支气管肺炎患儿机体免疫功能变化的分析

目的通过对支气管肺炎患儿T细胞亚群、血清免疫球蛋白、血清补体及细胞因子变化的分析,探讨小儿支气管肺炎机体免疫功能状态及免疫学发病机制,为临床了解病情、选择适当的治疗方案提供理论依据。方法支气管肺炎组65例,男39例,女26例,年龄2个月～13岁,平均年龄4.1岁。对照组20例,男12例,女8例,年龄1～12岁,平均年龄4.3岁。应用多色流式细胞术检测T细胞亚群(CD3+、CD3+CD4+Th、CD3+CD8+Ts、CD3+CD4+Th/CD3+CD8+Ts)、应用免疫散射比浊法检测血清免疫球蛋白(IgG、IgA、IgM)、血清补体(C3、C4)、应用ELISA法检测血清细胞因子(IFN-γ、IL-4)。结果支气管肺炎组T细胞亚群改变明显,CD3+、CD3+CD4+Th显著低于对照组,有统计学意义(P<0.01);CD3+CD8+Ts显著高于对照组,有统计学意义(P<0.01);CD3+CD4+Th/CD3+CD8+Ts比值降低,与对照组相比,有统计学意义(P<0.05)。支气管肺炎组血清IgA、IgG水平显著低于对照组,有统计学意义(P<0.01);支气管肺炎组血清补体C3低于对照组,有统计学意义(P<0.05)。支气管肺炎组血清细胞因子IFN-γ浓度及Th1/Th2比值高于对照组,有统计学意义(P<0.05)。结论支气管肺炎患儿存在细胞免疫和体液免疫功能紊乱,对支气管肺炎患儿检测免疫功能有助于判断病情、指导治疗。     

IMMUNE RESPONSES IN AUTOIMMUNE HEPATITIS: EFFECT OF PREDNISONE AND AZATHIOPRINE TREATMENT: CASE REPORT

The role of the immune response in autoimmune hepatitis has not been studied before and after prednisone and azathioprine treatment. Distributions of blood lymphocytes (CD4+, CD8+, CD19+, CD23+, CD16/56+), levels of serum immunoglobulins (IgM, IgG, IgE, IgA) and cytokines (IFN-γ, IL-4, IL-12, TNFα ) were studied in a child (f/14 y/o) with autoimmune hepatitis before and after prednisone (20 mg/d) and azathioprine (50 mg/d) treatment (nephelometry, UniCAP Total IgE Fluoroenzymeimmunoassay, flow cytometry, cytokine ELISA). Patient was studied for 0-2.5 yrs; treatment was initiated 12 weeks post diagnosis. Numbers of CD4+ T cells increased (50%), while CD19+ and CD23+ cells decreased (>50%) post treatment; other lymphocyte subsets were unaffected by treatment. Serum IgG and IgE levels decreased (>50%) after treatment; serum IgM and IgA were within normal range and were not affected by treatment High levels of IFN-γ (5-23 pg/ml) were initially detected in serum, which decreased after treatment (<0.1 pg/ml). Furthermore, low levels of IL-4 (0.2 pg/mL) were detected before treatment, which were not detected after treatment (<0.1 pg/ml). In contrast, before treatment, IL-12 and TNFα were not detected in serum; however after treatment the levels of IL-12 and TNFα dramatically increased. Prednisone and azathioprine treatment decreased total serum IgG, IgE, IFN-γ and IL-4 levels, and blood CD19+ and CD23+ cells; however serum IL-12, TNFα and blood CD4+ T cells increased with treatment. Understanding immunomodulation in autoimmune hepatitis will provide better insight and mechanisms of this disease and may tailor more effective therapeutic intervention.     

Changes in immunological recovery in patients who received post-transplant G-CSF or GM-CSF after autologous peripheral blood stem cell transplantation (PBSCT)

In this prospective study, the effects of granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) on immunological reconstitution after autologous peripheral blood stem cell transplantation (PBSCT) were investigated for 6 months. Thirty-five patients received G-CSF 5 microg/kg per day and 26 patients received GM-CSF SC 5 microg/kg per day from day 1 to leukocyte engraftment (>1000 per mm3). Peripheral blood samples were obtained on 14, 28, 100, and 180 days after transplantation for immunological evaluation. CD3+, CD4+, CD8+, CD19+, and CD56+ cells were analysed by flow cytometry. Immunoglobulin levels (IgG, IgA, and IgM) and complement levels (C3c and C4) were measured by nephelometry. Both G-CSF and GM-CSF groups were comparable with respect to age, sex, the period from diagnosis to transplantation, total nucleated cells infused, the number of CD34+ cells, conditioning regimens (TBI and non-TBI), and post-transplant infection. CD3+ and CD8+ cells on day 14 following autologous PBSCT + G-CSF were significantly higher than following autologous PBSCT + GM-CSF (p = 0.008 and p = 0.021, respectively). The number of CD4 cells and the CD4/CD8 ratio were not different at several time points between the two groups. CD19+, CD56+ cells and immunoglobulin levels showed a faster recovery pattern in the autologous PBSCT + G-CSF group. The effect of G-CSF on immune reconstitution after autologous PBSCT is more prominent than that of GM-CSF. The possible role of haematopoietic growth factor on immune recovery and its clinical importance should be investigated in further studies.     

免疫增强型肠外营养对门静脉高压症术后营养、免疫和炎症反应的影响

目的: 观察比较免疫增强型肠外营养疗法与标准营养疗法对肝硬化门静脉高压症手术患者术后营养、免疫状态和急性炎症反应的影响。方法: 选择42例接受门静脉高压症手术的肝硬化患者，随机分为2组: 标准营养组（TPN,n=20）和免疫增强营养组（TPN加谷氨酰胺和人重组生长激素，n=22），术后3 d开始进行等氮等热量营养支持，持续7 d。手术当天（0 d）、3 d和10 d清晨分别抽取静脉血,检测血清前白蛋白、转铁蛋白、T细胞亚群CD4+、CD8+、CD4+/CD8+、IgG、IgA、IgM、IL-2、TNF-α和CRP。结果:免疫增强营养组在术后第10 d血清前白蛋白、转铁蛋白、CD4+、CD4+/CD8+、IgG和 IL-2水平显著高于对照组（P<0.05），TNF-α和CRP显著低于对照组（P<0.05）。结论:免疫增强型肠外营养疗法比标准营养疗法更能改善肝硬化门静脉高压症手术患者术后营养状态和免疫功能，减轻急性炎症反应。     

Immune-Mediated Diseases and Immunodeficiencies Associated with Thymic Epithelial Neoplasms

Introduction

This retrospective study aimed to characterize the clinical hematological and immunological features of patients with thymic epithelial neoplasms.

Methods

From a cohort of 512 patients with thymic epithelial neoplasms, 79 patients diagnosed with autoimmune/immunodeficiency conditions or signs and/or symptoms suggesting an autoimmune or immunodeficiency state were evaluated by standard immunological and hematological testing.

Results

Elevated percentages of CD2+, CD3+, and CD8+ lymphocytes were observed in 44 (57.1%), 33 (41.8%), and 32 (40.5%) patients. Low CD4+ and CD19+ percentages were observed in 25 (31.6%) and 36 (46.2%), respectively; CD4+:CD8+ ratios were inverted in 18 (22.8%). IgG, IgA, and IgM levels were low in 12 (15.8%), 9 (11.7%) and 15 (19.7%) patients, respectively. Patients with immunodeficiency condition(s) were more likely to have high CD8+ percentages (p?=?0.040), low CD19+ percentages (p?=?0.025), and/or inverted CD4+/CD8+ ratios (p?=?0.034). Patients with autoimmune condition(s) were more likely to have a high/normal CD4+ percentage (p?=?0.038). High CD2+ percentages were associated with lower mean IgG and IgA levels (p?=?0.030 and p?=?0.017, respectively). High CD3+ and CD8+ percentages were associated with lower mean IgA levels (p?=?0.046 and p?=?0.013, respectively). Low CD19+ percentages were associated with lower mean IgG and IgA levels (p?=?0.004 and p?Conclusion Signs/symptoms and history of autoimmune and immunodeficiency conditions among patients with thymic epithelial neoplasms are associated with high frequencies of abnormalities in immunoglobulin levels and lymphocyte immunophenotypes, suggesting a role for their assessment.     

1alpha,25-dihydroxyvitamin D3 increases IgA serum antibody responses and IgA antibody-secreting cell numbers in the Peyer's patches of pigs after intramuscular immunization

Pigs were injected intramuscularly (i.m.) twice with human serum albumin (HSA) with or without 1alpha,25-dihydroxyvitamin D3[1alpha,25(OH)2D3] with a 5-week interval. The supplementation of 1alpha,25(OH)2D3 enhanced the HSA-specific IgA serum antibody response but decreased the IgM, IgG, IgG1 and IgG2 responses. Furthermore, higher numbers of HSA-specific IgA antibody-secreting cells were obtained in systemic lymphoid tissues (local draining lymph node, spleen and bone marrow) as well as in Peyer's patches and lamina propria of the gut (GALT). In addition, the in vivo mRNA expression for Th1 [interferon (IFN)-gamma, interleukin (IL-2)], Th2 (IL-4, IL-6 and IL-10) and Th3 [transforming growth factor (TGF)-beta] cytokines as well as the percentage of different cell subsets (CD2+, CD4+, CD8+, IgM+, MHC II+, CD25+) of monomorphonuclear cells from the local draining lymph node were determined at different time-points after the i.m. immunizations. Cytokine profiles did not resemble a typical Th-cytokine profile using 1alpha,25(OH)2D3: higher levels of IL-10 and significantly lower levels of IL-2 were observed the first day after the primary immunization. However, significantly higher levels of IL-2 and significantly lower levels of IFN-gamma were observed the first day after the second immunization. Furthermore, after the second immunization TGF-beta mRNA expression decreased more quickly in the 1alpha,25(OH)2D3 group. This difference became significant 7 days after the second immunization. One week later a significantly higher percentage of CD25+ cells was observed in this group, indicating more activated T and B cells using the steroid hormone. These results suggest that in pigs the addition of 1alpha,25(OH)2D3 to an intramuscularly injected antigen can enhance the antigen-specific IgA-response and prime GALT tissues, but the relation with cytokines and cell phenotype in the local draining lymph node needs further clarification.     

支原体肺炎患儿免疫球蛋白、T淋巴细胞亚群细胞因子检测的临床意义

目的:观察支原体肺炎(MPP)患儿外周血免疫球蛋白、T淋巴细胞亚群以及细胞因子的含量变化,并探讨其在MPP发病机制中的作用。方法:采用流式细胞技术检测43例MPP患儿和30例正常对照组儿童外周血T淋巴细胞亚群CD3+、CD4+、CD8+,并用速率散射比浊法检测血清IgG、IgA和IgM含量,采用ELISA检测血清干扰素-γ(IFN-γ)、白介素(IL-2、IL-4和IL-6)水平。结果:MPP患儿外周血CD3+、CD4+T细胞百分率分别为61.45±6.75和33.52±5.81,较正常对照组68.28±7.34和38.71±6.29显著降低(P<0.05),CD8+T细胞和CD4+/CD8+比值较对照组无显著差别(P>0.05);MPP患儿血清免疫球蛋白与正常对照组比较,IgG和IgA均无明显差异,IgM较对照组增高(P<0.05);MPP患儿IFN-γ、IL-4、IL-6血清水平以及IFN-γ/IL-4比值较正常对照组明显增高(P<0.05),而IL-2水平低于正常对照组(P<0.05)。结论:MPP患儿存在免疫功能减低,免疫调节紊乱,辅助性T细胞亚群(Thl/Th2)失衡,并以Thl型细胞介导的免疫反应占相对优势状态。     

Analysis of peripheral blood T-cell subsets,natural killer cells and serum levels of cytokines in children with Down syndrome

The objective of this study was to evaluate the relationship between humoral and cell-mediated immune response parameters and impairment of immune functions in children with Down syndrome (DS). The patient group was consisted of cytogenetically documented 32 children with DS. Lymphocyte subsets and natural killer cells were counted by flow-cytometry system. Levels of interleukin (IL)-1β, IL-2, IL-4, IL-6, IL-8, IL-10 and tumour necrosis factor-alpha (TNF-α) were detected by enzyme-linked immunosorbent assay method. Serum IgG, IgM, IgA levels were measured by turbidimetric methods. The percentage of CD8+ lymphocytes and CD56+ cells of patients with DS were significantly higher, whereas CD20+ lymphocytes were lower than that of controls (P < 0.05). The percentage of CD2 and CD4 levels and CD4/CD8 ratio of patients with DS and normal controls were similar (P > 0.05). Levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-α levels were decreased in children with DS (P < 0.05). Levels of other studied cytokines between patients with DS and controls were not statistically different (P > 0.05, for all). Serum IgG, IgM and IgA levels were found to be similar between the groups (P > 0.05). It has been known that IL-4 and IL-10 are anti-inflammatory molecules which inhibit the synthesis of proinflammatory cytokines such as IL-6 and TNF-α. In this study, levels of IL-4 and IL-10 were significantly increased, but IL-6 and TNF-α levels were decreased in children with DS. These results may suggest that continuing anti-inflammatory state in DS and this process may explain the cause of recurrent infection of the disease. On the other hand, in contrast to the low percentage of CD20+ cells, high percentage of CD8+ and CD56+ cells were found. Our findings may demonstrate that the cell-mediated and humoral immune system parameters in children with DS were altered according to healthy children.     

不同麻醉深度对结直肠癌腹腔镜手术患者肠道免疫及肠功能恢复的影响

目的探讨不同麻醉深度对结直肠癌腹腔镜手术患者肠道免疫以及肠功能恢复的影响。方法选择拟行全身麻醉下腹腔镜结直肠癌根治手术患者80例,随机分为2组。对照组(40例)术中脑电双频指数(BIS)维持在50~59,观察组(40例)BIS维持在40~49。比较2组患者术前(T0)、术后12 h(T1)、术后24 h(T2)、术后72 h(T3)肠道免疫指标,包括Treg/Th17、白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、白细胞介素-10(IL-10)、转化生长因子-β1(TGF-β1)、免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、CD3+、CD4+、CD8+,以及肠道功能恢复情况。结果2组患者围术期不同时间肠道免疫指标变化差异有统计学意义(P<0.05);血清IL-6、IL-17均于T1时升高,T2时达高峰,T3时回落,Treg/Th17、TGF-β1、IL-10、CD3+、CD4+、CD8+、IgA、IgG则于T1时降低,T2时达低峰,T3时回升。观察组患者T1、T2、T3时血清IL-6、IL-17低于对照组(P<0.05),Treg/Th17、TGF-β1、IL-10、CD3+、CD4+、CD8+、IgA、IgG高于对照组(P<0.05)。观察组患者术后肠鸣音恢复时间、首次肛门排气时间、首次肛门排便时间、进食恢复时间均短于对照组(P<0.05)。结论全身麻醉时BIS维持在40~49,可保护结直肠癌腹腔镜手术患者肠道免疫功能,促进肠道功能恢复。     

Analysis of the Immune Status in Latvian Chernobyl Clean-up Workers with Nononcological Thyroid Diseases

The aim of the present work was to characterize the immune status of 385 individuals who participated in the 1986-90 clean-up work of the after effects of the Chernobyl nuclear power plant explosion. Fifty-nine Chernobyl clean-up workers developed the most common thyroid diseases; euthyroid nodular and diffuse goiter; 47 healthy blood donors were taken as controls. The levels of immunoglobulins (IgA, IgG and IgM), the numbers of peripheral blood leukocytes, lymphocytes, monocytes, T lymphocytes and their subpopulations (CD3+, CD4+, CD8+), B lymphocytes (CD19+), natural killer (NK) cells (CD16+), classical and alternative pathway activity of complement (CH50, APH50), the C3 split product C3d, and neutrophil phagocytosis were determined in the peripheral blood. We found a significantly decreased number of CD16+ cells (natural killer), of CD4+ and CD8+ T lymphocytes, a reduced neutrophil phagocytic activity as well as a significant complement activation in Chernobyl clean-up workers with and without thyroid diseases when compared with normal levels and those in the control group. In addition, the number of CD3+ and CD4+ cells was significantly higher in patients with nodular goiter when compared with that in patients with diffuse goiter. Levels of IgG and numbers of monocytes were significantly decreased in persons who worked in Chernobyl in 1986 during the first 2 months after the accident (with maximal radiation exposure) but were without correlation to thyroid disorders. Our results clearly reflect an impaired immune system in the Chernobyl clean-up workers even 10-14 years after the nuclear accident.     

Immune response and in vivo production of cytokines in patients with liver hydatidosis

Cytokines play an important role in the human immunological response, but the exact role of cytokines in the human immune response against parasites, especially against Echinococcus granulosus, remains unclear. IL-1, IL-2, IL-4 and tumour necrosis factor (TNF) levels in peripheral blood of 21 patients with liver hydatidosis were evaluated before surgical treatment, and the levels of IgA, IgM, IgG, IgE, specific IgE against E. granulosus, C3, C4 and BF complement fractions and CD20, CD3, CD4, CD8 and CD16 cell percentages were also determined, as was the relationship between these variables and cytokine levels. Data from hydatid patients were compared with data obtained from 21 healthy volunteers. Hydatid patients showed increases of IgG, IgE, IgEs and IL-2 (P< 0.01), and decreases of IL-1 and TNF levels (P< 0.001), but these variables (respectively) increased in patients showing cysts in the central area of the liver or with a wide opening of cysts in the biliary tract. The increase of IL-1, IL-2 and IL-4 showed a close relationship with the number, characteristics and above all the location of cysts within the liver itself. IgG and IL-4 levels and also IgG and IgE levels showed a significant correlation (P< 0.05).     

Immunological evaluation of late complement component-deficient individuals.

The possible contribution of additional immunologic variables to the susceptibility of late complement component-deficient individuals to meningococcal disease has not been systematically examined in previous studies. Thus, we studied three groups of patients: (1) 24 healthy individuals, (2) 8 complement-sufficient individuals with a history of recurrent bacterial meningitis, and (3) 19 complement-deficient individuals with prior meningococcal infection. No statistical differences were noted among the three groups for the following parameters: the absolute number and the percentage of lymphocytes; CD3+, CD4+, CD8+, CD20+, and CD16+ cells; and the CD4+/CD8+ ratio. The concentration of C4 and circulating immune complexes was also similar among the groups. The concentrations of IgG, IgM, and IgA were slightly, but significantly, decreased in the complement-deficient individuals. Of interest, the coefficient of spontaneous and lipopolysaccharide-stimulated activation of neutrophils was significantly depressed in the deficient individuals. We hypothesize that the terminal complement components may participate in maximal neutrophil activation.     

谷氨酰胺对老年胃肠道肿瘤患者术后蛋白质代谢及免疫功能的作用

目的:探讨谷氨酰胺对老年胃肠道肿瘤患者术后蛋白质代谢及免疫功能的影响。方法:选取2007-03/2010-03胃肠道肿瘤患者87例,术后2 h开始给予肠外营养,同时加入谷氨酰胺0.6 g/(Kg.d),持续8 d。采用单向免疫扩散法测定血清IgA、IgG、IgM,采用免疫组化法测定外周血CD3+、CD4+、CD8+、CD4+/CD8+,同时测定蛋白质代谢的指标(包括氮平衡、血浆白蛋白、前白蛋白、转铁蛋白)。结果:老年胃肠道肿瘤经治疗后CD3+、CD4+、CD8+、CD4+/CD8+、IgG、IgA、IgM显著升高,与治疗前比较差异有统计学意义(P<0.05);术后第4天Alb、PAB、TF显著下降(P<0.05),术后第8天得到较为明显的恢复(P<0.05);肿瘤患者负氮平衡状态术后早期加重,经谷氨酰胺治疗8 d后恢复至术前水平(P<0.05),差异有统计学意义。结论:谷氨酰胺可显著改善老年胃肠道肿瘤患者术后营养,提高患者的免疫功能。     

ICP患者血清FE_3及免疫功能指标测定的临床意义

目的：探讨ICP患者的血清游离E3和β-HCG及IgG、IgM、IgA、C3、C4和外周血淋巴细胞亚群（CD4＋、CD8＋和CD4＋/CD8＋）水平的变化与患者发病的关系。方法：游离E3和β-HCG两项指标采用放射免疫分析,IgG、IgM、IgA、C3和C4采用免疫比浊法。CD4＋、CD8＋测定采用流式细胞术。结果：ICP患者组游离E3和β-HCG水平呈前者高于对照组非常显著（P〈0.01）;后者则略高于对照组,但并无统计学意义（P〉0.05）;五项体液免疫学指标呈IgG水平低于对照组（P〈0.01）;而IgM、IgA、C3、C4四项指标水平与对照组比较均无显著差异（P均〉0.05）。淋巴细胞亚群测定呈CD4＋T细胞水平与对照组比较无显著差异（P〉0.05）;而CD8＋T细胞水平显著高于对照组（P〈0.05）;CD4＋/CD8＋两种T淋巴细胞比值则显著低于对照组（P〈0.05）。结论：ICP患者血清10项指标的测定对于了解和认识其发病机理及预估病情有帮助。     

脐血间充质干细胞移植脊髓损伤恢复期患者的免疫功能变化*

背景：间充质干细胞移植因其具有一定的免疫原性,对脊髓损伤患者免疫功能的影响尚无深入系统的报道。 目的：观察脐血源间充质干细胞移植对脊髓损伤患者免疫功能的影响。 方法：61例脊髓损伤患者采用静脉滴注结合腰椎脊髓蛛网膜下腔注射脐血间充质干细胞悬液治疗。应用流式细胞术及免疫比浊法分别测定患者移植前后T淋巴细胞亚群、免疫球蛋白及补体的含量。 结果与结论：与治疗前相比,患者CD3+、IgA及IgG有下降趋势,差异有显著性意义;CD4+、CD8+、CD4+/CD8+、IgM、C3及C4均有升高或下降趋势,但差异无显著性意义。提示脐血源间充质干细胞移植对细胞及体液免疫不会激活急性免疫应答,移植是安全的,存在负向免疫调节作用的可能,但尚需进一步完善相关指标,扩大样本,明确相关机制。 关键词：脐血源间充质干细胞;细胞移植;脊髓损伤;免疫功能;T淋巴细胞亚群;免疫球蛋白;补体 doi:10.3969/j.issn.1673-8225.2012.01.037     

Tracking changes of lymphocyte subsets and pre-inflammatory mediators in full-term neonates with suspected or documented infection

Investigation was made of changes in immune system parameters during the course of neonatal infection. The study population consisted of 95 full-term neonates matched for chronological age and sex, divided into three groups: suspected infection (n=20), sepsis (n=25), infection-free control subjects (n=50). Serial measurements were made of the cytokines interleukin-6 (IL-6), interleukin-1b (IL-1b) and tumour necrosis factor-α (TNF-α), lymphocyte subsets [CD3+, CD4+, CD8+, natural killer (NK) cells and B cells], the immunoglobulins (Ig) (IgG, IgM and IgA), C-reactive protein (CRP), and the total blood count, before, 2 days after initiation of treatment and after stopping treatment (time periods first, second and third, respectively). IL6, TNF-α, IL1-b and CRP were higher at the first time period in the sepsis group, and IL6 and TNF-α continued to be higher in this group at the second period. IL-6 and TNF-α were precise sepsis predictors with sensitivity and specificity of 0.92, 0.98 and 0.91, 0.92, respectively. NK cells, B cells, CD3+, CD4+, CD8+ were higher in the sepsis and suspected infection groups, but the ratios CD3+/CD4+, CD3+/CD8+, CD4+/CD8+ showed no difference from the controls. IgG was lower and IgM higher in the sepsis group. In the control subjects CD3+, CD4+, CD8+ lymphocytes increased with increasing age. It is concluded that IL-6 and TNF are good diagnostic markers of sepsis in full-term neonates. Lymphocyte subsets were affected by both the clinical condition and the chronological age. NK and B cells may be elevated in suspected and documented sepsis, and further studies are needed to determine their clinical significance.     

受血者输血中Rh血型E抗原对患者机能免疫功能影响

目的 探讨受血者输血中Rh血型E抗原对患者机能免疫功能影响.方法 收集2014年3月至2016年7月200组受-供血者的血标本,其中100组受-供血者E抗原均呈阴性为A组,另100组受血者E抗原呈阴性、供血者E抗原呈阳性为B组.受血者输血前后分别检测血清白细胞介素-2(IL-2)、免疫球蛋白M(IgM)、IgG抗体及血中T淋巴细胞亚群(CD4+、CD8+).结果 A组输血前后血清IL-2、IgM及IgG抗体水平均无明显变化.B组输血后IL-2、IgM及IgG抗体水平均呈先逐渐升高,后逐渐降低的过程,均在输血后5d达到最高,在输血后18d基本恢复至输血前水平.B组输血后3、5、10d IL-2、IgM及IgG抗体水平均明显高于A组(P均＜0.05);A组输血前后血清CD4+、CD8+细胞数无明显变化.B组输血后CD4+细胞数均呈先逐渐升高后降低,CD8+细胞逐渐降低后升高,均在输血后3d达到最高和最低,在输血后18d基本恢复至输血前水平;B组输血后5、10d CD4+细胞数均明显高于A组,CD8+细胞低于A组(P均＜0.05).结论 Rh(E)抗原阴性的受血者在输注E抗原阳性血制品后,其机能免疫功能将出现有时间限制的改变;临床应加强对受-供血者的Rh(E)抗体的检测,配型满意后方进行输血,提高临床输血的科学性、合理性与安全性.     

Interleukin-6 synthesis and IgE overproduction in children with perinatal human immunodeficiency virus-type 1 infection.

BACKGROUND: Unbalanced interleukin network and elevated IL-6 synthesis are suggested mechanisms of immunoglobulin overproduction in children with perinatal human immunodeficiency virus-type 1 (HIV-1) infection. OBJECTIVE: To investigate whether elevated IL-6 synthesis is a general mechanism of immunoglobulin overproduction in perinatal HIV-1 infection. METHODS: In vitro spontaneous and phytohaemoagglutinin (PHA)-stimulated IL-6 and IL-2 synthesis, serum IgE, IgG, IgA, and IgM levels, CD4+ T-lymphocyte counts, and HIV-1 RNA copy numbers were cross-sectionally determined in 31 children with perinatal HIV-1 infection. Children with immunoglobulin z-scores in the highest quartile were defined as children with high immunoglobulin level. Relationships between interleukin synthesis, high immunoglobulin levels, and HIV-1 related disease were studied. RESULTS: Children with high IgE levels had higher spontaneous IL-6 synthesis (1337 +/- 138 pg/mL) compared with those without high IgE levels (861 +/- 194 pg/mL; P < .001). By contrast, spontaneous IL-6 synthesis was similar in children with or without high IgG, IgA, or IgM levels. Decreased PHA-stimulated IL-2 synthesis, low CD4+ lymphocyte counts, elevated HIV-1 RNA copy numbers, and severe disease correlated with high IgE (but not IgG, IgA, and IgM) levels. IgG, IgA, and IgM levels correlated with each other, but not with IgE levels. CONCLUSION: The increased IL-6 synthesis in HIV-1+ children may affect IgE rather than other immunoglobulin isotype levels. Overall results suggest that IgE and IgG, IgA, IgM overproduction have distinct underlying mechanisms.     

A Comprehensive Immunological Analysis in Chronic Fatigue Syndrome

A detailed analysis of cell-mediated and antibody-mediated immunity was performed in 20 CDC-defined patients with chronic fatigue syndrome (CFS) and 20 age- and sex-matched healthy controls. CD3+, CD4+, CD8+, and CD20+ lymphocytes were comparable in two groups. Natural killer cells as defined by CD16, CD56 and CD57 antigens were significantly reduced in CFS. A significant increase in the proportions of CD4+ ICAM 1+ T cells was observed in CFS. Monocytes from CFS displayed increased density (as determined by mean fluorescence channel numbers) of intercellular adhesion molecule 1 (ICAM-1) and lymphocyte function associated antigen 1 (LFA-1), but showed decreased enhancing response to recombinant interferon-gamma in vitro. The lymphocyte DNA synthesis in response to phytohaemoglobulin (PHA), Concanavalin A (Con A) and pokeweed mitogen (PWM) was normal but the response to soluble antigens was significantly reduced. Serum IgM, IgG, IgA, and IgG subclasses were normal. In vivo specific antibody response to pneumococcus vaccine was depressed in CFS. Forty percent of patients showed titres of anti-human herpes virus 6 (anti-HHV-6) antibody higher than that in the controls (greater than or equal to 1/80). These data suggest immunological dysfunction in patients with chronic fatigue syndrome. The significance of these observations is discussed.