞和ＣＤ４细胞数、ＣＤ４／ＣＤ８比值下降，与正常儿童比较有显著性差别。提示反复呼吸道感染儿有细胞免疫功能降低及免疫调节紊乱。