带状疱疹患者CD_4~+T淋巴细胞亚群的检测

目的通过观察带状疱疹患者T细胞亚群的变化,分析机体免疫功能与患带状疱疹的相关性,揭示带状疱疹发病的规律和机理。方法采用流式细胞仪技术检测73例不同年龄和性别的带状疱疹患者T细胞亚群的分布情况,并选择88例健康体检者做为健康对照。结果带状疱疹患者血清CD4+T细胞显著降低,CD3+T细胞降低,CD8+T细胞升高,CD4/CD8比值有所下降;不同年龄和不同病程的患者间也存在T细胞亚群的明显差异。结论带状疱疹患者存在CD4+T细胞的降低和T细胞亚群免疫功能下降,其在带状疱疹的发生和发展中可能起重要作用;老年人是带状疱疹发病的危险人群。     

带状疱疹患者T细胞亚群的检测

目的:检测带状疱疹患者外周血T细胞亚群表达水平。方法:采用流式细胞仪检测116例带状疱疹患者及80名健康对照者外周血T细胞亚群。结果:带状疱疹患者外周血CD3~+T细胞、CD4~+T细胞均显著高于健康人群,患者不同年龄组间、不同病程组间CD3~+T细胞、CD4~+T细胞无明显差异。结论:带状疱疹患者CD3~+T细胞、CD4~+T细胞升高,提示特异性细胞免疫得以重建。     

带状疱疹患者外周血CD100表达变化及其对CD8+T细胞功能的调控作用

目的检测带状疱疹患者血浆可溶型CD100(sCD100)和外周血T细胞中膜型CD100(mCD100)表达变化, 观察外源性CD100对带状疱疹患者CD8+ T细胞的功能调控。方法收集2019年7月至2021年4月在驻马店市中心医院就诊的带状疱疹患者53例以及入组年龄和性别匹配的健康对照25例。采集受试者静脉抗凝血, 分离血浆和外周血单个核细胞, 酶联免疫吸附试验检测血浆sCD100水平, 流式细胞仪检测CD4+ T细胞和CD8+ T细胞中mCD100表达。纯化CD8+ T细胞, 比较带状疱疹患者和对照CD8+ T细胞分泌毒性分子和细胞因子的差异。使用重组人CD100和重组水痘-带状疱疹病毒糖蛋白刺激带状疱疹患者纯化的CD8+ T细胞, 观察重组人CD100对CD8+ T细胞分泌毒性分子和细胞因子的影响。组间比较采用t检验。结果带状疱疹组血浆sCD100水平[(1.12 ± 0.23) ng/ml]低于对照组[(1.31 ± 0.28) ng/ml, t = 2.97, P = 0.004], mCD100+CD8+ T细胞比例(17.41% ± 4.26%)高于对照组(14.69% ...     

HLA-DR antigen expression on peripheral T cell subsets in pityriasis rosea Gibert, herpes zoster, and psoriasis

Using 2 color fluorescein activated cytometric analysis, HLA-DR antigen expression in T cell subsets was studied in pityriasis rosea (PR) and compared to the results from herpes zoster (HZ) of viral origin and psoriasis (Ps). In HZ and PR, HLA-DR was significantly expressed on the T cell surface (Leu-4+ cells). Among the T cell subsets, HLA-DR antigen was predominantly expressed on suppressor/cytotoxic cells (Leu-2a+) in HZ. In contrast, it was predominantly expressed on helper cells (Leu-3a+) in PR. However, activated T cell antigen (Tac) was not significantly expressed on T cells (Leu-4+) in either HZ or in PR. This HLA-DR antigen expression of T cell subsets was depressed to the normal level in the recovery phases of HZ and PR.     

凋亡抑制蛋白c-FLIP在带状疱疹患者细胞免疫中作用的研究

目的探讨凋亡抑制蛋白c-FLIP在抗水痘-带状疱疹病毒(VZV)免疫中的作用。方法采用流式细胞术检测30例无恶性肿瘤的带状疱疹患者、17例伴恶性肿瘤的带状疱疹患者和20例正常对照者外周血T细胞和B细胞内c-FLIP蛋白表达阳性率和CD3+T细胞阳性率。结果急性期伴有恶性肿瘤的带状疱疹患者外周血T细胞内c-FLIP表达明显低于无恶性肿瘤和正常对照组(P<0.05,P<0.01),无恶性肿瘤组明显低于正常对照组(P<0.05);恢复期无恶性肿瘤的带状疱疹患者外周血T细胞内c-FLIP表达明显增加,与急性期相比有明显差异(P<0.01),但恢复期的伴恶性肿瘤和急性期相比无明显差异(P>0.05);外周血B细胞内c-FLIP表达在急性期和恢复期的带状疱疹患者中无明显差异(P>0.05)。CD3+T细胞在带状疱疹患者外周血中的阳性率与c-FLIP有相似的表达趋势,两者呈正相关(r分别为0.806和0.534,P均<0.05)。结论凋亡抑制蛋白c-FLIP在急性期带状疱疹患者外周血T细胞内低表达,恢复期则高表达,且与T细胞数量明显正相关,表明其可能参与带状疱疹患者T细胞的增殖,在带状疱疹发生、发展中发挥一定的作用。     

复发性生殖器疱疹患者外周血T淋巴细胞和共刺激分子的检测

目的检测复发性生殖器疱疹(RGH)患者外周血中T细胞亚群和共刺激分子的表达,探讨其在RGH免疫中的作用。方法用免疫荧光技术和流式细胞仪检测RGH及对照组血中T细胞亚群和共刺激分子(CD28,CD25,Fas,FasL,4-1BB)的水平。结果 RGH组CD3+,CD4+/CD8+,CD4+CD28+细胞百分数(59.48±10.9,0.89±0.20,27.69±7.34)显著低于健康对照组(69.79+5.63,1.14+0.39,33.68±7.32),差异均有统计学意义(P<0.05);CD4+CD28-,CD25+细胞百分数及Fas(6.55±4.46,15.81±8.62,27.58±3.10)显著高于健康对照(1.93±1.36,7.13±5.13,23.11±5.63),差异均有统计学意义(P<0.01,P<0.05)。结论 RGH外周血CD3+,CD4+/CD8+下降,CD4+CD28+低表达,及CD25+和Fas高表达,可能是RGH复发的免疫障碍环节之一。     

带状疱疹患者外周血CD4+ T淋巴细胞及皮损组织中自噬水平的检测

【摘要】 目的 观察带状疱疹患者外周血CD4+ T淋巴细胞、皮损组织表皮中自噬蛋白表达的变化及皮损组织表皮细胞中自噬囊泡的生成情况,探讨水痘-带状疱疹病毒感染与细胞自噬之间的关系。方法 选取2017年12月至2018年12月在解放军南部战区总医院皮肤科就诊的35例带状疱疹患者,男20例、女15例,年龄18 ~ 79（59.23 ± 9.27）岁,疼痛时间（5.14 ± 2.28） d,出疹时间（3.45 ± 1.77） d。流式细胞仪检测患者外周血CD4+ T淋巴细胞中自噬蛋白微管相关蛋白1轻链3B（LC3B）、Beclin-1、p62的表达,30例健康成人作为对照组。获取12例带状疱疹患者的皮损组织,免疫组化检测表皮中LC3B、Beclin-1、p62的表达,透射电镜观察表皮细胞中自噬囊泡的生成,以同一患者皮损周围未受累皮肤组织作为对照。组间比较采用两独立样本t检验。结果 带状疱疹患者外周血CD4+ T淋巴细胞中LC3B、Beclin-1阳性表达率（61.23% ± 7.61%、35.84% ± 4.22%）明显高于对照组（36.56% ± 4.27%、15.34% ± 1.89%;t = 15.75、24.56,均P < 0.01）,而p62阳性表达率（5.75% ± 0.67%）明显低于对照组（10.03% ± 1.15%,t = 18.65,P < 0.01）。12例带状疱疹患者皮损组织表皮中LC3B、Beclin-1的表达明显高于周围正常皮肤组织,而p62的表达明显低于周围正常皮肤组织（t = 2.86、4.58、2.43,均P < 0.05）。透射电镜观察示,12例带状疱疹患者皮损区表皮细胞中有较多包饶着病毒颗粒的自噬囊泡生成,皮损区自噬囊泡计数明显高于周围正常皮肤（t = 9.67,P < 0.01）。结论 带状疱疹患者外周血CD4+ T淋巴细胞与皮损组织表皮中自噬水平升高。     

带状疱疹后遗神经痛相关危险因素分析

目的：明确带状疱疹后遗神经痛(postherpetic neuralgia,PHN)的危险因素。方法：分析潍坊医学院附属医院2017年9月至2019年2月带状疱疹住院患者的临床资料,依据发病后1个月是否有PHN,分为病例组和对照组。对两组患者进行单因素及多元logistic回归分析。结果：共筛选出513例患者,其中111例发生PHN（21.6%）。单因素分析示年龄、吸烟史、部位、皮疹面积、临床分型、前驱症状、早期治疗时间、使用糖皮质激素、糖尿病与PHN的发生有关。多因素Logistic回归分析结果显示,PHN的危险因素有年龄≥60岁、有吸烟史、发病诱因为精神/焦虑、初始治疗时间＞7天、急性期重度疼痛和糖尿病史(OR=6.013、3.391、6.800、22.071、21.996、3.163, 95％CI：1.694～21.341、1.219～9.436、1.310～35.296、4.049～120.314、2.864～168.946、1.281～7.811,均P＜0.05)。结论：年龄＞60岁、有吸烟史、发病诱因为精神/焦虑、早期治疗时间＞7天、重度急性期疼痛、糖尿病是PHN发生的危险因素。     

阿昔洛韦与万乃洛韦治疗带状疱疹的疗效比较

目的:观察阿昔洛韦与万乃洛韦治疗带状疱疹的临床疗效。方法:30例带状疱疹随机分为2组。A组用阿昔洛韦,B组用万乃洛韦治疗。分别观察其起效时间,皮损清除时间,带状疱疹相关性疼痛(ZAP)缓解率及带状疱疹后遗神经痛(PHN)发生率等临床指标;结果:在两组中万乃洛韦显示出比阿昔洛韦更好的临床疗效。在各项临床指标的改善程度方面,万乃洛韦明显优于阿昔洛韦;结论:与阿昔洛韦相比,万乃洛韦在带状疱疹方面显示出更好的临床疗效。使用万乃洛韦治疗带状疱疹在改善带状疱疹的相关性痛及后遗神经疼痛方面显著优于阿昔洛韦,尤其是对老年带状疱疹患者。     

Thermography as a predictor of postherpetic neuralgia in acute herpes zoster patients: a preliminary study

Background/purpose: Infrared thermal images in patients suffering from herpes zoster (HZ) may exhibit thermal asymmetry due to the unilateral distribution of HZ lesions. This study examined the usefulness of infrared thermography in acute HZ as a predictor for the development of postherpetic neuralgia (PHN). Methods: The authors collected demographic and clinical data including age, sex, onset of skin lesion, pain intensity by a visual analogue scale (VAS) and the development of PHN from a total of 55 patients diagnosed with HZ. We evaluated the body surface thermographic parameters between the lesion and contralateral normal skin: maximal difference in the temperature (ΔT) and the size of the body surface area (BSA) showing thermal asymmetry. Results: Temperatures of the lesions were found to be warmer than the control side in most patients with acute HZ. We compared the patient group who developed PHN with those who did not. In univariate analysis, patients with PHN were older (P=0.004), had a higher VAS score for pain (P<0.001), higher ΔT (P<0.001) and larger BSA (P=0.001). In logistic regression analysis to identify independent risk factors of PHN, older age (>60 years old) and ΔT more than 0.5 °C were found to be statistically significant.     

系统性硬皮病患者外周血Th17/Treg细胞与病情活动的相关性

目的 探讨系统性硬皮病（SSc）患者外周血Th17/Treg细胞与病情活动的相关性。方法 45例SSc患者中活动组21例,非活动组24例,正常人对照组24例。用流式细胞仪检测外周血Th17、Treg细胞各占CD4+细胞的百分比。荧光定量PCR法检测外周血单一核细胞（PMBC）中白介素17A（IL-17A）、维A酸类核孤儿受体γ（RoRγt）、叉头状螺旋转录因子3（FoxP3）mRNA水平。酶联免疫吸附试验检测血清IL-17水平。结果 ①SSc活动组、非活动组和正常人对照组外周血Th17细胞占CD4+细胞的百分比分别为2.34 ± 1.19、0.68 ± 0.39和0.57 ± 0.49,活动组显著高于非活动组、正常人对照组（P < 0.05）。3组外周血Treg细胞比例差异无统计学意义（P > 0.05）;②SSc活动组、非活动组和正常人对照组外周血IL-17水平分别为53.60 ± 9.90、15.18 ± 3.24、15.53 ± 4.12 pg/ml,对照组和非活动组均显著低于活动组（P < 0.05）;③SSc活动组、非活动组和对照组3组外周血细胞IL-17A mRNA表达水平分别为11.73 ± 0.80、9.77 ± 1.30、10.79 ± 0.74,活动组显著高于对照组、非活动组（P < 0.05）;3组外周血细胞中RoRγt mRNA表达水平分别为18.48 ± 1.09、15.89 ± 1.48、17.77 ± 1.64,活动组显著高于对照组和非活动组（P < 0.05）,3组外周血细胞FoxP3mRNA表达水平差异无统计学意义（P > 0.05）;④外周血Th17细胞比例、血清IL-17水平与活动组SSc患者的病情活动度呈正相关,分别为r = 0.675（P < 0.05）、r = 0.644（P < 0.05）。结论 Th17细胞亚群在活动期SSc患者体内扩增,其扩增与SSc活动密切相关。     

特应性皮炎患者外周血CD4+CD25+调节性T细胞的检测

目的 探讨CD4+CD25+调节性T细胞（CD4+CD25+ Treg）在特应性皮炎（AD）发病中的作用机制及临床意义。方法 流式细胞仪分析AD患者外周血中CD4+CD25+ Treg细胞数量,实时荧光定量PCR检测外周血单核细胞（PBMC）中Foxp3 mRNA水平,ELISA检测血清中IL-2、IL-4、IL-10、IFN-γ水平。结果 AD患者外周血中CD4+CD25+ Treg细胞占CD3+ T细胞及CD4+ T细胞的比例均明显低于正常人对照组（t′ = 3.775、4.533,P值均 ＜ 0.01）;外周血中CD4+CD25+ Treg细胞占CD3+ T细胞比例在AD患者急性期明显低于慢性期（t = 2.217,P < 0.05）,而在急性期与亚急性期、亚急性期与慢性期之间差异均无统计学意义（t = 1.558、0.49,P值均 ＞ 0.05）。AD患者PBMC中Foxp3 mRNA的水平低于正常人对照组（z = -2.368,P ＜ 0.05）;其外周血中CD4+CD25+ Treg细胞与血清中IL-2和IL-10成正相关（r = 0.512、0.494,P值均 ＜ 0.05）,与IL-4和IFN-γ的相关性无统计学意义（r = -0.110、-0.237,P值均 ＞ 0.05）。结论 在AD患者中,外周血中CD4+CD25+ Treg细胞数量及Foxp3 mRNA水平均下降,从而可能减少对Th2细胞增生及其细胞因子分泌的抑制,使Th2占优势,参与AD的发病。     

Management of Herpes Zoster and Post-Herpetic Neuralgia

Herpes zoster and its sequela post-herpetic neuralgia (PHN) are conditions with significant morbidity. PHN is a chronic, debilitating neuropathic pain that can persist long beyond resolution of visible cutaneous manifestations. This paper provides practical guidelines for management of herpes zoster and PHN. For herpes zoster, antivirals should be started, preferably within 72 h of onset, to reduce the severity and duration of the eruptive phase and to reduce the intensity of acute pain. PHN can be treated with either topical or systemic agents. Topical lidocaine and capsaicin are effective. For patients with more severe pain, the following systemic agents can be considered (in decreasing order of recommendation): the anticonvulsants gabapentin and pregabalin, the tricyclic antidepressants amitriptyline, nortriptyline, and desipramine, and, lastly, the opioid analgesics tramadol, morphine, oxycodone, and methadone. For patients at high risk of developing PHN, early initiation of gabapentin or amitriptyline after the onset of herpes zoster is suggested. The new zoster vaccine has been shown to be effective in reducing the incidence of herpes zoster and PHN.     

Association of rs3783641 single‐nucleotide polymorphism in GTP cyclohydrolase 1 gene with post‐herpetic neuralgia

Post‐herpetic neuralgia (PHN) is a well‐established clinical problem with potential severe personal and socioeconomic implications. GTP cyclohydrolase 1 (GCH1) gene, which encodes the rate‐limiting enzyme in tetrahydrobiopterin synthesis, has been strongly implicated to be associated with neuropathic pain in previous animal and human studies. The rs3783641 (T > A) single‐nucleotide polymorphism (SNP) in the GCH1 gene is functional. Here we examine the association between rs3783641 and PHN. A total of 292 subjects including 103 PHN patients, 87 herpes zoster (HZ) patients and 102 healthy controls were enrolled in this study. The rs3783641 polymorphisms were detected via the high‐resolution melting curve (HRM) method. There were statistical differences between PHN group and the other two groups in genotype distribution (P = 0.029 and 0.017, respectively) and allele frequency (P = 0.032 and 0.005, respectively) of rs3783641. The proportion of subjects with AA genotype in the PHN group was significantly lower compared to HZ group and control group (P = 0.026 and 0.016, respectively). The frequency of A allele was lower in the PHN group than in control group (P = 0.005), and the frequency of T allele in the PHN group was higher than in HZ group and control group (P = 0.001 and 0.003, respectively). The results of this study suggest that the rs3783641 SNP in the GCH1 gene is associated with PHN, and the AA genotype showed a protective effect in PHN.     

流式细胞术双色免疫荧光标记观察寻常性银屑病患者外周血淋巴细胞亚群

目的了解寻常性银屑病患者外周血淋巴细胞亚群的变化。方法应用流式细胞仪双色免疫荧光标记,检测98例寻常性银屑病患者外周血淋巴细胞亚群并与102名正常人进行比较。结果银屑病患者外周血CD4+细胞百分数显著高于正常人对照组(P<0.05);NK细胞百分数显著低于正常人对照组(P<0.01),寻常性进行期银屑病患者T细胞和CD4+细胞显著高于静止期银屑病患者(P<0.05),进行期银屑病患者T细胞、B细胞、CD4+细胞百分数均显著高于正常人对照组(P<0.001),NK细胞显著低于正常人对照组(P<0.001)。静止期银屑病患者与正常人对照组相比淋巴细胞亚群各项指标无明显差异。结论寻常性银屑病患者外周血淋巴细胞亚群的变化主要表现在T、B淋巴细胞特别是CD4+细胞的升高和NK细胞的降低。     

带状疱疹患者血清Th细胞因子的检测

目的分析机体细胞免疫功能与带状疱疹的关系。方法采用双夹心ELISA法测定带状疱疹患者血清IL-2,IL-4和TNF-α水平。结果患者血清IL-2,TNF-α水平均较正常对照组明显下降(P<0.001),IL-4水平较正常对照组明显升高(P=0.044);不同年龄和性别患者之间存在差异。结论带状疱疹患者存在血清Th细胞因子异常,外周血清Th1/Th2细胞因子水平明显失衡可能在带状疱疹的发生和发展中起重要作用;年龄可能是带状疱疹发生的危险因素。     

斑秃患者外周血CD4~+ CD25~+ Treg细胞计数及TGF-β_1的表达

目的通过检测斑秃患者外周血中CD4+CD25+Treg细胞计数、转化生长因子-β1(TGF-β1)的表达水平,探讨斑秃的发病机制。方法采用流式细胞技术检测50例未治疗的斑秃患者外周血中CD4+CD25+Treg细胞的水平变化,ELISA法检测血清中TGF-β1含量,并进行相关性分析,以30例健康者作为正常对照。结果斑秃患者组外周血CD4+CD25+Treg细胞占T淋巴细胞的比率和血清TGF-β1浓度均低于正常对照组(P均<0.01),且重型患者组显著低于正常对照与局限型患者组(P<0.01),局限型患者组低于正常对照组(P<0.05)。斑秃患者外周血CD4+CD25+Treg细胞水平,血清中TGF-β1含量均与SALT评分呈显著负相关(r=-0.566,-0.471;P均<0.01),而两者呈显著正相关(r=0.584,P<0.01)。结论斑秃患者外周血中CD4+CD25+Treg细胞与血清中TGF-β1呈一定相关性,且两者与斑秃病情的严重程度相关;CD4+CD25+Treg细胞的数量减少和TGF-β1表达降低可能与斑秃的细胞免疫失调有关。     

麻风康复者外周血Treg细胞及IL-10水平检测

目的：通过检测麻风康复者外周血中CD4+CD25+Foxp3+Treg细胞百分比、IL-10的表达水平,探讨麻风康复者的细胞免疫水平。方法：采用流式细胞技术检测25例麻风康复者和20名健康者对照的外周血中CD4+CD25+Foxp3+Treg细胞的水平变化,ELISA法检测血清中IL-10水平,并进行相关性分析。 结果：麻风康复者组外周血CD4+CD25+Foxp3+Treg细胞占CD4+CD25+Treg淋巴细胞的比率和血清IL-10浓度分别为(7.45±1.43)%和(13.45±3.61)pg/mL,均高于正常对照组的(5.89±1.21)%和(9.23±1.51)pg/mL（P＜0.01）。麻风康复者及正常对照外周血CD4+CD25+Foxp3+Treg细胞水平与血清中IL-10含量呈正相关（P＜0.05）。结论：麻风康复者外周血中CD4+CD25+Foxp3+Treg细胞与血清中IL-10高于正常对照,麻风康复者可能存在细胞免疫失调状态。     

CD4+CD25+ Treg cells in patients with toenail onychomycosis

The essential role played by CD25+CD4+ regulatory T (Treg) cells in the control of immunity against some pathogens such as Helicobacter pylori is now well established. But their role in cutaneous fungal infections is still unknown. Onychomycosis is the chronic fungal infection of the nails, which is very common. The aim of this study was to evaluate possible relationship of CD4+CD25+ Treg cells and onychomycosis. Peripheral blood samples were investigated for CD4+CD25+ Treg cells using flow cytometry analysis in 43 toenail onychomycosis patients and in 30 healthy controls. We have found that onychomycosis patients had a higher expression of CD25+CD4+ Treg cells than controls, with values of 8.45 ± 4.47% versus 4.64 ± 1.59%, respectively (P = 0.001). The results of this study suggests that increased numbers of CD4+CD25+ Treg cells may play a role in failure of clearance of dermatophytes from skin by preventing the protective inflammation which is leading to development of onychomycosis. Accordingly, we address the possibility that CD4+CD25+ Treg cells may play a role in immune pathogenesis of other superficial fungal infections.