1,25-(OH)2维生素D3对NOD小鼠的免疫干预作用

目的　探讨 1,2 5 (OH) 2 维生素D3 〔1,2 5 (OH2 )D3 〕对环磷酰胺促发的NOD小鼠 1型糖尿病的预防作用。方法　取体重相近的 4周龄NOD雌性小鼠 2 0只在实验开始前均一次性腹腔注射环磷酰胺 2 80mg/kg以加速胰岛炎。分为两组 ,每组 10只 ,干预组隔日腹腔注射 1,2 5 (OH2 )D3 5 μg/kg ,对照组注射等量的花生油。 3 0天实验结束时 ,观察糖尿病发生率 ,行HE染色观察胰岛炎程度 ,免疫组化观察bcl 2 ,bax在胰岛的表达 ,流式细胞仪定量测定脾脏T淋巴细胞的凋亡率。结果　 1,2 5 (OH) 2 D3 干预组糖尿病发病率较花生油对照组发病率低 ;1,2 5 (OH) 2 D3 干预后血糖值较干预前显著下降 (P <0 .0 1) ;干预组胰岛炎严重程度较花生油对照组明显减轻 ;胰岛细胞抑制凋亡的bcl 2基因的表达在 1,2 5 (OH ) 2 D3 处理组高于花生油对照组 ,而促进凋亡的bax基因的表达在 1,2 5 (OH ) 2 D3 组低于花生油对照组 (均P <0 .0 5 ) ;1,2 5 (OH ) 2 D3 组脾淋巴细胞凋亡率为 (3 2 .3 1± 7.0 1) % ,而花生油对照组凋亡率为 (2 4.19± 7.70 ) % (P <0 .0 5 )。结论　 1,2 5 (OH) 2 D3 对环磷酰胺加速的NOD小鼠胰岛具有保护作用。     

1,25-二羟基维生素D3对小鼠成骨细胞增殖的影响

目的 检测1,25-二羟基维生素D3[1,25(OH)2D3]对小鼠成骨细胞增殖及细胞周期的影响及其意义.方法 取出生24 h内的小鼠30只,无菌条件下取出颅骨,应用酶消化法进行成骨细胞培养,在培养液中加入不同浓度的1,25(OH)2Ds(10-8、10-9、10-11 mol/L),应用四唑蓝比色法(MTT)法检测其对成骨细胞增殖的影响,应用流式细胞仪检测其对成骨细胞细胞周期的影响.结果 小鼠成骨细胞在1,25(OH)2D3处理的24、48、72 h,10-8、10-9mol/L组与对照组吸光度(A)相比较,差异有统计学意义(P＜0.01),10-11mol/L组与对照组A比较,差异无统计学意义(P＞0.05);1,25(OH)2D3作用下小鼠成骨细胞S期(8.00±1.42)、G2-M期(7.70±0.67)的细胞减少,G1期(84.30±1.90)细胞增加. 结论 1,25(OH)2D3可以抑制体外培养的小鼠成骨细胞的增殖,并呈现一定的浓度依赖性.     

1，25（OH）2D3在小鼠下颌骨髁状突矿化中的作用

目的探讨1,25（OH）2D3在小鼠下颌骨髁状突矿化中的作用。方法利用影像学、组织学、RT-PCR等方法比较分析6周龄野生型和1-α羟化酶基因敲除小鼠下颌骨髁状突矿化的差异。结果与野生型小鼠相比,1-α羟化酶基因敲除小鼠下颌骨矿化明显不良,骨钙素（OCN）在下颌骨髁状突成骨细胞表达降低,Biglycan表达增加。结论1,25（OH）2D3在小鼠下颌骨髁状突矿化过程中起重要作用。     

慢阻肺患者血清1,25(OH)_2D_3、钙水平与肺功能关系的研究

目的分析探讨慢性阻塞性肺疾病急性加重期患者血清1,25-二羟维生素D3[1,25(OH)2D3]、钙(Ca2+)水平与其肺功能关系的相关性。方法选取2013年12月至2014年4月在我院住院的慢阻肺患者60例,分别在其慢阻肺急性加重期和稳定期,抽取静脉血,检测患者血清1,25(OH)2D3、Ca2+、磷(P)的水平,并同时检测其动脉血气分析及肺功能。结果急性加重期的血清1,25(OH)2D3、Ca2+、P以及FEV1/FVC等指标与稳定期相比,明显降低;急性加重期患者血清中1,25(OH)2D3、Ca2+与FEV1(%)呈正相关(r=0.341,0.454,P均0.01)。结论慢阻肺急性加重期患者的血清1,25(OH)2D3、Ca2+水平与FEV1(%)有相关性,在一定程度上反映了慢阻肺患者疾病严重程度。     

1,25-二羟维生素D3对人成骨细胞基质金属蛋白酶及其抑制因子的作用

目的　研究 1, 25 二羟维生素D3 [ 1α, 25 (OH)2D3 ]对人成骨细胞基质金属蛋白酶(MMP) 1、MMP 2、膜型基质金属蛋白酶 1 (MT1 MMP)、基质金属蛋白酶抑制因子 1 (TIMP 1 )的影响,探讨 1α, 25(OH)2D3 调节骨代谢作用机制。方法　人成骨细胞用 1α, 25 (OH)2D3 干预。Western杂交检测MT1 MMP蛋白质表达。MMP 1、MMP 2、TIMP 1的分泌及MMP 2的活性用ELISA检测。Northern杂交检测维生素D受体、MT1 MMPmRNA表达。结果　 1α, 25 (OH)2D3 对人成骨细胞MMP 1、MMP 2、TIMP 1表达无影响, 10-10 ~ 10-8 mol/L 1α, 25 (OH)2D3 干预诱导成骨细胞MT1 MMP表达呈剂量依赖性 (P值均 <0 05);促进MMP 2激活呈剂量依赖性 [MMP 2活性分别为(42 3 ± 8 6)、(64 4 ±11 4)、(93 5 ±9 9)μg/L, P值均<0 05]。结论　由于MT1 MMP在骨吸收过程中起着关键作用, 1α, 25(OH)2D3 可通过诱导成骨细胞MT1 MMP表达刺激骨吸收。     

1,25-二羟维生素D3对被动致敏人气道平滑肌细胞的抑制作用

目的 检测1,25-二羟维生素D3[1,25-(OH)2D3]对被动致敏的人气道平滑肌细胞(HASMC)的增殖及其表达基质金属蛋白酶-9(MMP-9)和解整合素-金属蛋白酶33(ADAM33)的影响,探讨其调节支气管哮喘(简称哮喘)患者气道重塑的可能机制.方法用10%哮喘患者血清被动致敏HASMC,以10%非哮喘患者血清为对照.四甲基偶氮唑盐(MTT)法检测不同浓度1,25-(OH)2D3对HASMC细胞增殖活力的变化并确定其有效作用浓度.然后以有效作用浓度的1,25-(OH)2D3预处理HASMC,MTT法测定细胞增殖活力,流式细胞仪测定细胞周期,实时荧光定量PCR及蛋白免疫印迹法分别检测细胞中MMP-9及ADAM33的表达情况.结果 (1)1,25-(OH)2D3在(10-9～10-7)mol/L浓度下能浓度依赖性地抑制被动致敏的HASMC增殖(P<0.05);(2)10-7 mol/L的1,25-(OH)2D3能时间依赖性地抑制被动致敏的HASMC增殖并特异性抑制细胞周期中G1/S的转化;(3)VD组MMP-9及ADAM33蛋白表达较哮喘组分别下降了(63.4±3.6)%和(50.9±2.9)%,但仍显著高于对照组(P<0.01);(4)VD组MMP-9及ADAM33 mRNA表达较哮喘组分别下降了(52.2±2.5)%和(67.8±3.2)%,但仍显著高于对照组(P<0.01).结论 1,25-(OH)2D3能从多个层面抑制被动致敏的HASMC的功能,这可能是其调节哮喘气道重塑的作用机制之一.

Abstract：

Objective To investigate the effects of 1,25-(OH)2D3 on the proliferation of passively sensitized human airway smooth muscle cells(HASMCs) and their expressions of MMP-9 and a disintegrin and metalloprotease 33(ADAM33). Methods HASMCs were passively sensitized with 10% serum from asthmatic patients. MTT colorimetri assay was used to examine the effect of 1,25-(OH)2D3 on cell proliferation at different concentrations(10-10 mol/L, 10-9 mol/L, 10-8 mol/L, 10-7 mol/L).By this way, its optimal inhibitory concentration was determined. And then the effects of 1,25-(OH)2D3 at the optimal concentration on cell proliferation was examined by the same MTT assay and cell cycle analysis by flow cytometry. The expressions of MMP-9 and ADAM33 in HASMCs were studied by real-time quantitative RT-PCR and Western blotting analysis. Results (1)Inhibition of cell proliferation by 1,25-(OH)2D3 was barely detectable at 10-10 mol/L. But with the increasing concentration ranging from 10-9 mol/L to 10-7 mol/L, 1,25-(OH)2D3 markedly inhibited the cell proliferation concentration-dependently and reached the maximum effect at the concentration of 10-7 mol/L.Accordingly,10-7 mol/L was chosen as the optimal concentration of 1,25-(OH)2D3 for the following study. (2)At the concentration of 10-7 mol/L,1,25-(OH)2D3 inhibited the cell proliferation of passively sensitized HASMCs in a time-dependent manner and hampered the G1/S transition. (3)1,25-(OH)2D3 pretreatment attenuated the MMP-9 and ADAM33 protein levels in passively sensitized HASMCs by (63.4±3.6)% and (50.9±2.9)%,respectively (P<0.01). (4)1,25-(OH)2D3 significantly inhibited the MMP-9 and ADAM33 mRNA levels in passively sensitized HASMCs by (52.2±2.5)% and (67.8±3.2) %, respectively (P<0.01). Conclusion 1,25-(OH)2D3 has a direct inhibitory effect on passively sensitized HASMCs in vitro,including the inhibition of cell proliferation and the expressions of MMP-9 and ADAM33,which maybe associated with the beneficial role of 1,25-(OH)2D3 in the prevention and therapy of asthmatic airway remodeling.     

1,25(OH)_2D_3干预IL-17及巨噬细胞炎性蛋白3α表达抑制大鼠肝纤维化形成的作用机制

目的探讨在肝纤维化形成过程中肝组织及外周血中IL-17和巨噬细胞炎性蛋白(MIP)3α的表达变化,以及1,25(OH)2D3经干预IL-17通路抑制肝纤维化形成的作用机制。方法 48只SD大鼠随机分为4组:正常组(橄榄油)、模型组(CCl4橄榄油溶液)、药物对照组(CCl4橄榄油溶液+橄榄油灌胃)、治疗组(CCl4橄榄油溶液+1,25(OH)2D3橄榄油溶液灌胃)。8周后取肝组织行HE染色和Masson染色,并对其纤维化程度进行病理分期;采用ELISA法检测干预后不同时间点(4、6、8周)血清中IL-17水平;免疫组化法分析不同时间点(4、6、8周)各组大鼠肝组织IL-17和MIP3α的蛋白表达;real time-PCR法检测第8周各肝组织IL-17和MIP3α的mRNA表达。计量资料的组间比较采用单因素方差分析,进一步两两比较采用LSD-t检验,相关性检验采用直线相关分析。结果 8周时模型组及药物对照组肝纤维化显著,治疗组肝纤维化程度明显减轻。4组间各个时间点(4、6、8周)血清IL-17水平比较差异均有统计学意义(F值分别为6.13、5.79、7.18,P值均0.05);正常组血清IL-17水平很低,各个时间点(4、6、8周)模型组及药物对照组血清IL-17水平与正常组比较显著升高(P值均0.01);治疗组各时间点血清中IL-17表达水平较模型组和药物对照组均显著降低(P值均0.05),但均以第4周表达水平最高。免疫组化和real time-PCR法检测显示,对照组肝组织中几乎不表达IL-17,且MIP3α表达甚微;随着肝纤维化的进展,血清中IL-17水平逐渐降低,肝组织中IL-17水平逐渐升高(r=-0.793,P0.01);4组间各时间点(4、6、8周)肝组织表达IL-17、MIP3α水平差异有统计学意义(IL-17:F值分别为11.02、9.61、7.45,P值均0.05;MIP3α:F值分别为9.47、8.93、6.15,P值均9.05);模型组及药物对照组各时间点(4、6、8周)肝组织表达IL-17、MIP3α蛋白较正常组均显著升高(P值均0.01),治疗组肝组织各时间点表达量较模型组和药物对照组均明显降低且差异均有统计学意义(P值均0.05),均于第8周时表达量最高。模型组及药物对照组第8周IL-17、MIP3αmRNA表达水平较正常组明显增多,治疗组较药物对照组和模型组显著减少,组间比较差异有统计学意义(F值分别为7.36、10.15,P值均0.05)。结论 (1)在肝纤维化发生发展过程中,血清IL-17水平先升高后降低,而肝组织中IL-17表达水平呈逐渐升高趋势,提示肝纤维化后期血清中Th17渐被趋于肝脏;(2)1,25(OH)2D3治疗组肝脏中IL-17和MIP3α蛋白及mRNA水平较模型组及药物对照组均明显降低,提示IL-17通路可能为1,25(OH)2D3抑制肝纤维化发生发展的作用机制之一。     

腹腔注射胰岛素或其B链肽对NOD小鼠胰岛TNF/TNFR1系统表达的影响

以胰岛素或其B链肽 (9 23)免疫 4周龄NOD小鼠,可下调胰腺干扰素γ、肿瘤坏死因子(TNF) α、TNF受体 1 (TNFR1 )、CPP32mRNA表达,下调胰岛细胞及浸润的炎症细胞TNF α、TNFR1、CPP32蛋白表达,减轻胰岛炎程度,降低糖尿病发病率。     

初诊2型糖尿病患者血清25-羟维生素D3水平与胰岛β细胞功能和胰岛素抵抗的相关性

目的 评估初诊2型糖尿病患者低维生素D血症发生率,探讨血清25-羟维生素D3与胰岛β细胞功能和胰岛素抵抗的关系.方法 入选2008年4至7月在四川省人民医院就诊的初诊2型糖尿病患者97例（糖尿病组）,其中男57例,女40例,年龄（52±10）岁.以同期健康体检者69名为对照组,其中男40名,女29名,年龄（50±11）岁.采用高压液相色谱法测定2组参试者空腹血清25-羟维生素D3水平.根据25-羟维生素D3是否＜37.5 nmol/L将糖尿病组分为低25-羟维生素D3亚组（n=61）和非低25-羟维生素D3亚组（n=36）,比较糖化血红蛋白、稳态模型胰岛素抵抗指数、胰岛β细胞功能指数、早期相胰岛素分泌指数、葡萄糖曲线下面积、胰岛素曲线下面积.采用多元逐步回归分析评价血清25-羟维生素D3与性别、年龄、体质指数、腰臀比、血压、血脂、糖化血红蛋白、胰岛素抵抗及胰岛β细胞功能的相关性.结果 糖尿病组血清25-羟维生素D3水平显著低于对照组[（36±19）nmol/L vs（80±26）nmol/L,t=-13.00,P＜0.01].糖尿病组低25-羟维生素D3的发生率为62.9%（61/97）.与非低25-羟维生素D3亚组比较,低25-羟维生素D3亚组糖化血红蛋白、葡萄糖曲线下面积较高[（10.1±3.0）% vs （7.7±2.6）%,（32±7）h·mmol-1·L-1 vs （25±7）h·mmol-1·L-1,t值分别为4.44、4.45,均P＜0.01],胰岛β细胞功能指数、早期相胰岛素分泌指数、胰岛素曲线下面积较低[21±16 vs 75±64,1.9±1.9 vs 8.3±7.7,（30±21）h·mU-1·L-1vs（104±80）h·mU-1·L-1,t值分别为-5.68、-6.81、-7.69,均P＜0.01].多元逐步回归分析显示,2型糖尿病患者早期相胰岛素分泌指数、胰岛素曲线下面积与25-羟维生素D3独立正相关（t值分别为2.21、4.67,均P＜0.01）.结论部分初诊2型糖尿病患者存在25-羟维生素D3缺乏,缺乏程度与血糖升高程度有关;25-羟维生素D3缺乏与早期相胰岛素分泌和总体胰岛素分泌下降有关.     

IL—4对NOD小鼠1型糖尿病免疫干预及其机制的探讨

目的：探讨IL－4对NOD鼠1型糖尿病发病率,胰岛炎的影响及其机制。方法：采用人类1型糖尿病动物模型NO（nonobese diabetic)鼠,IL－4处理后检测血糖,尿糖及糠愕病发病率,HE染色观察胰岛炎程度,流式细胞仪测定周围及中枢淋巴细胞亚群的变化,结果IL－4处理组糖尿病发病率为12．50％,明显低于对照组（62．50％）（P＜0．05）,且胰岛炎的严重程度亦低于对照组;处理组周围单个核细胞（CD 4/CD 8及IL－2R＋细胞百分比增高,胸腺CD＋4,CD＋8细胞百分比增高而D＋4 CD＋8细胞百分比下降（P＜0．01）。结论 IL－4有降低NOD鼠1型糖尿病发病率及胰岛炎严重程度的作用,这种作用可能与IL－4影响了淋巴细胞亚群的分布从而纠正了免疫调节失衡有关。     

NOD小鼠胰岛内TNF/TNFR1凋亡通路的动态变化

随着病程的进展和胰岛炎的加重,NOD小鼠胰腺γ干扰素(IFNγ)、肿瘤坏死因子α(TNFα)、肿瘤坏死因子受体(TNFR)1和半胱氨酸蛋白32(CPP32)mRNA表达增加,胰岛细胞及浸润的炎症细胞TNFα、TNFR1、CPP32蛋白表达增加,提示Th1细胞因子和TNF/TNFR1凋亡通路在1型糖尿病发病中起重要作用。     

黄芪多糖影响NOD小鼠胰岛超微结构及胰腺Th1/Th2型细胞因子表达

探讨黄芪多糖（APS）对1型糖尿病的影响。电镜观察NOD小鼠胰岛超微结构，RT—PCR检测胰腺Th1／Th2型细胞因子表达。APS组胰岛超微结构保存完好，Th1型细胞因子表达下调，Th2型细胞因子表达上调。APS可纠正1型糖尿病的细胞因子免疫失衡。     

Effect of 24,25-dihydroxyvitamin D3 on 1,25-dihydroxyvitamin D3 [1,25-(OH)2D3] metabolism in vitamin D-deficient rats infused with 1,25-(OH)2D3

Previous studies revealed that administration of 24,25-dihydroxyvitamin D3 [24,25-(OH)2D3] to calcium (Ca)-deficient rats causes a dose-dependent reduction in markedly elevated serum 1,25-(OH)2D3 level. Although the results suggested that the metabolism of 1,25-(OH)2D3 was accelerated by 24,25-(OH)2D3, those experiments could not define whether the enhanced metabolism of 1,25-(OH)2D3 played a role in the reduction in the serum 1,25-(OH)2D3 level. In the present study, in order to address this issue more specifically, serum 1,25-(OH)2D3 was maintained solely by exogenous administration through miniosmotic pumps of 1,25-(OH)2D3 into vitamin D-deficient rats. Thus, by measuring the serum 1,25-(OH)2D3 concentration, the effect of 24,25-(OH)2D3 on the MCR of 1,25-(OH)2D3 could be examined. Administration of 24,25-(OH)2D3 caused a dose-dependent enhancement in the MCR of 1,25-(OH)2D3, and 1 microgram/100 g rat.day 24,25-(OH)2D3, which elevated serum 24,25-(OH)2D3 to 8.6 +/- 1.3 ng/ml, significantly increased MCR and suppressed serum levels of 1,25-(OH)2D3. The effect of 24,25-(OH)2D3 on 1,25-(OH)2D3 metabolism developed with a rapid time course, and the recovery of iv injected [1 beta-3H]1,25-(OH)2D3 in blood was significantly reduced within 1 h. In addition, there was an increase in radioactivity in the water-soluble fraction of serum as well as in urine, suggesting that 1,25-(OH)2D3 is rapidly degraded to a water-soluble metabolite(s). Furthermore, the reduction in serum 1,25-(OH)2D3 was associated with a reduction in both serum and urinary Ca levels. Because the conversion of [3H]24,25-(OH)2D3 to [3H]1,24,25-(OH)2D3 or other metabolites was minimal in these rats, 24,25-(OH)2D3 appears to act without being converted into other metabolites. These results demonstrate that 24,25-(OH)2D3 rapidly stimulates the metabolism of 1,25-(OH)2D3 and reduces its serum level. It is suggested that 24,25-(OH)2D3 plays a role in modifying serum 1,25-(OH)2D3 concentrations by affecting the metabolism of 1,25-(OH)2D3 and may have a therapeutic values in the treatment of hypercalcemia or hypercalciuria caused by 1,25-(OH)2D3 excess.     

Contrasting effects of exogenous 1,25-dihydroxyvitamin D [1,25-(OH)2D] versus endogenous 1,25-(OH)2D, induced by dietary calcium restriction, on vitamin D receptors

The biological actions of 1,25-dihydroxyvitamin D [1,25-(OH)2D] are mediated by specific binding of the hormone with an intracellular vitamin D receptor, which ultimately regulates expression of genes within the target tissues. The quantity of vitamin D receptors varies between target tissues and within target tissues, depending on the physiological state of the animal. One factor that can modulate tissue vitamin D receptor content is 1,25-(OH)2D. In the present study performed in male rats, exogenous administration of 36 ng 1,25-(OH)2D3/day for 7 days increased plasma 1,25-(OH)2D concentrations 5-fold above those in control rats (to 261 +/- 17 pg/ml). Compared with those in control rats, 1,25-(OH)2D3 treatment resulted in a 1.5-fold increase in duodenal vitamin D receptor content (351 +/- 16 vs. 520 +/- 21 fmol/mg protein) and a 3-fold increase in renal vitamin D receptor content (60.3 +/- 5.2 vs. 193.8 +/- 22.7 fmol/mg protein). The effects of endogenously produced 1,25-(OH)2D on tissue vitamin D receptor content were studied by feeding rats either a 0.02% or 1% calcium diet for 2, 7, 14, or 21 days. Rats fed the low calcium diet exhibited plasma 1,25-(OH)2D concentrations similar to (day 7) or exceeding (days 14 and 21) those achieved by exogenous administration of 1,25-(OH)2D3, yet duodenal vitamin D receptor content was not up-regulated by dietary calcium restriction at any time point. The renal vitamin D receptor content of calcium restricted rats was 20-38% lower (P less than 0.05) than that in rats fed a calcium-replete diet 7, 14, and 21 days after initiation of the dietary treatments. These data suggest that under physiological conditions, increased plasma concentrations of 1,25-(OH)2D do not result in up-regulation of tissue vitamin D receptor concentrations, and that dietary calcium restriction must induce some factor(s) that results in down-regulation of vitamin D receptors in the kidney.     

雷公藤多甙用于1型糖尿病患者的免疫干预治疗

目的观察用雷公藤多甙对1型糖尿病患者进行免疫干预治疗的疗效。方法在均使用胰岛素作为基础治疗的情况下,46例1型糖尿病患者随机分为治疗组(加用雷公藤多甙)及对照组,每组23例。比较入组时和治疗6个月后血糖、血清C肽、胰岛自身抗体水平和T淋巴细胞亚群的变化。结果两组患者入组时血糖控制均较差,治疗后空腹血糖(FBG)及餐后血糖(PBG)以及HbAIC均有显著下降(P< 0．01),但与对照组相比,治疗组降低更明显(P<0．05或P<0．01)。两组治疗后空腹和餐后C肽水平均呈现下降趋势(P<0．05),但治疗组的下降率较小(P<0．01)。入组时两组的胰岛素剂量相似,治疗6个月后雷公藤多甙治疗组所用的胰岛素剂量较对照组少(P<0．01)。治疗前,两组患者存在血清谷氨酸脱羧酶抗体(GADA)、胰岛细胞抗体(ICA)、蛋白酪氨酸磷酸酶抗体(IA-2A)阳性。治疗后对照组抗体水平无变化,治疗组GADA和IA-2A的阳性率及均值水平趋下降(均P<0．05)。治疗组在治疗后外周血CD4+、HLA- DR+T淋巴细胞亚群均值水平降低[(42．3±3．3)％vs(38．4±3．6)％,(21．2±2．6)％vs(16．7±3．1)％,P<0．01],CD8+ T淋巴细胞亚群水平升高[(23．0±2．8)％vs(27．7±2．1)％,P<0．01],而对照组无明显变化。结论雷公藤多甙可在一定程度上减轻1型糖尿病患者自身免疫导致的胰岛β细胞破坏,从而延缓疾病的进程。     

Systemic cardiovascular disease in uremic rats induced by 1,25(OH)2D3

OBJECTIVE: Vitamin D may contribute to cardiovascular disease in the absence of hypercalcemia in patients with chronic kidney disease. METHODS: We investigated the effects of long-term (6-week) treatment with 1,25(OH)2D3, at a non-hypercalcemic dosage (0.25 microg/kg per day per orally) in 5/6 nephrectomized rats: (i) vehicle-treated, sham-operated rats; (ii) 1,25(OH)2D3-treated, sham-operated rats; (iii) vehicle-treated, 5/6 nephrectomized rats; and (iv) 1,25(OH)2D3-treated, 5/6 nephrectomized rats. RESULTS: Creatinine clearance after 6 weeks was significantly lower and parathyroid hormone levels were significantly higher in 1,25(OH)2D3-treated uremic rats, compared with uremic controls (P < 0.01). Serum calcium levels, as well as the calcium-phosphorus product, did not differ between both groups. Mean systolic blood pressure in 1,25(OH)2D3-treated animals was significantly increased, compared with vehicle (each P < 0.01). In addition, 1,25(OH)2D3-treated uremic animals showed left ventricular hypertrophy. Diffuse aortic calcification involving the intima and media layer occurred in 1,25(OH)2D3-treated uremic animals, but not in other groups. The mean aortic wall area and lumen area were increased two-fold in 1,25(OH)2D3-treated uremic animals compared with vehicle (P < 0.01), whereas the wall/lumen ratio remained unchanged, indicating fusiform aneurysm formation. CONCLUSIONS: Hypertension, left ventricular hypertrophy, aortic calcification, and aneurysm, without hypercalcemia, occurred in 1,25(OH)2D3-treated, 5/6 nephrectomized rats. These data indicate a permissive effect of uremia for cardiovascular damage induced by non-hypercalcemic doses of 1,25(OH)2D3.     

免疫检查点抑制剂治疗后发生1型糖尿病二例报道并文献综述

本文报道2例使用免疫检查点抑制剂(ICIs)治疗后发生T1DM的患者。1例为青年女性,表现为爆发性T1DM,起病时C-P无法检测出;另1例老年女性,表现为C-P逐渐下降。2例均以DKA起病。本文对2例患者的诊断及治疗进行综述并文献复习。     

Levels of 1,25(OH)2D3 for patients with pulmonary tuberculosis and correlations of 1,25(OH)2D3 with the clinical features of TB

Background

To determine the 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] concentrations to patients with tuberculosis (TB) and whether it influenced the patient’s clinical features.

Methods

For the first part, a total of 153 healthy adults and 74 patients with pulmonary TB (PTB) were enrolled. Serum concentrations of 1,25(OH)2D3 were determined by liquid chromatography-tandem mass spectroscopy to examine the 1,25(OH)2D3 concentrations of the two groups from the peripheral blood. If there are differences between the two groups, what follow will increase the experimental group numbers to examine the relationship among the 1,25(OH)2D3 concentrations with the numbers of the lesion area, the tubercule bacilli in sputum and the CD4/CD8 ratio of T lymphocytes in the peripheral blood.

Results

In the first part, the 1,25(OH)2D3 concentrations was lower in patients with TB than in those healthy adults [365.9 (SD 235.7) vs. 464.3 (SD 335.6), P<0.05]. In the second part, we increased the sample size to 134 (male 91 cases, female 43 cases). we found that the plasma levels of 1,25(OH)2D3 are not correlated with the numbers of the lesion area and the tubercule bacilli in sputum, but the 1,25(OH)2D3 levels can interact the ratio of CD4/CD8 T lymphocytes, it shows a positive correlation with the ratio of CD4/CD8 T lymphocytes.

Conclusions

The 1,25(OH)2D3 concentrations in TB patients lower than the healthy adults, it might exist as a risk factor during the development of TB or TB might affect the levels of 1,25(OH)2D3. But the different status vitamin D concentration might not affect the numbers of the lesion area, the tubercule bacilli in sputum. It shows a positive correlation with the ratio of CD4/CD8 T lymphocytes. The study will have a significance value to clinical medicine, but further study will need to study the levels of 1,25(OH)2D3 with the TB.