围生期缺氧缺血后脑组织型纤溶酶原激活物的活性变化

目的　探讨缺氧缺血后脑组织型纤溶酶原激活物 (TPA)的活性变化。方法　 1.通过延迟剖宫产术致胎鼠宫内窘迫 ,实验分空白对照组、缺氧缺血 15min组、缺氧缺血 3 0min组。每组取 8例测试脑组织TPA活性。 2 .分别对新生小鼠脑微血管内皮细胞、星形胶质细胞进行缺氧条件下培养 ,每组取 8例测试TPA活性。结果　缺氧缺血 15min、3 0minTPA活性升高 (P <0 .0 1)。缺氧后内皮细胞TPA活性增高 (P <0 .0 1) ,星形胶质细胞TPA活性无明显变化 ( P >0 .0 5 )。结论　缺氧缺血后脑TPA活性增高 ,高活性的TPA可能是脑缺氧缺血致不可逆神经元损伤的一个重要媒介     

体外血脑屏障模型的建立

目的：建立一种相对简单可靠、接近在体状态的SD大鼠体外血脑屏障模型。方法：原代分离、纯化培养大鼠脑微血管内皮细胞和星型胶质细胞,将两种细胞共培养建立体外血脑屏障模型。VIII因子、GFAP免疫组化鉴定细胞类型,相差显微镜下观察细胞形态,透射电镜观察内皮细胞超微结构及紧密连接,γ计数仪测定核素标记牛血清白蛋白(125I-BSA)通透量检测血脑屏障(BBB)功能。结果：VIII因子、GFAP免疫组织化学结果显示培养的脑微血管内皮细胞和星形胶质细胞纯度分别为90%和99%以上。透射电镜显示内皮细胞间有高度发达的紧密连接、未见有W eible-Palade小体、少见吞饮小泡1。25I-BSA通透量结果显示,血脑屏障模型组在限制大分子量物质的能力上优于其他各组,与脑微血管内皮细胞单独培养组及空白对照组比较,差异有显著性意义(P<0.01)。结论：利用同种属脑微血管内皮细胞与星型胶质细胞共培养,建立了一种简便可行、与在体血脑屏障结构类似,并具有在体血脑屏障的限制物质通透能力的SD大鼠体外血脑屏障模型。[中国当代儿科杂志,2005,7(6):526-529]     

血管内皮生长因子小分子干扰RNA体外实验对缺氧视网膜微血管内皮细胞的影响

目的 探讨血管内皮生长因子小分子干扰RNA(VEGFsiRNA)体外实验对缺氧视网膜微血管内皮细胞(RMECs)的影响.方法 原代培养未足月胎儿的视网膜微血管内皮细胞,用氯化钴模拟缺氧生长状态.设计、合成VEGFsiRNA并转染缺氧培养的细胞,分为VEGFsiRNA转染组(实验组)、缺氧组(空白对照组)和阴性siRNA转染组(阴性对照组),用RT-PCR和Western blot分别从mRNA和蛋白水平检测转染前后VEGF表达的变化,噻唑蓝比色法(MTT法)观察细胞的生长增殖情况.结果 转染VEGFsiRNA-脂质体复合物后24 h、48 h、72 h,hRMECs VEGFmRNA表达水平较对照组分别下降21.05%、79.67%和90.48%.hRMECs VEGF蛋白的表达水平较对照组分别下降14.58%、66.97%和81.61%.转染后12 h、24 h、48 h及72 h hRMEC8的增殖分别被抑制达15.0%、42.9%、78.3%和65.9%.结论 VEGFsiRNA能下调未足月胎儿缺氧视网膜微血管内皮细胞VEGF的表达,抑制视网膜微血管内皮细胞增殖,是基因治疗早产儿视网膜病变的一个研究方向.     

新生儿肺疾病的纤溶改变及其与肺动脉压力的关系

目的：研究新生儿肺疾病的纤溶改变及其与肺动脉压力的关系。方法：用发色底物法测定27例新生儿肺疾病患儿(病例组)及25例正常新生儿(对照组)血浆组织纤溶酶原激活剂(TPA)和纤溶酶原激活抑制物(PAI)活性变化;用超声多普勒方法测定肺动脉血流加速时间(TPV)与右室射血时间(RVET)之比值(TPV/RVET),以此估计新生儿肺动脉压力(TPV/RVET比值与肺动脉压力成反比)。结果：病例组PAI活性［(9.3±4.1) AU×10-1/ml］明显高于对照组［(5.5±3.0) AU×10-1/ml］,P<0.01,TPV/RVET比值(0.29±0.05)明显低于对照组(0.34±0.08),(P<0.05);发生肺出血者肺动脉压力［TPV/RVET (0.23±0.02)］显著升高,P<0.05。肺出血恢复期新生儿TPA ［(3.7±1.7) IU×10-1/ml］及血小板［(180±30)×109/L］明显高于肺出血发生时［TPA (1.8±0.7) IU×10-1/ml,血小板(98±39)×109/L］,(P<0.01)。结论：新生儿肺疾病时由于肺动脉压力增高,肺血管内皮细胞破坏,导致TPA释放减少,PAI活性增高,纤溶活性降低。     

永生化小鼠Bend.3细胞株具有脑微血管内皮细胞的屏障特性

目的：评价永生化小鼠脑微血管内皮细胞株Bend.3是否具有脑微血管内皮细胞的屏障特性。方法：将小鼠脑微血管内皮细胞株Bend.3接种于细胞培养插内,跨内皮细胞电阻抗（transendothelial electrical resistance,TEER）和辣根过氧化物酶（horseradish peroxidase,HRP）通透性实验检测其屏障功能。Western blot法和直接荧光染色法观察其紧密连接相关蛋白Occludin、ZO-1的表达及细胞骨架蛋白F-actin的分布。结果：Bend.3细胞的TEER随培养时间延长逐渐升高,10 d达82.3±6.0 Ω?cm2,与培养3 d时的37.3±3.1 Ω?cm2 相比,差异有统计学意义（P<0.05）。其培养10 d和3 d的平均HRP通透率在120 min分别为（2.2±0.05）%和(4.3±0.20）%,差异有统计学意义（P<0.05）。培养10 d时该细胞表达高浓度的紧密连接蛋白Occludin、ZO-1,且F-actin主要分布在细胞周边,线条完整连续,未见明显缝隙形成。结论：小鼠脑微血管内皮细胞株Bend.3具有脑微血管内皮细胞的屏障特性,且其屏障功能在接种10 d后可达到最理想的状态。［中国当代儿科杂志,2010,12（6）：474-478］     

低分子肝素抑制肾小球系膜细胞增生机制的研究

目的：低分子肝素是肾脏疾病治疗中常用药物,能抑制肾小球系膜细胞的增生,其机制常不清楚,本研究探讨低分子肝素(LMWH)对大鼠肾小球系膜细胞(GMCs)增生水平的影响及其机制。方法：GMCs细胞共设3组:①GMCs组;②LPS组:即GMCs+LPS;③LMWH组:即GMCs+LPS+LMWH,而LMWH终浓度分别为2.5 IU/ml,25 IU/ml和250 IU/ml。采用MTT法于培养24 h和48 h观察各组中GMCs增生水平,选择药物的最佳GMCs增生抑制浓度及时间;采用免疫细胞化学方法观察培养48 h后3组(LMWH终浓度为250 IU/ml)GMCs涂片中单核细胞趋化蛋白-1(MCP-1)及核转录因子-κB(NF-κB)的表达;采用ELISA方法观察培养的上清液中MCP-1浓度。结果：LMWH 250 IU/ml组对GMCs增生的抑制最为显著,其GMCs增生水平低于LPS组和LMWH 2.5 IU/ml,25 IU/ml组(P<0.05);各浓度LMWH对GMCs增生的抑制作用48 h强于24 h(P<0.05)。LMWH 250 IU/ml组48 h的MCP-1阳性率明显低于LPS组(P<0.01),而与GMCs组差异无显著性(P>0.05);LPS组48 h的MCP-1阳性率明显高于GMCs组(P<0.01)。LMWH 250 IU/ml组48 h的NF-κB表达阳性率与LPS组和GMCs组比较差异均无显著性(P>0.05);LPS组的NF-κB表达阳性率明显高于GMCs组(P<0.01)。LMWH 250 IU/ml组GMCs培养上清液中MCP-1浓度明显低于LPS组(P<0.01),与GMCS组差异无显著性(P>0.05)。结论：LMWH能抑制大鼠GMCs增生,明显下调GMCs中MCP-1的异常表达及分泌,而对NF-κB活性无明显抑制。     

α-干扰素对血管瘤血管内皮细胞周期、凋亡的影响

目的 观察α-干扰素对体外培养血管瘤内皮细胞周期、凋亡的影响,探讨干扰素治疗血管瘤的机制.方法 用组织块法培养增生期血管瘤内皮细胞,分别用1×104U,1×105U,1×106Uα-干扰素干预,对照组不加任何药物,继续培养24h后,用流式细胞仪检测细胞周期、凋亡变化.结果 α-干扰素作用24 h后血管瘤内皮细胞G1期前出现二倍体凋亡峰;1×104U、1×105U、1×106Uα-干扰素组G1期百分率分别为(63.68±0.66)%、(72.97±1.56)%、(63.27±5.64)%,对照组为(58.75±0.32)%,与对照组比较,P＜0.05;1×104U、1×105U、1×106Uα-干扰素组S期百分率分别为(32.99±2.01)%、(25.02±1.31)%、(37.93±5.31)%,对照组为(26.46±1.94)%,与对照组比较,P＞0.05;1×104U、1×105U、1×106Uα-干扰素组G2/M期百分率分别为(0.01±0.05)%、(2.43±0.27)%、(3.99±1.27)%,其百分率随α-干扰素浓度升高而增高.细胞凋亡百分率随α-干扰素浓度增加而增高,1×104U、1×105U、1×106Uα-干扰素组凋亡百分率分别为(11.89±0.56)%、(18.88±3.04)%、(31.92±1.92)%,对照组凋亡率为(3.25±0.23)%,与对照组比较,P＜0.01.结论 α-干扰素能导致血管瘤血管内皮细胞G1、G2期阻滞和凋亡,细胞凋亡率与药物浓度存在剂量依赖关系.干扰素可能通过血管内皮细胞G1、G2期阻滞,抑制血管瘤血管内皮细胞的增殖、诱导血管内皮细胞凋亡而达到治疗血管瘤的作用.     

Changes of Fibrinolysis and Their Relationship with Pulmonary Artery Pressures in Neonates with Lung Diseases

目的　研究新生儿肺疾病的纤溶改变及其与肺动脉压力的关系。方法　用发色底物法测定 2 7例新生儿肺疾病患儿 (病例组 )及 2 5例正常新生儿 (对照组 )血浆组织纤溶酶原激活剂 (TPA)和纤溶酶原激活抑制物(PAI)活性变化 ;用超声多普勒方法测定肺动脉血流加速时间 (TPV)与右室射血时间 (RVET)之比值 (TPV/RVET) ,以此估计新生儿肺动脉压力 (TPV/RVET比值与肺动脉压力成反比 )。结果　病例组PAI活性 [(9.3±4 .1)AU× 10 -1/ml]明显高于对照组 [(5 .5± 3.0 )AU× 10 -1/ml],P <0 .0 1,TPV/RVET比值 (0 .2 9± 0 .0 5 )明显低于对照组 (0 .34± 0 .0 8) ,(P <0 .0 5 ) ;发生肺出血者肺动脉压力 [TPV/RVET (0 .2 3± 0 .0 2 ) ]显著升高 ,P <0 .0 5。肺出血恢复期新生儿TPA [(3.7± 1.7)IU× 10 -1/ml]及血小板 [(180± 30 )× 10 9/L]明显高于肺出血发生时 [TPA (1.8± 0 .7)IU× 10 -1/ml,血小板 (98± 39)× 10 9/L],(P <0 .0 1)。结论　新生儿肺疾病时由于肺动脉压力增高 ,肺血管内皮细胞破坏 ,导致TPA释放减少 ,PAI活性增高 ,纤溶活性降低。     

脂多糖对大鼠脑微血管内皮细胞通透性的影响及机制研究

目的：了解脂多糖（LPS）对大鼠脑微血管内皮细胞(BMECs)通透性的影响及其可能的机制。方法：分离和培养原代大鼠BMECs,随机分为对照组和LPS干预组。利用跨内皮细胞电阻抗检测 BMECs 屏障功能,Pull-down法测定RhoA活性,Western blot检测p115RhoGEF和紧密连接蛋白ZO-1、occludin、claudin-5的蛋白表达量。结果：与对照组（159.0±8.6 Ω?cm2）比较,LPS作用3 h后,大鼠BMECs 跨内皮细胞电阻抗值明显下降(108.3±4.2 Ω?cm2),作用12 h后达最低(85.4±2.5 Ω?cm2)。LPS作用5 min后RhoA明显活化,1 h后出现p115RhoGEF蛋白表达上调,3 h后紧密连接蛋白ZO-1、occludin和claudin-5的表达水平均不同程度下降,与对照组比较差异有统计学意义（P<0.05）。结论：LPS诱导大鼠BMECs中p115RhoGEF/RhoA信号通路活化,导致紧密连接蛋白表达水平降低,引起 BMECs 通透性增加。     

钙敏感受体对乳鼠心肌细胞凋亡的诱导作用

探讨在缺氧/复氧所诱导乳鼠心肌细胞凋亡中,钙敏感受体（calcium - sensing receptor,CaSR）对Fas/Fas配体（Fas L）途径的影响。方法对8只2日龄Wistar大鼠心肌细胞进行原代培养,后随机分为三组：(1)对照组：细胞不经缺氧/复氧处理,在其他组复氧开始时培养基内加入与用药组等体积的生理盐水;(2)缺氧/复氧组：心室肌细胞缺氧2h/复氧24h,细胞培养基内于复氧开始时加入与用药组等体积的生理盐水;(3) CaSR激动剂氯化钆(GdCl3)组：细胞培养基内于复氧开始时加入300μmol/L CaSR激动剂GdCl3。流式细胞仪分析细胞凋亡率,透射电镜观察细胞超微结构,蛋白印迹法检测CaSR、Fas和FasL蛋白的表达。结果流式细胞仪检测显示,缺氧/复氧组心肌细胞凋亡为12.18％±1.54％,与对照组相比,心肌细胞凋亡明显增加(P＜0.01)。CaSR激动剂GdCl3使心肌细胞凋亡进一步增加至20.25％±2.87％ (P＜0.01)。透射电镜下可见线粒体絮状变、线粒体嵴溶解、空泡样变;CaSR激动剂使CaSR、Fas和FasL表达进一步上调,明显高于缺氧/复氧组(P＜0.05)。结论CaSR激活参与了缺氧/复氧所诱导的乳鼠心肌细胞凋亡,CaSR可通过激活Fas/FasL死亡受体途径导致乳鼠心肌细胞凋亡。     

Activity and Toxicity of Intravenous Erwinia Asparaginase Following Allergy to E. coli‐Derived Asparaginase in Children and Adolescents With Acute Lymphoblastic Leukemia

Background

Erwinia asparaginase is antigenically distinct from E.coli‐derived asparaginase and may be used after E.coli‐derived asparaginase hypersensitivity. In a single‐arm, multicenter study, we evaluated nadir serum asparaginase activity (NSAA) and toxicity with intravenously administered asparaginase Erwinia chrysanthemi (IV‐Erwinia) in children and adolescents with acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma with hypersensitivity to E.coli‐derived asparaginase.

Patients and Methods

Between 2012 and 2013, 30 patients (age 1–17 years) enrolled from 10 centers. Patients received IV‐Erwinia, 25,000 IU/m²/dose on Monday/Wednesday/Friday, for 2 consecutive‐weeks (6 doses = 1 cycle) for each dose of pegaspargase remaining in the original treatment plan. The primary objective was to determine the proportion of patients achieving NSAA ≥0.1 IU/ml 48 hr after dose 5 in Cycle 1. Secondary objectives included determining the proportion achieving NSAA ≥0.1 IU/ml 72 hr after Cycle 1 dose 6, and the frequency of asparaginase‐related toxicities.

Results

Twenty‐six patients completed Cycle 1; 24 were evaluable for NSAA assessment. In Cycle 1, NSAA ≥0.10 IU/ml was detected in 83% of patients (95% confidence interval [CI], 63–95%) 48 hr post‐dose 5 (mean ± SD; 0.32 IU/ml ± 0.23), and in 43% (95% CI, 22–66%) 72 hr post‐dose 6 (mean ± SD; 0.089 IU/ml ± 0.072). For all 30 patients over all cycles, hypersensitivity/infusional reactions with IV‐Erwinia occurred in 37%, pancreatitis 7%, and thrombosis 3%.

Conclusions

IV‐Erwinia administration in children/adolescents appeared feasible and tolerable. A therapeutically‐effective NSAA (≥0.10 IU/ml) was achieved in most patients at 48 hr, but in fewer than half 72 hr post‐dosing, suggesting that monitoring NSAA levels and/or every 48 hr dosing may be indicated. Pediatr Blood Cancer 2015. © 2015 Wiley Periodicals, Inc.     

人外周血T淋巴细胞集落(TL—CFU)培养的研究

本文报道用PHA作为刺激物，采用简化的一步法在甲基纤维素培养基上培养人外周血T淋巴细胞集落（TL一CFU）获得成功，并对TL一CFU培养的适宜条件进行了探讨；同时，对集落组成细胞进行了T淋巴细胞表型分析；在此适宜条件下，对健康成人外周血TL—CFU产率进行了测定。结果显示：（1）培养体系中PHA2ul／ml、20％小牛血清（FCS）、5×10（－5）M2一巯基乙醇、0．8％甲基纤维素、60％RPMI1640、2×105MNC／ml、培养时间七天为TL—CFU培养的适宜条件；（2）集落组成细胞中CD3+细胞占92．5±4．59％、CD4+、CD8+细胞分别为57．83±7．85％及46．66±4．76％、CD4／CD8之比为1．24±0．17；（3）健康成人外周血TL一CFU产率为351．58±21.97／2×105MN。基于上述结果认为，该培养方法操作简便、集落产率高，为研究T淋巴细胞及其亚群提供了条件。     

可溶性白细胞介素-2受体检测在儿童EB病毒感染相关疾病中的应用价值

目的探讨可溶性白细胞介素(白介素)-2受体检测在儿童EB病毒(EBV)感染相关疾病鉴别诊断中的应用价值。方法将72例患儿分为IM组、IM转化EBV相关的噬血细胞淋巴组织细胞增生症(EBV-HLH)组和EBV-HLH组;采用酶联免疫吸附试验(ELISA)分别检测患儿血清可溶性白介素-2受体和EBV抗体四项(EBV壳抗原VCA-IgM、VCA-IgG和EBV早期抗原EA-IgG、EBV核抗原-1 EBNA-1-IgG),荧光实时定量PCR检测患儿血浆EBV-DNA的表达,流式细胞术分析淋巴细胞亚群(CD3,CD4,CD8,CD19,CD56)。结果 72例患儿急性期可溶性白介素-2受体水平均超过2 400 U/ml;IM转化组在急性期可溶性白介素-2受体水平仅轻度增高(4 320 U/ml),与IM组(3 310 U/ml)无明显差异,治疗后却明显增高(8 970 U/ml),并接近EBV-HLH组水平(11 230U/ml);EBV抗体四项显示IM转化组和EBV-HLH组在治疗后VCA-IgG和EA-IgG仍然持续高滴度,同时EBV核抗原-1-IgG仍持续阴性;三组急性期都有EBV-DNA拷贝数从低拷贝至高拷贝的病例,治疗后IM转化组和EBV-HLH组仍可检测到EBV-DNA(3×103~4×105copies/ml);IM转化组和EBV-HLH组CD8+细胞在治疗后仍持续较高水平[(61.32±4.63)%,(68.36±4.32)%],并同时出现NK细胞(CD56+)比例下降[(9.23±3.28)%,(10.52.±3.34)%]。结论结合EBV抗体、EBV-DNA和淋巴细胞亚群检测,可溶性白介素-2受体检查有可能成为追踪观察EBV感染相关疾病的指标之一。     

High-dose systemic interleukin-2 therapy in stage IV neuroblastoma for one year after autologous bone marrow transplantation: Pilot study

Despite intensified chemotherapy protocols, including autologous bone marrow transplantation (ABMT), stage IV neuroblastoma has a poor prognosis, and modern therapeutic trends are aimed at the eradication of minimal residual disease, which is thought to be the main factor leading to relapse. In this pilot study, we report the systemic administration of high doses of interleukin-2 after ABMT in four patients. Five-day cycles of IL-2 at a dose of 18 × 10⁶ IU/m²/day were administered at variable time intervals as frequent as it was necessary to maintain the levels of natural killer (NK) cytotoxic activity higher than the median control value (40 LU/ ml blood) throughout 1 year from the start of first IL-2 treatment. After Il-2 infusion, NK and LAK activities increased significantly (median 742 × 10⁻³ LU/ml blood and 186.8 × 10⁻³ LU/ml blood, respectively). Toxicities were transient and no life-threatening complications were observed. Fever, anorexia, skin rash and enlarged liver were always present. Anaemia, thrombocy-topenia, leukocytosis, lymphocytosis and and eosinophilia occurred following most of the IL-2 courses. Although the small number of patients does not allow an estimation of the immuno-modulatory-antineoplasic effects of IL-2, the results seem promising for the management of neuroblastoma patients. © 1996 Wiley-Liss, Inc.     

The relationship between procollagen-III-peptide and the severity of esophageal varices in children with biliary atresia after Kasai operation

Biliary atresia (BA) is a common cause of infantile cholestasis. Disease progression leads to intra hepaticfibrosis, and thus to the development of PH and EV. Our objective has been to study the relationship between procollagen-III-peptide (PIIIP) and the severity of EV in children with BA after Kasai operation. Children below 15 years of age (n=29) with BA after a Kasai operation were evaluated for EV by endoscopy. Healthy (n=26) children of the same age and sex distribution who participated in the hepatitis B vaccination program served as the controls. Serum PIIIP was determined by radioimmunoassay. The BA patients were classified on the basis of severity of EV (Paquet's classification) into three groups: group 1 (n=15) had grade 0, group 2 (n=8) grade 1–2, and group 3 (n=6) grade 3–4 EV. In group 3, serum PIIIP (2.9 ± 1.3 IU/ml) was significantly higher than in group 2 (1.5 ± 0.4 IU/ml) (P < 0.05). Serum PIIIP levels were increased in group 2 compared with group 1 (1.2 ± 0.4 IU/ml) and in group 1 compared with the control group (1.2 ± 0.2 IU/ml), but this difference was not significant. PIIIP levels increased with severity of the EV in the BA patients. Hence, high PIIIP levels may serve as a non invastive indicator of EV developing in postoperative BA patients. Accepted: 8 January 2001     

CONGENITAL RICKETS Study of the Evolution of Secondary Hyperparathyroidism

Abstract. A case of congenital rickets of nutritional origin is described in a light-for-date premature infant (gestational age 34 weeks, birthweight 1100 g). X-rays of the long bones showed spread, frayed and cupped metaphyses at birth and at the age of 16 days. Serum calcium was 8.2 mg/100 ml, phosphorus 3.4 mg/100 ml and alkaline phosphatase (A.P.): 323 IU/ml (N≤200) at the age of 3 days. Very high level of serum immunoreactive parathyroid hormone (iPTH) was found at the age of 16 days=295 μlEq/ml (N≤50). Evidence of maternal vitamin D deficiency was demonstrated by low plasma 25-hydroxycholecalciferol (25-OH-CC): 1.0 ng/ml (N: 13.2±4.2) soon after delivery; it was found to be normal (10.2 ng/ml) six months later. Ca infusion (15 mg/kg/3 h) resulted in a marked fall of serum iPTH (280 to 84 μlEq/ml). Administration of vitamin D₂ (2400 IU/day for 10 days) induced some healing of the metaphyses; A. P. remained elevated (400 IU/ml); plasma 25-OH-CC was normal 10.2 ng/ml and serum iPTH was 115 μlEq/ml. When 25-OH-CC was given orally for ten days (15 μg/day), plasma 25-OH-CC rose to 64.5 ng/ml with a minor change of serum iPTH (94 μlEq/ml); X-rays of the bones showed osteoporosis. These results suggest a reduced conversion of 25-OH-CC into 1–25-(OH)₂-CC.     

Dose–Effect Relationship of Alkylating Agents on Testicular Function in Male Survivors of Childhood Lymphoma

The purpose of our study was to assess the gonadal function in male survivors of childhood lymphoma. We studied 171 male survivors of childhood lymphoma (83 with B-cell non-Hodgkin lymphoma [B-NHL], 32 with T-cell non-Hodgkin lymphoma [T-NHL], 50 with Hodgkin lymphoma [HL], and 6 with anaplastic large-cell lymphoma [ALCL]), measuring follicle-stimulating hormone [FSH] and luteinizing hormone [LH] levels at a median age of 21.1 (17–30.4) years after a median delay of 9.3 (2–22.4) years from treatment. FSH levels were above normal range (≥10 IU/L) in 42.1% and LH levels ≥8 IU/L in only 8.9% of survivors. In multivariate analysis, only the following chemotherapeutic agents were associated with higher FSH or LH levels: cyclophosphamide (P < .0001, .04), lomustine (CCNU; P = .002, 0.04), and procarbazine (P < .0001, .07). No significant correlation was found between FSH or LH levels and age or pubertal status at diagnosis. Mean FSH level was significantly lower in NHL survivors treated more recently: 6 ± 5.1 IU/L in B-NHL survivors treated since 1986 versus 12.3 ± 5.4 IU/L for those treated before 1981 (P = .0001), and 6.8 ± 9.6 IU/L in T-NHL survivors treated since 1989 versus 9.4 ± 5.7 IU/L for those treated before 1989 (P = .035). In HL, mean FSH level was 12.4 ± 9.9 IU/L following procarbazine containing chemotherapy versus 3.4 ± 1.9 IU/L in the absence of procarbazine and increased significantly with the number of MOPP/OPPA (mechlorethamine, Oncovin [vincristine], procarbazine, and prednisone/Oncovin, procarbazine, and prednisone, and Adriamycin [doxorubicin]) courses received, from 6.8 ± 5.7 IU/L for 1–2 MOPP/OPPA to 12.6 ± 7.5 for 3–4 MOPP/OPPA and 19.6 ± 13.3 for more than 4 MOPP/OPPA (P for trend = .006). Testicular toxicity of alkylating agents on childhood lymphoma survivors is dose dependent and not correlated to diagnosis, age, or pubertal status at diagnosis.     

Antigen specific cytokine response in pediatric patients with atopic dermatitis

The physiopathology of atopic dermatitis (AD) has still to be elucidated. T effector cells with cutaneous homing receptors or T-cell derived cytokines have been assumed to be implicated in the pathogenetic mechanisms in AD and to be responsible for the different immunologic responses of patients. In fact, the large majority of AD patients display high IgE levels while others do not develop an abnormal IgE response. Although, there are not significant clinical features characterizing the two different groups, patients with normal IgE belong to a younger age range, raising the possibility that the hypothesized dichotomy of AD might be due to age. In the present study we included 172 outpatient children attending the Pediatric Department of our institution. Serum IgE levels and percentages of peripheral T lymphocytes expressing the cutaneous homing antigen (CLA) were evaluated and results were analyzed in relation to the activity of the disease (SCORAD index) or age. In the overall patients, the IgE levels increased significantly with age (0-1 yr: 19.50 IU/ml; 1-3 yr: 62.0 IU/ml; 3-8 yr: 96.0 IU/ml; >8 yr: 148.5 IU/ml; p<0.001) and with the severity of the disease (SCORAD low: 46.80 IU/ml; medium: 42.90 IU/ml; high: 148.5 IU/ml; p=0.01). Percentages of CLA+ peripheral T lymphocytes also increased with age (0-1 yr: 3.3; 1-3 yr: 4.85; 3-8 yr: 10.6; >8 yr: 12.5; p<0.001), although they were not significantly different in patients with different SCORAD (p=0.89). We further investigated the cellular immune response to a specific antigen in 25 subjects, matched for age, SCORAD, and CLA+ T-cell percentages. Among them, 13 patients had casein serum specific IgE and 12 had no evidence of casein sensitization. Peripheral blood mononuclear cells were kept in short-term culture with endotoxin-free casein fractions and IFN-gamma, TNF-alpha, IL-5, IL-10 cytokine-producing cells were detected by ELISpot. Statistical analysis showed significant higher numbers of TNF-alpha- or IL-10-producing cultures (stimulation index >3) in the 'allergic' patients than in the milk tolerant subjects (p=0.01 and 0.05). The analysis of individual responses confirmed this finding but also provide evidence of a significant increase in IFN-gamma-producing cells (p=0.05) induced by casein stimulation in the group of 'non-allergic' children. Our data showed that immunologic parameters as IgE levels or CLA+ T cells in AD pediatric patients are influenced by the age, confirming that age could represent a bias in the analysis of immune response in those patients. Although, we demonstrated in children with AD the existence of different cytokine patterns of the lymphocyte response that could account for the different immunologic features between the two hypothesized forms of AD, which are not dependent on age.     

Effect of dexamethasone on rat plasma platelet activating factor acetylhydrolase during the perinatal period

It has been previously reported that the administration of dexamethasone (DEX) to adult rats increases the activity of plasma platelet-activating factor acetylhydrolase (PAF-AH) and prevents the development of intestinal necrosis caused by platelet activating factor (PAF) injection. In this report, we examined the effect of DEX administration on plasma PAF-AH activity during the perinatal period. Timed-pregnant rats received DEX (0.2–1.0 mg/kg/d) or normal saline (controls) on days 16–18 (early group) or days 18–20 (late group) of gestation. Maternal plasma PAF-AH activity was lower in late gestation than in postpartum period (P < 0.001). Fetal and neonatal plasma PAF-AH activity was higher than maternal values (P < 0.05). No changes of PAF-AH activity were seen in maternal, fetal or neonatal plasma after prenatal DEX administration at the aforementioned doses. A higher dose of DEX (1.3 mg/kg/d × 4d) or cortisone (200 mg/kg/d) produced an elevation of maternal plasma PAF-AH activity (DEX 79.2 ± 3.0, cortisone 70.5 ± 1.9 vs. controls 49.4 ± 2.3 nmol/min/ml, P < 0.01), but resulted in a high fetal mortality. Treatment of newborn rats with DEX (0.5 mg/kg/d) on days 1–3 after birth, increased plasma PAF-AH activity on day 4 (DEX 292 ± 5 versus controls 140 ± 9 nmol/min/ml, P < 0.001) and day 6 (DEX 302 ± 12 versus controls 136 ± 6 nmol/min/ml, P < 0.001). Postnatal administration of DEX increases the plasma PAF-AH activity in the rat. Only high doses of prenatal corticosteroids that cause fetal death can elevate maternal plasma PAF-AH activity.