大蒜素对IgA肾病模型大鼠Th1/Th2免疫平衡的影响

目的 探讨Th1/Th2免疫平衡在IgA肾病发病中的影响和大蒜素对IgA肾病的治疗作用.方法 选取雌性SD大鼠30只,随机分为对照组、模型组、大蒜素高剂量组、大蒜素低剂量组和泼尼松组.药物干预8周,观察各组大鼠肾脏病理学变化,ELISA法检测血清白细胞介素-4、干扰素-γ含量,对检测结果进行分析.结果 与模型组比较,大蒜素高、低剂量组血清白细胞介素-4水平均明显下降(均为P=0.0001<0.01),而两组间无明显差异(P>0.05),泼尼松组下降效果不明显(P=0.071>0.05).与模型组比较,大蒜素高、低剂量组血清干扰素-γ水平均明显升高(分别为P高剂量组=0.016,P低剂量组=0.022,均P<0.05),而两组间无明显差异(P>0.05),泼尼松组升高效果不明显(P=0.563>0.05).大蒜素高、低剂量组肾组织光镜病理学改变及免疫荧光与模型组相比均明显减轻.结论 大蒜素可以使IgA肾病大鼠血清中白细胞介素-4水平下降,干扰素-γ水平上升,从而调节IgA肾病大鼠的Th1/Th2细胞平衡紊乱,减少系膜区IgA免疫复合物沉积,减轻肾脏病理改变,达到治疗IgA肾病大鼠的目的.     

IgA肾病患者血清聚合IgA1对足细胞增殖的影响

目的观察IgA肾病（IgA nephropathy,IgAN）患者与正常人的血清热聚合IgAl（aggregated IgAl,aIgAl）对足细胞增殖的影响。方法收集原发性IgAN患者及健康人的血清,利用层析法分离获得血清单体IgAl（monomefic IgAl,mIgAl）,将mIgA1热聚合为aIgA1。利用浓度为0．25、0．5、1．2m咖l的患者与正常人的algA1分别刺激小鼠MPC5足细胞株,利用MTT法检测algA1对足细胞增殖的影响。结果正常组和患者组aIgA1刺激足细胞后细胞MTT吸光度的差异无统计学意义。刺激24h组与刺激48h组MTT吸光度的差异也无统计学意义。不同浓度aIgA1刺激组间MTT吸光度的差异有统计学意义P〈0．05）,相比于不加刺激的阴性对照组（SFM）,1、2mg／ml组的吸光度分别为其0．46和1．66倍。结论足细胞可能会直接对IgA1产生反应,algA1可以影响足细胞增殖;低浓度aIgA1抑制足细胞增殖,高浓度algA1促进足细胞增殖;患者与正常人的aIgA1对足细胞增殖的影响没有不同。     

IgA肾病的治疗现状

IgA肾病是全球最常见的原发性肾小球疾病中的一种,其发病机制复杂,临床表现多样化,故缺乏统一的治疗标准。目前临床治疗主要是结合肾组织病理改变对症治疗。反复发作肉眼血尿型主要是去除诱因,扁桃体切除可作为一种治疗手段。孤立性镜下血尿型主要是定期复查。有蛋白尿和／或高血压、肾功能不全患者,血管紧张素转换酶抑制剂可根据情况选择,必要时应用免疫抑制剂。     

IgA肾病患者血清IgA1的测定和分析

目的　测定IgA肾病血清IgA1 、多聚体IgA1 和单体IgA1 水平 ,探讨IgA肾病发病机制。方法　通过Jacalin亲和层析对IgA肾病患者 (43例 )血清分离 ,得到Jacalin结合蛋白 ,测定总IgA1 浓度 ;将Jacalin结合蛋白用排阻层析法进一步分离 ,测定多聚体IgA1 和单体IgA1 水平及其比值。结果　IgA肾病组血清总IgA1 [(0 .72± 0 .2 0 )mg/ml]、多聚体IgA1 [(0 .0 97± 0 .0 4 2 )mg/ml]和单体IgA1 [(0 .42 4± 0 .1 50 )mg/ml]水平均高于健康对照 (P <0 .0 0 1 ) ;多聚体IgA1 与单体IgA1 的比值对照组无差异 (P >0 .0 5)。结论　IgA肾病患者血清中IgA1 的两种形式均有所增加 ,有可能在IgA肾病的发病中起一定作用     

中医药治疗IgA肾病的研究进展

IgA肾病是全世界最常见的原发肾小球疾病,有30％～40％的患者在明确诊断后的20～30年内发展为终末期肾病.IgA肾病病理分型复杂,西医治疗效果差异较大,免疫抑制剂及激素类药物的长期应用增加了患者发生不良反应的风险.而中医对IgA肾病的理论认识日益成熟,已形成了多种论治体系.在临床中,中药对IgA肾病血尿、蛋白尿治疗...     

观察鸡卵黄免疫球蛋白(IgY)对小鼠单核吞噬细胞吞噬功能的影响

目的观察鸡蛋卵黄免疫球蛋白IgY对小鼠单核吞噬细胞吞噬功能的影响.方法用鸡卵黄免疫球蛋白IgY经口灌胃,观察小鼠单核吞噬细胞碳粒廓清率和小鼠腹腔巨噬细胞吞噬鸡红细胞的吞噬能力.结果鸡卵黄免疫球蛋白IgY 具有提高小鼠单核吞噬细胞碳粒廓清率及增强小鼠腹腔巨噬细胞吞噬鸡红细胞的吞噬能力.结论鸡卵黄免疫球蛋白IgY能提高小鼠单核吞噬细胞吞噬功能,具有增强小鼠免疫功能的作用.     

795例IgA肾病患者的病理分析

[目的]回顾性分析不同年龄组IgA肾病患者的病理改变特点,以利于早期诊断和治疗.[方法]将我院795例(2000～2008年)经皮肾穿刺活检确诊为原发性IgA肾病的患者按不同年龄分为儿童组、青-中年组和老年组,逐项分析病例组织光镜和免疫荧光检查的相关资料.[结果]在795例病理资料中,儿童组患者病理学分级以Ⅰ～Ⅱ级为主,免疫荧光检查以单纯IgA+IgM+C3沉积多见;青-中年组患者病理学分级以Ⅰ～Ⅲ级为主,免疫荧光检查也是以单纯IgA+IgM+C3沉积多见;老年组病理学改变从Ⅰ～Ⅳ级均可见到,主要以Ⅲ～Ⅳ级为主,免疫荧光检查以IgA+C3、IgA+IgM+C3沉积较多.[结论]IgA肾病的病理改变有随着年龄增大,病理改变越明显肾脏损害越严重的趋势,早期进行经皮肾活检有利于明确诊断及尽早治疗.     

IgA肾病的治疗进展

原发性IgA肾病是最常见的肾小球肾炎,是引起终末期肾功能衰竭的重要原因之一,其临床及病理表现多样,预后各不相同。本文就近年来对该病治疗的研究进展简要综述。     

Intralipid对吞噬细胞氧自由基产生的影响

目的 观察Ｉｎｔｒａｌｉｐｉｄ对内毒素所致的多形核白细胞氧自由基产生的影响,方法 取２２例健康志愿者静脉血,采用Ｂｏｙｕｍ法提取多核白细胞（ＰＭＮ）并在体外培养,采用不同剂量的脂多糖（ＬＰＳ）刺激ＰＭＮ,并和不同剂量Ｉｎｔｒａｌｉｐｉｄ共同作用,采用ＮＢＴ还原剂试验测定氧自由基的产生量。结果 ＬＰＳ刺激各组的ＮＢＴ值明显高于非刺激组,而且ＮＢＴ值与ＬＰＳ浓度明显相关,Ｉｎｔｒａｌｉｐｉｄ可明显浓度     

69例IgA肾病的临床病理分析

目的 研究IgA肾病临床和病理之间的相互关系,并用于指导治疗.方法 对2005年7月～2006年6月进行肾活检的69例IgA肾病患者的临床及病理资料进行分析.结果 IgA肾病临床表现多样,以蛋白尿伴血尿最多见,占53.6%,病理类型以Ⅱ、Ⅲ型多见.同时随着病理类型的加重,高血压、肾功能不全发生率亦增高.结论 IgA肾病病理和临床之间有一定的内在联系,应将临床和病理结合起来制订治疗方案和判断预后.     

Effects of three intravenous lipid emulsions on the survival and mononuclear phagocyte function of septic rats

The immunosuppressive effects of intravenous lipid emulsions are a matter of great concern and debate. In a rat model of gram-negative bacteremia, we assessed whether the use of three intravenous lipid emulsions with different triacylglycerol compositions could influence mortality, bacterial clearance, and prostaglandin E(2) (PGE(2)) levels and compared these groups with groups of orally fed rats and rats that received a small amount of calories in form of glucose without enteral feeding (starvation).RATS WERE ASSIGNED TO ONE OF FIVE GROUPS: group 1 (control, n = 15) received rodent chow ad libitum and saline infusion; group 2 (starvation group, n = 12) had no access to chow and received an infusion of 5% glucose; group 3 (n = 17) received total parenteral nutrition (TPN) with long-chain triacylglycerols; group 4 (n = 12) received TPN with medium- and long-chain triacylglycerols; and group 5 (n = 15) received TPN with its emulsion based on olive oil. Animals received isonitrogenous and isocaloric TPN. After 2 d of TPN, a dose of 10(8) colony-forming units of Escherichia coli was introduced via the venous catheter; 2 d later the animals were killed. Blood, spleen, liver, and lungs were cultured. Circulating levels of PGE(2) were measured.Bacterial growth in the liver and lungs were significantly higher in groups 3 and 4 than in group 1, with no differences among the other groups. Rates of bacteremia were significantly higher in groups 3 and 4 than in group 1, with no differences among the other groups. Plasma levels of PGE(2) did not differ, and mortality was unaffected.Bacterial clearance clearly was preserved in orally fed, control rats when compared with rats on TPN with long-chain triacylglycerols or medium- plus long-chain triacylglycerols. However, the use of a lipid emulsion enriched intravenously with oleic acid was a valid way of reducing this disturbance, although plasma levels of PGE(2) and survival were not modified.     

Markers of peripheral B lymphocytes and their function in IgA nephropathy

Peripheral blood B-lymphocyte markers and functions were observed in 21 patients with IgA nephropathy (IgA NP), 18 patients with systemic lupus erythematosus (SLE) and 16 controls. IgA NP B-lymphocytes similarly to that of SLE B-lymphocytes expressed significantly higher positivity with Leu 1 (CD 5) monoclonal antibody than controls. CD 5 positive B-lymphocytes are thought to be a distinct subset of the B-cells (autoregulatory B-lymphocytes) inducible in IgA NP by lipopolysaccharide (LPS) stimulation in parallel to their expression of surface IgM heavy chain positivity. The activated state of IgA NP B-lymphocytes have been proved by their higher OKIa (HLA-DR) positivities but lower IOB1a (CD 21, C3b-receptor) and decreased IgG-Fc-receptor (ox- rosette) expression. IgA NP B-lymphocytes showed a higher IgA but also IgG and IgM polyclonal immunoglobulin production than control B-lymphocytes in co-cultures with T-lymphocytes. Not only regulatory T-lymphocyte subsets but also serum derived from IgA NP patients stimulated the immunoglobulin production of IgA NP B-lymphocytes.     

单核吞噬细胞应答伤寒沙门菌的实验研究

目的 研究单核吞噬细胞应答伤寒沙门菌的机理。方法 采用体外培养的PMA分化的THP－1细胞，检测其内化和杀伤胞内伤寒沙门菌的活性，以及伤寒沙门菌诱导PMA分化的THP－1细胞产生TNF－α和IL－12的情况。结果 PMA分化的THP－1细胞内化和杀伤Vi阴性伤寒沙门菌的活性明显高于内化和杀伤Vi阳性伤寒沙门菌的活性。IFN－γ明显中此活性。伤寒沙门菌诱导PMA分化的THP－1细胞可以产生一定量的TNF－α和IL－12，然而，IFN－γ活化的PMA分化的HTP－1细胞产生TNF－α和IL－12的量明显增加。结论 伤寒沙门菌在单核吞噬细胞中的存活可能与Vi抗原的存在有关；IFN－γ在调节机体细胞免疫，防循伤寒沙门菌感染中起着重要的作用。     

The mononuclear phagocyte system: a new classification of macrophages, monocytes, and their precursor cells

There have been many attempts in the past to classify phagocytic mononuclear cells and to define the cell system they are considered to form—among these being the “macrophage system” of Metchnikoff, the “reticulo-endothelial system” of Aschoff, and the “reticulo-histiocyte system” proposed by Volterra and reintroduced by Thomas. None of these is entirely adequate in the light of present knowledge. In 1969, therefore, a group of workers proposed a new classification of all highly phagocytic mononuclear cells and their precursors in what they termed the “mononuclear phagocyte system”. This system includes the promonocytes and their precursors in the bone marrow, the monocytes in the peripheral blood, and the macrophages in the tissues. Subsequent consultation with numerous other specialists throughout the world led to a certain number of changes in this classification, which is now proposed in revised form.     

IgA肾病中关于细胞凋亡的研究进展

IgA肾病(IgAN)是全球范围内最常见的原发性肾小球疾病之一,近年来在儿童中的患病率明显升高,部分患儿最终发展为终末期肾病(ESRD),对儿童的生活质量及生命造成了严重威胁;由于其发病机理尚不明确,以及临床表现的多样性和预后的差异性,在临床上尚无疗效确切公认的治疗方法,药物治疗是常用的治疗手段.细胞凋亡是细胞生命活动中的基本现象,是近年生命科学研究的热点.该文对IgAN中有关细胞凋亡的研究进展进行综述,指出对细胞凋亡的干预可能是一种对IgAN新的治疗靶点.     

小儿IgA肾病临床病理分析

目的:探讨小儿IgA肾病(IgAN)临床病理特点。方法:对我院1984～2005年6月经皮肾活检病理检查确诊的小儿原发性IgA肾病的临床病理资料进行回顾性分析。结果:小儿IgAN临床以单纯血尿最常见(36.8%),其次是血尿伴蛋白尿(31.6%);临床表现及病理改变以肾病综合征最重,其次是血尿伴蛋白尿,易合并肾功能不全和高血压;肾病综合征的免疫复合物沉积以IgA+IgG+IgM型多见,单纯血尿、血尿伴蛋白尿以IgA+IgG型免疫复合物沉积为主。结论:小儿IgAN的临床及病理分级与治疗及其预后有关,只有通过肾活检病理检查才能更好地认识小儿IgAN,制定正确的治疗方案,客观的评估预后。