狂犬病疫苗接种者的细胞免疫应答研究

[目的]研究狂犬病疫苗对接种者的狂犬病毒细胞免疫作用。[方法]接种狂犬病疫苗者在注射完狂犬病疫苗后15天作狂犬病毒抗体和淋巴细胞转化率检测。[结果]接利，狂犬病疫苗者的总淋巴细胞转化率、自发淋巴细胞转化率、狂犬病毒淋巴细胞转化率和特异性淋巴细胞转化率的均数分别为83．99％、8．93％、15．06％和6．13％，抗体阳性组和抗体阴性组的狂犬病毒淋巴细胞转化率、特异性淋巴细胞转化率的差异有统计学意义（P〈0．01）。[结论]接种狂犬病疫苗后，73．08％的狂犬病毒抗体阳性者产生了细胞免疫应答，狂火病毒抗体阴性者对狂犬病毒无特异性细胞免疫力。     

八段锦锻炼结合健康教育对175例糖尿病亚健康状态者血糖干预作用研究

目的 研究八段锦锻炼结合糖尿病健康教育和饮食控制等综合措施对糖尿病亚健康状态血糖的干预作用.方法 将175例研究对象按年龄分2层,每层分为对照、健康教育、八段锦3组,3组分别采取不同的干预措施,分别于实验开始、3个月、6个月进行相关指标的检测.结果 糖尿病总发生率为6.29%.对照组、健康教育组、八段锦组空腹血糖恢复正常率分别为11.86%、65.00%,69.64%;OGTT餐后2小时血糖转化为正常率分别为6.78%、15.00%、48.21%.试验者随访3个月后2层的八段锦组、健康教育组的方法均有降空腹血糖作用,随访6个月后,八段锦组、健康教育组平均空腹血糖已达正常水平.2组效果差异没有显著性;35～55岁年龄的八段锦、健康教育组者的OGTT餐后2小时血糖下降,平均值达正常水平,且八段锦组效果优于健康教育组.结论 八段锦锻炼结合糖尿病健康教育对空腹血糖和OGTT餐后2小时血糖均有降低作用,且八段锦组效果优于健康教育组. 分别为11.86%、65.00%,69.64%;OGTT餐后2小时血糖转化为正常率分别为6.78%、15.00%、48.21%.试验者随访3个月后2层的八段锦组、健康教育组的方法均有降空腹 糖作用,随访6个月后,八段锦组、健康教育组平均空腹血糖已达正常水平.2组效果差异没有显著性;35～55岁年龄的八段锦、健康教育组者的OGTT餐后2小时血糖下降,平均值达正常水平,且八段锦组效果优于健康教育组.结论 八段锦锻炼结合糖尿病健康教育对空腹血糖和OGTT餐后2小时血糖均有降低作用,且八段锦组效果优于健康教育组. 分别为11.86%、65.00%,69.64%;OGTT餐后2小时血糖转化为正常率分别为6.78%、15.00%、48.21%.试验者     

狂犬病疫苗细胞免疫作用研究

目的观察狂犬病暴露后接种疫苗对机体的细胞免疫作用。方法狂犬病暴露者接种狂犬病疫苗后,检测狂犬病毒抗体的同时,运用淋巴细胞转化试验,检测自发淋巴细胞转化率和狂犬病疫苗剌激后的狂犬病毒淋巴细胞转化率,以后者减前者计算出狂犬病毒特异性淋巴细胞转化率。结果狂犬病疫苗接种后,抗体效价达到大于1∶5的100人中,76人同时产生细胞免疫力(即狂犬病毒特异性淋巴细胞转化率大于5%);而抗体效价等于1∶5的4人和未产生抗体的35人中,无人产生细胞免疫力。结论狂犬病暴露者接种狂犬病疫苗后,并非都能同时产生体液和细胞免疫,不能产生细胞免疫的这部分人,其总体细胞免疫功能亦偏低。     

耐多药结核病患者细胞免疫功能的初步研究

目的 动态观察耐多药结核病患者机体细胞免疫状态,为临床诊治用药提供支持,为以后耐多药结核病的免疫治疗打下初步基础。 方法 用绝对浓度法进行药敏试验,筛选出耐多药结核(Multi-drug resistant tuberculosis,MDR-TB)患者50例,药物敏感性结核(drug-susceptible tuberculosis,S-TB)患者50例,另于体检者中选取健康对照(healthycontrol,HC)20例,流式细胞分析淋巴细胞亚群(CD4⁺、CD3⁺、CD8⁺分子等),酶联免疫吸附法 (enzyme-linked immunosorbent assay,ELISA)检测血清细胞因子(IFN-γ、IL-2、IL-4 和IL-10等),比较耐多药结核病患者血清学与全敏结核病患者血清、正常人血清之间的差异。 结果 各组间CD3⁺分子百分比差异无统计学意义,健康组与各结核组CD4⁺、CD8⁺、CD4⁺/CD8⁺ 百分比差异有统计学意义,耐多药结核组与结核敏感组CD4⁺、CD8⁺、CD4⁺/CD8⁺ 百分比差异有统计学意义。健康组与各结核组IFN-γ、IL-2、IL-4 和IL-10的浓度差异均有统计学意义,耐多药结核组与结核敏感组IL-2、IL-4 和IL-10的浓度差异有统计学意义。耐多药结核组CD4⁺、CD4⁺/CD8⁺比值、IL-2显著低于结核敏感组,CD8⁺、IL-4 和IL-10显著高于结核敏感组(P<0.05)。 结论 结核病患者细胞免疫功能均下降,表现为CD4⁺淋巴细胞百分比降低, CD8⁺淋巴细胞百分比升高, CD4⁺/CD8⁺比值降低甚至倒置,增强抗结核免疫反应的细胞因子IFN-γ、IL-2浓度降低而抑制此反应的细胞因子IL-4和IL-10浓度升高。耐多药结核病患者较敏感结核病患者的细胞免疫功能进一步下降,表现为上述变化更加显著,使病情表现更加复杂及增加了治疗难度。     

HIV-infected patients show impaired cellular immune response to influenza vaccination compared to healthy subjects

Detailed data on cellular immune response to influenza vaccination in HIV-infected patients are lacking. We analyzed cellular (IL-2, IL-4, IL-5, IL-10, IL-12, IL-13, IFN-γ, TNF-α, GM-CSF) and humoral (IgG and IgM) immune response in 81 HIV-infected and 30 HIV-negative subjects, before (T0) and 4 weeks (T1) after receiving a single dose of trivalent MF59-adjuvanted influenza vaccine. No difference in humoral response (IgG or IgM) was demonstrated between the two groups. While an increase in most cytokines from T0 to T1 was observed in HIV-uninfected subjects, cytokines production did not significantly increased in HIV-infected patients. Exploring Th1 response, higher CD8 cells count was significantly associated with lower post-vaccination IFNγ levels, while a higher CD4 cells count was associated with a greater response. Exploring Th2 response, higher HIV viral load was significantly associated with reduced post-vaccination IL-10 levels. In conclusion, in HIV-infected patients influenza vaccination could have good efficacy in sustaining humoral response but cellular response appeared impaired.     

病毒性心肌炎患者细胞免疫功能检测的临床价值

目的 探讨病毒性心肌炎患者细胞免疫功能检测的临床价值.方法 选取医院收治的病毒性心肌炎患者112例作为病毒性心肌炎组,另选取同期健康体检112人作为健康组,对两组免疫功能进行比较;对病毒性心肌炎患者采用中西医结合的方法进行治疗,比较患者治疗前后免疫功能变化.结果 病毒性心肌炎组CD3+为(45.66±6.67)％;CD4+为(35.42±6.17)％;CD8+为(23.56±5.14)％;CD4 +/CD8+比值为1.43±0.23较健康组显著降低;病毒性心肌炎组经治疗后,CD3+为(61.33±6.69)％;CD4+为(47.16±6.38)％;CD8+为(28.71±5.67)％;CD4+/CD8+比值为1.79±0.31,较治疗前T淋巴细胞亚群免疫指标显著上升;病毒性心肌炎组经治疗后,TNF和sIL-2R水平均降低,差异均有统计学意义(P＜0.05).结论 病毒性心肌炎患者多存在不同程度的细胞免疫功能低下,临床医师应提高病毒性心肌炎患者的免疫功能.     

The effect of maternal antibodies on the cellular immune response after infant vaccination: A review

During the last few decades, maternal immunization as a strategy to protect young infants from infectious diseases has been increasingly recommended, yet some issues have emerged. Studies have shown that for several vaccines, such as live attenuated, toxoid and conjugated vaccines, high maternal antibody titers inhibit the infant’s humoral immune response after infant vaccination. However, it is not clear whether this decreased antibody titer has any clinical impact on the infant’s protection, as the cellular immune responses are often equally important in providing disease protection and may therefore compensate for diminished antibody levels. Reports describing the effect of maternal antibodies on the cellular immune response after infant vaccination are scarce, probably because such studies are expensive, labor intensive and utilize poorly standardized laboratory techniques. Therefore, this review aims to shed light on what is currently known about the cellular immune responses after infant vaccination in the presence of high (maternal) antibody titers both in animal and human studies. Overall, the findings suggest that maternally derived antibodies do not interfere with the cellular immune responses after infant vaccination. However, more research in humans is clearly needed, as most data originate from animal studies.     

血必净注射液对重症脓毒症患者机体炎性反应和细胞免疫功能的影响

目的 评价血必净注射液对重症脓毒症患者机体炎性反应和细胞免疫功能的影响.方法 选择2008年9月至2009年8月ICU收治的62例确诊重症脓毒症患者,按随机数字表法分为治疗组30例和对照组32例,两组均给予脓毒症集束化治疗,治疗组加用血必净注射液100ml静脉滴注,2次/d,连续使用7d,观察两组患者治疗前后血清肿瘤坏死因子α(TNF-α)、白细胞介素(IL)-6、IL-10、C反应蛋白(CRP)以及外周血T淋巴细胞亚群CD4+、CD8+、CD4+CD8+和CD14+单核细胞人类白细胞抗原(HLA)-DR表达的变化.结果 两组患者治疗前血清TNF-α、IL-6、IL-10和CRP水平以及外周血CD4+、CD8+、CD4+/CD8+和CD14+单核细胞HLA-DR表达比较差异无统计学意义(P＞0.05).与对照组比较,治疗组治疗后血清TNF-α、IL-6、IL-10、CRP水平显著降低[(64.4±13.5) ng/L比(96.1 ±22.1) ng/L,(153.8 ±23.8) ng/L比(180.1 ±21.7) ng/L,(73.8±13.8) ng/L比(101.1±11.7)ng/L,(53.7±18.8) mg/L比(91.3±32.8) mg/L,P＜ 0.05],而外周血CD4+、CD8+、CD4+/CD8+升高(0.311±0.021比0.424±0.035,0.201±0.017比0.238±0.038,1.78±0.21比1.56±0.18,P＜ 0.05 ),CD14+单核细胞HIA-DR表达上调[(38.4±11.5)％比(18.1±12.1)％,P＜0.05].结论 血必净注射液可降低重症脓毒症患者机体炎性反应,纠正细胞免疫功能紊乱,有助于改善患者病情.     

中国31省1991-2005年狂犬病流行情况比较分析

目的了解3个“五年计划”期间中国31个省（自治区、直辖市）的狂犬病流行强度及其趋势。方法利用中国疾病预防控制中心的每年疫情报告数据进行常规的动态对比分析。结果15年来中国31省均有狂犬病死亡病例报告,共报告14942例。年均死亡率为0．080/10万,每5年年均死亡率环比增幅为-66．24%和506．13%,定基比上升104．62%。15年合计年均死亡率前五位为广西、湖南、贵州、江西和广东省。结论中国至少有27个省有狂犬病病例发生;长江中下游流域是主要发病地区。     

肠内营养对长期禁食危重症病人炎性反应和细胞免疫的影响

目的:前瞻性观察长期禁食的危重症病人对恢复肠内营养(EN)初期免疫炎性反应的影响. 方法:将28例禁食14 d以上的危重症病人,分别于实施EN前和EN后第1、第3和第7天检测外周血中内毒素、白细胞(WBC)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL-1、IL-6、IL-4、IL-10)、T淋巴细胞亚群(CD3、CD4、CD4/CD8)和抗组织相容性抗原-DR(HLA-DR)水平. 结果:①内毒素、WBC、CRP、TNF-α、IL-6水平在EN实施第1、3天后均较EN前显著提高;IL-1在EN实施第1天显著提高;IL-4和IL-10较EN实施前无明显改变.②CD4和CD4/CD8在EN第7天较EN前显著提高. 结论:长期禁食的危重症病人在恢复EN初期全身炎症反应增强,持续EN可减轻增强的炎性反应,并改善病人的细胞免疫功能.     

正常妊娠和妊娠期活动性TORCH感染者的细胞免疫功能及Th亚群激活状态研究

目的:研究活动性TORCH感染孕妇细胞免疫及Th亚群激活状态,以进一步探讨其发生机制。方法:用流式细胞仪结合微珠捕获法(cytometric bead array,CBA)测定血清6种Th1/Th2源细胞因子水平,流式细胞术计数外周血淋巴细胞及其亚群。结果:①正常孕妇的CD8+细胞〔(30.0±0.8)%〕较非孕对照〔(27.5±4.9)%〕增多、CD19+细胞〔(9.4±2.0)%〕较非孕对照〔(11.8±3.9)%〕减少;活动感染孕妇CD3+〔(65.6±6.5)%〕、CD4+〔(32.6±7.6)%〕和CD8+〔(27.7±5.1)%〕细胞数量均显著低于正常孕妇(P<0.05)。②正常孕妇的TNF-α〔(4.4±1.3)pg/ml〕及IL-2〔(4.0±1.1)pg/ml〕较非孕对照组显著降低,除IFN-γ外,多数Th1源与Th2源细胞因子的比值下降;活动感染孕妇IL-2水平〔(5.0±1.5)pg/ml〕及IL-2/IL-10比值(0.67±0.14)高于正常孕妇(P<0.05)。结论:①正常妊娠时机体处于免疫抑制状态,尤其以Th1细胞抑制明显,Th1/Th2平衡向Th2偏移。②活动感染孕妇以IL-2水平升高为主,似有Th1细胞激活,提示妊娠期活动性TORCH感染的发生可能与该阶段的Th1细胞抑制及Th亚群激活状态改变有关。     

Comparative studies of local antibody and cellular immune responses to influenza infection and vaccination with live attenuated reassortant influenza vaccine (LAIV) utilizing a mouse nasal-associated lymphoid tissue (NALT) separation method

The first and most significant barrier against influenza infection is the mucosal-associated lymphoid tissue of the upper airways and rodent nasopharyngeal-associated lymphoid tissue (NALT) is considered equivalent to the lymphoid tissue of human Valdryer's ring. This study is the first attempt to analyze and compare local and systemic cellular and antibody immune responses in NALT and spleen in a mouse model of experimental influenza infection and intranasal vaccination with LAIV (live attenuated reassortant influenza vaccine). It was shown that the vaccine strain completely inherited the ability to induce high-grade local antibody responses (secretory IgA + IgG + IgM), local cellular lymphoproliferative activity, CD4⁺, CD8⁺ and CD19⁺ lymphocyte and cytokine production responses from the virulent parental strain but it had less capacity to stimulate production of serum IgG, accumulation of CD8⁺ cells and IFN-γ production in the spleen. Primary non-complicated influenza infection and primary vaccination were accompanied by a short-term (24 h) increase in the levels of lymphocyte apoptosis in both NALT and spleen. However, experimental data indicated that vaccination with LAIV and uncomplicated forms of influenza infection did not influence immune system apoptosis following a secondary immune response.