恶性骨肿瘤患者T细胞亚群、红细胞免疫功能与Ag-NORs定量分析的关系及临床意义

目的 定量分析恶性骨肿瘤患者T细胞亚群、红细胞免疫功能及核仁组成区相关嗜银蛋白（Ag-NORs)的关系及其临床意义。方法 采用单克隆抗体直接免疫荧光法、红细胞花环试验及肿瘤免疫图像分析方法,分别对23例骨肿瘤患者和20例正常人（对照组）的外周血T细胞亚群、红细胞免疫功能及核仁银染区面积／细胞核面积比值（I．S％）进行分析。 结果 患者CD3^ `CD4^ ,T细胞及CD4^ `/CD8^ 比值以及E－C3bRR和I．S%值均明显降低,CD8^ 及E－ICR明显升高,与对照组相比较差异显著（P＜0．01）。结论 上述结果显示,恶性骨肿瘤患者免疫功能低下;Ag-NORs的检测与T细胞亚群、红细胞免疫功能的检测,能较全面地反映肿瘤患者的免疫功能状态,并可指导临床治疗。     

感染对肿瘤患者T淋巴细胞核仁区嗜银蛋白含量的影响

研究显示T淋巴细胞核仁区嗜银蛋白（AgNORs）含量检测不仅可准确反应肿瘤患者的免疫状态,而且与肿瘤的诊断、鉴别诊断、病情发展呈良好相关性。为研究感染对恶性肿瘤患者T淋巴细胞核仁区嗜银蛋白含量的影响,我们动态观察了恶性肿瘤并发感染的患者感染控制前、后其T淋巴细胞核仁区嗜银蛋白含量差异,并与一般感染者,患恶性肿瘤但不并发感染者作了比较,现将结果报告如下。     

肾移植受者排斥反应与外周血T细胞亚群变化

<正> 我们用OKT单克隆抗体(McAb)检测肾移植受者外周血T细胞亚群,并对16例尸体肾移植受者进行分析,其中8例进行手术后(用CsA前),用CsA及时发生排斥(治疗前)时检测比较。另8例较典型病例则分析其排斥反应出现与否以及与T细胞亚群的变化。结果显示OKT检测和临床判断基本相符,提示OKT检测为研究和诊断肾移植受者的急性排斥提供了较好的手段,现报道如下。     

肺结核病人外周血T淋巴细胞亚群、嗜银蛋白的测定

结核病的发生、发展及免疫功能等已有不少报道，关于核仁组成区嗜银蛋白（ＡｇＮＯＲｓ）在肺结核病人外周血淋巴细胞中的应用研究尚未见报道。本文通过对肺结核病人Ｔ淋巴细胞亚群及其Ａｇ－ＮＯＲｓ的对比分析，探讨二者的变化规律和相互联系，为指导临床免疫检测及治疗...     

急性心肌梗塞患者外周血活性T淋巴细胞亚群的研究

目的：研究１５例急性心肌梗塞患者外周血淋细胞亚群和活性标志的变化。方法：流式细胞仪技术,结果：急性心肌梗塞患者外周血淋巴细胞ＣＤ３＾＋ＤＲ＾＋和ＣＤ４＾＋和ＤＲ＾＋百分率明显高于对照组。结论：急性心肌梗塞患者存在免疫功能紊乱,辅助性Ｔ淋巴细胞处于高活性状态。     

90例苯暴露者T淋巴细胞核仁组成区嗜银蛋白检测

目的检测苯暴露者外周血T淋巴细胞核仁组成区嗜银蛋白（Ag-NORs）,评价其作为苯暴露者早期的效应生物标志物的价值。方法采用KL型肿瘤免疫图像分析系统及配套试剂分析接触苯的高暴露者、低暴露者和对照者Ag-NORs区面积与细胞核仁区的百分比（I.S%）。结果 I.S%在高暴露者组为（6.2±0.7）,低暴露组为（7.5±0.8）,正常对照组为（7.6±0.7）,3组差异有统计学意义（F=2.36,P=0.013）,其中高暴露组低于低暴露组和对照组,低暴露组与对照组比较差异无统计学意义（P〉0.05）。结论 Ag-NORs检测能反映个体的苯接触水平,对职业健康检查早期筛查易感人群有一定的意义。     

免疫球蛋白防治肾移植后T淋巴细胞降低肺部感染

背景：肾移植后T淋巴细胞降低就容易发生感染,肺部是主要靶器官,因此如何控制肺部感染,尤其是重症肺炎,成为改善肾移植患者预后关键所在。 目的：探讨在肾移植后未发生肺部感染之前,根据监测到T淋巴细胞水平降低,予用免疫球蛋白预防肺部感染的作用。 方法：纳入肾移植后半年内患者30例,随机分成治疗组和对照组各15例,所有患者均采用原有的免疫抑制剂。治疗组加用免疫球蛋白0.2 g/(kg•d),2次/d,临床观察肺部感染发生率,移植肾功能和T淋巴细胞水平。 结果与结论：免疫球蛋白治疗组普通肺炎和重症肺炎发生及死亡率明显低于对照组(P < 0.05),CD4⁺T淋巴细胞水平和CD4⁺/CD8⁺T淋巴细胞比值明显上升(P < 0.01),动态观察两组7,14,21 d CD4⁺T淋巴细胞的亚群数目明显高于对照组(P  < 0.01),而肾功能无变化。结果提示,免疫球蛋白能提高肾移植后患者T淋巴细胞水平,恢复机体免疫功能,增强抗感染能力,从而减少肺部感染的发生。     

尿毒症透析患者T淋巴细胞亚群的变化

尿毒症透析患者Ｔ淋巴细胞亚群的变化张怡玲，贾长绪，聂大平，张名义，吴冬梅大连医科大学附属二院肾内科大连１１６０２３透析疗法对尿毒症细胞免疫功能影响的报道甚少。我们观察４５倒尿毒症透析患者的Ｔ淋巴细胞亚群的变化，现将结果分析如下。！资料和方法１．ｌ一般...     

白血病时T淋巴细胞亚群的改变

白血病时Ｔ淋巴细胞亚群的改变毛玉文，尤育初，钱林法，李小雯，张红华，焦红近年来的研究表明，淋巴细胞不仅是免疫活性细胞，而且也参与机体的造血过程，且多数血液病的发展均伴有淋巴细胞亚群分布的改变［１～５］。因此，检测和分析淋巴细胞亚群的分布，对于评估血液...     

慢性乙型肝炎患者外周血T淋巴细胞亚群的变化

目的了解慢性乙型肝炎患者的细胞免疫功能. 方法用免疫花环法测定41例慢性乙肝患者外周血T细胞亚群并分析其变化. 结果 CD3、CD4细胞以及CD4/CD8比值较正常人显著减少(p<0.01),CD8细胞较正常人明显升高(p<0.01). 结论慢性乙肝患者外周血T细胞亚群紊乱,免疫功能低下.     

TLSFJM对小肠移植大鼠外周血及移植肠浸润T细胞的影响

目的：观察TLSFJM对大鼠小肠移植受体外周血及移植肠浸润T细胞的影响和对排斥反应的抑制效应。方法：应用免疫组化SABC法检测受体外周血及移植肠CD4^ 、CD8^ 、CD25^ 淋巴细胞和IL-4、IFN-γ的表达。结果：TLSFJM显著抑制外周血及移植肠浸润淋巴细胞CD4^ 、CD8^ 、CD25^ 和IFN-γ的表达，并提高IL-4的表达，显著延长受体大鼠的生存时间，但不能防止体质量下降，移植肠仍有排斥反应的病理组织学征象。结论：TLSFJM通过影响受体外周血及移植肠浸润T淋巴细胞对大鼠小肠移植发挥免疫抑制作用，但单独使用尚不足以作为预防和控制急性排斥反应的免疫抑制剂。     

Natural killer-cell activity in cyclosporine-treated renal allograft recipients

We prospectively studied natural killer (NK)-cell activity in 16 cyclosporine-treated renal transplant recipients. NK function remained intact in the group as a whole in the initial 6 months following transplantation. The percentage of CD16-positive cells within the peripheral blood mononuclear-cell population was highly correlated with NK activity both prior to and following transplantation in the absence of rejection. During rejection, the correlation was poor. A marked increase in NK activity occurred during 9 of 12 rejection episodes; similar increases in NK activity were rarely observed in the absence of rejection. Significant infiltrates of NK cells, as determined by expression of CD16, were not demonstrated in stained biopsy specimens obtained from rejecting allografts. Pretransplant NK activity did not predict clinical outcome of the allograft. Our results indicate that NK cells are activated during allograft rejection in cyclosporinetreated patients, but their exact role in the rejection process is unknown.     

流式细胞术检测肿瘤患者外周血T淋巴细胞亚群研究

目的 探讨肿瘤患者T淋巴细胞亚群的变化及临床意义。方法 采用流式细胞术检测27例肿瘤患者和25例正常对照组的T淋巴细胞亚群。结果 肿瘤患者CD3^＋T细胞、CD4^＋T细胞和CD4^＋／CD8^＋比值明显低于对照组并有统计学意义，而CD8^＋T细胞显著高于对照组（P〈0．01）。结论 肿瘤患者的免疫功能下降。流式细胞术对肿瘤患者的免疫功能的检测具有快速、敏感、准确的特点，对于评价疗效、判断预后具有重要价值。     

肾移植术后血清sICAM-1和sVCAM-1的动态监测及临床意义

目的：探讨肾移植术后监测血清可溶性细胞问粘附分子-1(sICAM-1)和可溶性血管细胞粘附分子-1(sVCAM-1)的临床意义。方法：采用ELISA法，动态监测86例肾移植患者手术前后血清sICAM-l和sVCAM-1的变化。结果：移植术前sICAM-1、sVCAM-l与对照组无显著性差别，术后均明显升高，于第3天时达到高峰，l周至2周后降至术前水平。发生急性排斥反应前l-3天血清sICAM-1、sVCAM-1即开始升高，抗排斥治疗有效后逐渐下降。并发感染时sICAM-1、sVCAM-l显著升高，CsA中毒时无明显变化。结论：动态监测血清sICAM-1、sVCAM-l可做为早期辅助诊断急性排斥反应的免疫学指标，有助于急性排斥反应与CsA肾中毒的鉴别。     

肾移植患者尿液中供者细胞DNA变化在急性排斥反应诊断中的意义

目的：探讨肾移植受者尿液中供者细胞的出现与急性排斥反应的相关关系及其临床意义。方法：以供者为男性、受者为女性或HLA-DR抗原有错配的80例肾移植受者为研究对象，定期收集尿液标本，从中提取DNA，利用特异性引物聚合酶链反应分别检测Y染色体上特异的基因片段DYZ-1和HLA-DR抗原的基因DRB-1。结果：手术当天受者的尿液中即有供者细胞出现，随着时间的推移，尿液中供者细胞DNA的基因表达强度逐渐减弱，直至术后30天，仍有90．0％受者的尿液中有供者细胞DNA的基因表达，其中8例(29．6％)发生了急性排斥反应；出院后发生急性排斥反应者，90．0％的尿液标本中能检测到供者细胞DNA，抗排斥治疗结束后2周，83．3％转为阴性；肾功能良好的稳定期受者，仅6．7％的受者尿液中DYZ-1或HLA-DRB基因阳性。结论肾移植受者尿中供者细胞DNA的检测可以作为诊断急性排斥反应的一种方法，其基因表达强度变化为定量评价排斥反应提供了可能性。     

Cyclosporin but not everolimus inhibits chemokine receptor expression on CD4+ T cell subsets circulating in the peripheral blood of renal transplant recipients

The peripheral chemokine receptors chemokine receptor 3 (CXCR3) and CC chemokine receptor 5 (CCR5) have been reported to be associated with allograft rejection. The impact of the expression of immunosuppressive drugs on peripherally circulating CD4⁺ T cell subsets after renal transplantion is unknown. Expression of CXCR3 and CCR5 was investigated by flow cytometry in 20 renal allograft recipients participating in a prospective, randomized trial ({"type":"clinical-trial","attrs":{"text":"NCT00514514","term_id":"NCT00514514"}}NCT00514514). Initial immunosuppression consisted of basiliximab, cyclosporin A (CsA), mycophenolate sodium and corticosteroids. After 3 months, patients were treated either with CsA, mycophenolate sodium (MPA) plus corticosteroids (n = 6), CsA and everolimus plus corticosteroids (n = 8) or CsA-free (CsA_free) receiving everolimus, MPA and corticosteroids (n = 6). After initial reduction of CD4⁺forkhead box protein 3 (FoxP3)⁺ and CD4⁺CD25^hiFoxP3⁺ regulatory T cells (T_regs) (P < 0·05; P < 0·01), 3-month post-transplant percentages of T_regs were reconstituted in CsA_free and CsA_lo arms compared to CsA_reg 12 months post transplant. Expression of CCR5 and CXCR3 on CD4⁺FoxP3⁺ and CD4⁺FoxP3^- T cells 12 months post transplant was increased in CsA_freeversus CsA_reg. Increase in CCR5⁺CXCR3⁺ co-expressing CD4⁺FoxP3^- cells between 3 and 12 months correlated negatively with the glomerular filtration rate (GFR) slope/year [modification of diet in renal disease (MDRD); r = −0·59, P < 0·01]. CsA, but not everolimus, inhibits both T_reg development and expression of CXCR3 and CCR5 on CD4⁺ T cell subsets. Increase in CCR5⁺CXCR3⁺ co-expressing CD4⁺FoxP3^- T cells is associated with early loss in allograft function.     

体外循环心脏直视手术对小儿T淋巴细胞亚群的影响

目的 探讨体外循环心脏直视手术对小儿T淋巴细胞亚群的影响。方法 选择先天性心脏病需行体外循环心脏直视手术患儿60例，采用中度低温体外循环，分别于术前、术毕、术后6小时、1、4、7天采集静脉血标本。应用流式细胞技术检测CD3、CD34、CD8阳性T淋巴细胞。结果 CD3、CD4T淋巴细胞于术后下降，CD8T淋巴细胞有上升。结论 体外循环心脏直视手术对小儿T淋巴细胞功能有明显的抑制作用。     

Thymic re-entry of mature activated T cells and increased negative selection in vascularized allograft recipients

Transplantation tolerance is a dynamic state that involves several homeostatic mechanisms intrinsic to the host. One of these mechanisms is activation-induced T cell death (AICD). However, it is unclear where AICD takes place during alloreactive responses. Since activated T cells can re-enter the thymus, we hypothesized that mature T cells activated by an allograft could be deleted upon re-entry into the thymus. To test this hypothesis, we used wild-type or 2C TCR transgenic mice receiving syngeneic or allogeneic heterotopic, vascularized heart grafts. First, we demonstrated that ex vivo CFSE-labelled T cells re-entered the thymus when transferred into allograft recipients but not when transferred into isograft recipients. Next, we compared the changes in cell subset numbers and incidence of apoptosis in the thymi and spleens of allograft or isograft recipients. Seven days after transplantation, at a time in which all the allografts were undergoing rejection, cells expressing donor-MHC class II molecules had migrated to the thymus and to the spleen. In the thymus of allograft recipients, overall cellularity was significantly reduced by 40% and associated with an increase in the number of double negative (CD4-CD8-) thymocytes and a decrease in double positive (CD4+CD8+) thymocytes, consistent with increased negative selection of thymocytes. Additionally, thymi of allograft recipients showed an increase in the number of recently activated, mature T cells (TCRhi, CD25+, CD44+) and a significant increase in the number of apoptotic cells, especially in the thymic medulla, that involved mature T cells as indicated by the TCRhi, CD44+, CD4 or CD8 single positive phenotype. Spleens of allograft recipients were increased in size and cellularity but did not show any of the changes in cell subsets seen in the thymi. Our data show that after allografting there is an increase in apoptotic cell death that is associated with negative selection of developing thymocytes as well as of alloreactive mature T cells that have re-entered the thymus upon activation in the periphery. This may occur upon migration of graft-derived antigen-presenting cells to the thymus.     

Monitoring of renal allograft recipients by quantisation of human cytomegalovirus genomes in peripheral blood leukocytes

The ratio of human cytomegalovirus (HCMV) genomes per cellular genomes in serial peripheral blood leukocyte (PEL) extracts of renal allograft recipients was quantitated by competitive nested polymerase chain reaction (PCR). Patients were also monitored for the development of acute HCMV infection by detection of HCMV pp65 antigenemia, HCMV IgM antibodies, and viruria. Compared to qualitative nested HCMV PCR, the frequency of positive PCR results in renal allograft recipients without further evidence of acute HCMV infection was significantly reduced by quantitative HCMV PCR. HCMV DMA levels ≥1,000 copies HCMV/10⁶ copies β-globin were found to be highly indicative for the development of a clinically symptomatic HCMV infection following renal allograft transplantation. In patients treated with ganciclovir, quantitation of HCMV target sequences allowed the assessment of the efficacy of antiviral therapy. © 1994 Wiley-Liss, Inc.     

环孢素A和他克莫司对肾移植受者外周血淋巴细胞活性影响的比较

目的：肾移植术后应用Calcineurin抑制剂需常规监测血清药物浓度,然而药物浓度并不能完全反应患者的免疫功能抑制状态,且药物的个体反应性差异较大,本研究旨在通过外周血单核细胞（PBMC）活性检测反应患者对Calcineurin抑制剂的敏感性。方法：采取40例肾移植受者术前抗凝血,Ficoll密度梯度离心法分离PBMC,置于RPMI1640培养基中培养,加入96孔培养板中予刀豆蛋白A刺激,并依次加入不同浓度的环孢素A（CsA）或他克莫司（TAC）,之后加入二苯基四氮唑溴盐（MTT）、二甲亚砜（DMSO）裂解后于波长570nm下测定吸光度。记录受试者肾移植后的急性排斥反应和巨细胞病毒感染等临床事件。结果：①受试者半数PBMC被抑制的药物浓度即为IC50。CsA和TAC的IC50均值分别为162.3ng/ml、0.289ng/ml,TAC对PBMC转化的抑制作用显著强于CsA;②Kendall相关系数分析示CsA的IC50与TAC的IC50之间有显著的相关关系（rk=0.3472,P=0.0082）;③CsA治疗组急性排斥反应发生率显著高于TAC组,而两组患者巨细胞病毒感染发生率差异不明显。结论：TAC抑制人PBMC母细胞转化能力约为CsA的589.1倍,因而TAC治疗的肾移植受者术后急性排斥反应发生率显著较低。将术前淋巴细胞的体外药敏试验与术后治疗性TDM合理结合,是改进个体化免疫抑制方案的举措之一。