急性亚急性重型病毒性肝炎时肝内淋巴细胞浸润与肝细胞坏死机理的探讨

目前一般认为病毒性肝炎时肝细胞坏死是T淋巴细胞杀伤带有病毒抗原的肝细胞所致,但在实际工作中发现不少病例肝细胞坏死与淋巴细胞浸润程度不一致。为此我们复查了18例急性或亚急性重型病毒性肝炎(甲、乙型各9例)尸检病例的肝组织切片,结果发现11例在大片坏死的肝小叶内淋巴细胞浸润很少,有的仅见个别淋巴细胞(半定量),     

合并肝细胞脂肪变性的慢性乙型肝炎患者调节性T淋巴细胞的变化及其意义

本研究旨在通过检测合并肝细胞脂肪变性的慢性乙型肝炎(CHB)患者外周血CD4+ CD25+T淋巴细胞水平与肝组织中Foxp3的表达,探讨肝细胞脂肪变性对CHB患者调节性T淋巴细胞(Tregs)的影响及其意义,现报道如下.     

T细胞免疫与乙型肝炎病毒感染慢性化的研究进展

乙型肝炎病毒(Hepatitis B virus,HBV)感染波及全球。我国是高发区。新生儿期感染HBV后,大多数转变为慢性携带者。成人感染HBV后,大部分很快将病毒清除,少部分转变为慢性乙型肝炎或携带者,其中少数形成肝硬化或肝细胞癌。已知乙型病毒性肝炎的发生发展与机体的免疫功能异常密切相关,极易引起慢性持续感染,其机制十分复杂.而T淋巴细胞是肝内最主要的炎症细胞。现将近年有关宿主T细胞免疫与HBV感染慢性化研究综述如下。     

CD4+T辅助细胞在乙型肝炎病毒感染中的作用

对乙型肝炎病毒抗原所引起的宿主细胞免疫应答,一般认为是乙型病毒性肝炎肝细胞损伤的决定因素,其免疫病理变化主要由T细胞调节,近十年的研究证明,作为T细胞亚群之一的CD4+T辅助细胞(Th)在许多方面有着重要的作用.     

乙型肝炎肝硬化患者血清透明质酸和可溶性白细胞介素2受体测定的意义

近年来,某些疾病监测数据表明,一些以T淋巴细胞激活为特征的病理情况及乙型肝炎肝硬化(简称肝硬化)患者的肝细胞损伤病理机制与T淋巴细胞功能有关[1].本研究通过测定45例乙型肝炎肝硬化患者血清HA和sIL-2R的水平,以探讨肝细胞损伤与sIL-2R和HA之间的关系.     

病毒性肝炎和肝硬化病人外周血单个核细胞γ干扰素诱生能力的研究

一般认为,病毒性肝炎尤是乙型病毒性肝炎的肝细胞损伤主要由机体免疫应答和免疫调节紊乱所致,但对其免疫病理过程还很不清楚。干扰素(IFN)和免疫系统关系极为密切,γ干扰素(IFHγ)本身就是淋巴因子,因而研究病毒性肝炎和肝硬化病人IFNγ反应规律,可望从干扰素角度探讨其免疫病理损伤机制、转归和T淋巴细胞功能状态。     

T淋巴细胞亚群与慢性乙型肝炎的关系

慢性乙型肝炎病毒(HBV)感染者的外周血及肝组织内T淋巴细胞亚群组成发生了数量和质量上的改变,导致了细胞免疫的功能损伤,感染慢性化.深入探讨各种T淋巴细胞在HBV感染中的功能及变化,将为理解乙型肝炎慢性化机制及临床治疗提供新的思路和方向.     

慢性乙型病毒性肝炎患者T细胞亚群研究进展

乙型肝炎病毒(HBV)感染可导致病毒肝炎,易于慢性化,并逐渐发展成肝硬化甚至肝癌,而严重威胁人类健康。乙型肝炎细胞损伤和炎症反应是由宿主免疫反应和病毒共同作用的结果,其中主要是通过细胞免疫反应引起肝细胞病变,T淋巴细胞在其中发挥了主要作用。各种免疫细胞特别是T细胞亚群之间的调节紊乱,是机体不能清除病原体及 HBV在肝内持续复制的主要原因。     

自身免疫性肝炎的特异性T淋巴细胞免疫

自身免疫性肝炎(AIH)是一种器官特异性自身免疫性疾病,以肝组织内T淋巴细胞浸润、高Y球蛋白血症、血清自身抗体阳性、具有人类白细胞抗原(HLA)遗传背景、常伴发其他自身免疫性疾病和对免疫抑制治疗有效为特征[1].自身免疫反应介导的肝细胞损伤是AIH发病机制之一,且遗传因素也参与了AIH的发病,而在AIH免疫发病机制方面,自身反应性T淋巴细胞,尤其是AIH靶抗原特异性T淋巴细胞起至关重要的作用,但具体机制尚未阐明. 一、AIH特异性靶抗原的认识 自身抗原是自身抗体和自身反应性T淋巴细胞作用的靶点,是自身免疫反应的基础.自身抗原必须满足4个条件:(1)必须存在一个相应的高滴度器官特异性自身抗体;(2)需证实T淋巴细胞对相对应的抗原致敏;(3)存在疾病特异性的B淋巴细胞和T淋巴细胞表位;(4)需有抗体和(或)自身反应性T淋巴细胞致病的证据.     

乙型肝炎的慢性化和慢性乙型肝炎的免疫学治疗

目前,全世界乙型肝炎病毒(HBV)携带者约3.5亿,其中1/ 4的人发展为进展性肝病,其严重并发症包括肝硬化和肝细胞癌。据估计,全球每年死于乙型肝炎及其并发症的人数多达1～2百万。而近年免疫学的发展为慢性乙型肝炎的治疗带来了希望。一、HBV感染后机体的特异性免疫应答HBV感染人体后,诱发机体产生特异性的免疫应答。其中,体液免疫所产生的抗 HBs可以直接中和血中的病毒颗粒。当HBV进入肝细胞后,细胞免疫,尤其是CD8 细胞毒T淋巴细胞(CTL)发挥了更为重要的作用。(一)特异性的CD8 CTL激活　通过T细胞受体(TCR)识别由主要组织相容性…     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.