急性肝损伤肝脏炎症环境对骨髓间充质干细胞移植疗效的影响

目的:探讨猪急性肝损伤肝脏内不同程度炎症反应对移植骨髓间充质干细胞(mesenchymal stem cells,MSCs)存活率和疗效的影响.8):对照组和移植组.每组均按照低浓度D氨基半乳糖胺(D-gal,0.25 g/kg)、高浓度D氨基半乳糖胺(D-gal,0.35 g/kg)给药,分别建立2种急性肝损伤模型,诱导24 h后,对照组动物门静脉注射生理盐水40 mL,移植组动物门静脉移植40 mL PBS(约8×107同种异体GFP-MSCs).2 wk内观察猪肝功能变化、病理变化、血清炎症指标和移植MSCs定植存活情况.结果:低浓度D-gal组血清IL-1、TNF-α水平明显低于高浓度D-gal组,差异有显著性.低浓度D-gal移植组与低浓度D-gal对照组比较,ALT、TB和NH3在早期有显著差异(D2:232.6±57.6 vs 334.4±42.3,12.2±3.3 vs 16.0±1.2,79.7±9.3 vs 127.8±28.2,P<0.05);高浓度D-gal移植组与高浓度D-gal对照组比较,肝功能指标有改善,但无显著意义.低浓度D-gal移植组MSCs定植存活率和肝细胞增殖率显著高于高浓度D-gal移植组.结论:骨髓间充质干细胞移植治疗肝损伤的疗效在很大程度上取决于肝脏炎症反应的程度,炎症反应越严重,移植细胞越不易存活;相反,较低的体内炎症环境有益于MSCs定植、存活和肝细胞再生.     

白介素-1β siRNA联合骨髓间充质干细胞协同治疗急性肝衰竭

目的:构建白介素(interleukin,IL)-1βsiRNA腺病毒载体并评估其联合骨髓间充质干细胞(mesenchymal stem cell,MSC)移植治疗急性肝衰竭(acute liver failure,ALF)的协同作用.方法:构建IL-1βsiRNA腺病毒载体并体外验证其对IL-1β的的抑制能力;体内实验筛选IL-1βsiRNA腺病毒载体的最佳干扰计量和最佳干扰时间点并检测其免疫源性;分离培养Balb/c小鼠骨髓MSC并进行鉴定,慢病毒稳定转染GFP;20%(v/v)四氯化碳(CCl4)橄榄油溶液8μg/L腹腔注射诱导小鼠ALF模型.100只小鼠随机分为5组:正常对照组(n=20);ALF组(n=20);ALF+IL-1βsiRNA组(n=20);ALF+MSC组(n=20);ALF+IL-1βsiRNA+MSC组(n=20).各组小鼠行干预后检测肝功能、生存率、血清炎症因子水平、组织病理学改变、肝细胞凋亡、增殖和肝脏中血管内皮生长因子(vascular endothelial growth factor,VEGF)和肝细胞生长因子(hepatocyte growth factor,HGF)含量.免疫组织化学和荧光显微镜观察肝脏组织切片中GFP阳性细胞.结果:分离获取的MSC表达CD45阴性、CD44阳性、CD90阳性和CD29阳性.IL-1βsiRNA腺病毒载体在体外能够抑制脂多糖刺激后的Raw264.7细胞株分泌IL-1β.qPCR实验显示腺病毒剂量为1×108 pfu、注射36 h后时体内干扰效率最高.尾静脉注射1×108 pfu腺病毒空载体4 h后,血清中干扰素(interferon,IFN)-γ、肿瘤坏死因子(tumor necrosis factor,TNF)-α和IL-6水平无明显升高.联合治疗组CXCL1、IL-1β、IL-10、IL-6、谷丙转氨酶(alanine aminotransferase,ALT)和谷草转氨酶(aspartate aminotransferase,AST)水平与单纯MSC组相比具有统计学差异,但与IL-1βsiRNA组相比无统计学差异;联合治疗组在促进肝细胞增殖、降低肝细胞凋亡、分泌VEGF和HGF水平上与IL-1βsiRNA组或者MSC组相比均具有统计学差异;免疫组织化学及荧光显微镜显示联合治疗组存活MSC数量比MSC组明显增多,具有统计学差异.结论:IL-1βsiRNA能够有效降低ALF体内炎症反应,并通过提高移植MSC的存活增强其组织修复与再生的能力.两者联合应用具有更好的肝保护作用.     

自体骨髓间充质干细胞移植对实验性急性肝功能衰竭的治疗作用

目的: 探讨自体骨髓间充质干细胞(me s enchymalstem cells, MSCs)移植联合内科方法对急性肝功能衰竭动物的协同治疗作用.方法: 采用D-氨基半乳糖(D-Gal)诱导建立猪急性肝功能衰竭模型. 12只实验动物随机分为4组( n = 3), 联合治疗组: 诱导24 h后, 门静脉移植5×107自体MSCs, 每24 h自体血浆100mL、甘利欣100 mg滴注; 单纯内科治疗组: 诱导后每24 h自体血浆100 mL、甘利欣100 mg滴注; 单纯自体MSCs移植组: 诱导24 h后, 经门静脉移植5×107自体MSCs; 对照组: 除普通观察护理外, 不予以任何治疗. 以对照组存活时间为整个实验观察窗口, 观察家猪的肝脏功能及病理变化.结果: 对照组全部死亡后(存活44±3.5 h), 其他3组所有实验动物人为促死. 肝脏功能指标在联合治疗组、单纯内科治疗组及单纯MSCs移植组明显优于对照组( P<0.05), 联合治疗组比较单纯内科治疗组及单纯自体MSCs移植组有明显改善( P<0.05). 肝脏病理HE染色提示联合治疗组、单纯内科治疗组病理改变轻于其他组, 联合治疗组病理改变轻于内科治疗组, 单纯MSCs移植组与对照组比较无明显差异. 免疫组织化学显示联合治疗组肝脏细胞增殖率(34%)明显优于其他组, 单纯内科治疗组、单纯MSCs移植组及对照组无明显差异.结论: 单纯骨髓MSCs移植或者内科治疗急性肝功能衰竭有一定效果, 骨髓MSCs移植联合内科治疗具有一定协同作用, 可明显改善D-Gal诱导的急性肝衰竭家猪的肝脏指标, 促进肝组织及功能恢复.     

微囊化肝细胞移植对急性肝功能衰竭大鼠细胞因子的影响

目的 观察微囊化肝细胞移植对急性肝功能衰竭(ALF)大鼠脂多糖(LPS)、TNF-α、IL-1β和IL-6的影响.方法 用D-氨基半乳糖诱导大鼠ALF模型.造模后18 h,60只大鼠均分为模型组、裸肝细胞移植组和微囊化肝细胞移植组,72 h取血标本,检测血常规、Cr、肝功能、PT和血氨;鲎试剂检测LPS;ELISA法检测TNF-α、IL-1β和IL-6.多组比较采用单因素方差分析.结果 裸肝细胞移植组和微囊化肝细胞移植组大鼠Cr、肝功能、PT及血氨较模型组有明显改善(P<0.01),且微囊化肝细胞移植组较裸肝细胞移植组改善更明显,差异有统计学意义(P<0.01).裸肝细胞移植组和微囊化肝细胞移植组LPS为(1.2±0.3)和(0.5±0.1)ng/L,TNF-α为(27.7α4.2)和(21.7±3.2)μg/L,IL-1β为(298.7±13.9)和(247.7±14.1)ng/L,IL-6为(275.7±51.8)和(208.7±48.1)ng/L;模型组分别为(2.1±0.6)ng/L、(37.7±5.1)μg/L、(355.5±26.4)ng/L和(424.8±67.8)ng/L,裸肝细胞移植组LPS、TNF-α、IL-1β、IL-6与模型组比较,差异有统计学意义(F=6.24,F=67.3,F=8.38,F=7.59,均P<0.01);微囊化肝细胞移植组与模型组比较,差异亦有统计学意义(F=11.73,F=10.75,F=15.91,F=10.83,均P<0.01);微囊化肝细胞移植组与裸肝细胞移植组比较,差异亦有统计学意义(F=5.49,F=4.01,F=7.53,F=3.35,均P<0.01).结论 微囊化肝细胞移植可通过降低LPS、TNF-α、IL-1β及IL-6而发挥抗ALF的作用.     

急性肝衰竭大鼠高迁移率族蛋白B1的变化和意义

目的:比较高迁移率族蛋白B1(high mobility group protein B1,HMGB1)与其他炎症因子在急性肝衰竭(acute liver failure,ALF)大鼠肝组织和血清中出现时间及持续时间,探讨其来源及作用.方法:采用腹腔内注射D-氨基半乳糖(D-galactosamine,D-Gal)和脂多糖(lipopolysaccharide,LPS)制备大鼠ALF模型,以腹腔内注射生理盐水作为对照组.于注射后3、6、12、24、48、72 h检测血清中肝功能的变化,观察肝组织病理,实时荧光定量PCR检测肝组织中HMGB1、白介素1β(interleukin 1β,IL-1β)、IL-6、肿瘤坏死因子-α(tumor necrosis factor-α,T N F-α)m R N A变化,E L I S A法检测血清中HMGB1、IL-1β、IL-6、TNF-α水平变化,免疫组织化学检测肝组织中H M G B 1表达变化.使用重组高迁移率族蛋白B1(recombinant high mobility group protein 1,r HMGB1)单独尾静脉注射或联合D-G a l、L P S腹腔内注射,观察大鼠的一般情况并计算生存率.结果:采用D-Gal和LPS成功建立大鼠ALF模型.ALF大鼠肝组织中HMGB1 m RNA表达和血清中HMGB1水平高峰均较IL-1β、I L-6、T N F-α出现晚,但其高峰持续时间更长.D-Gal和LPS注射后的3 h,免疫组织化学可见肝细胞中HMGB1由细胞核转移到细胞质中;注射后24-48 h,肝脏正常组织结构消失,HMGB1蛋白自坏死的肝细胞被动释放.添加外源性r HMGB1使大鼠死亡时间提前,ALF大鼠在相同时间点死亡率升高.结论:大鼠ALF过程中HMGB1由坏死的肝细胞被动释放,其出现时间较其他炎症因子为晚.HMGB1与其他炎症因子相互作用,可能进一步促进ALF中的炎症反应.     

S期激酶相关蛋白2在急性肝功能衰竭大鼠肝组织中的表达

目的 探讨急性肝功能衰竭(ALF)大鼠S期激酶相关蛋白2(Skp2)表达变化及意义.方法 雄性SD大鼠256只,其中240只用D-氨基半乳糖溶液制备ALF模型.将大鼠分为ALF模型组、裸肝细胞移植组和微囊化肝细胞移植组,经腹腔分别注射RPMI 1640培养液、裸肝细胞悬液、微囊化肝细胞悬液各2 mL.另外6只作为健康对照组,另10只用于肝细胞分离.免疫组织化学法检测不同时间点大鼠肝细胞中Skp2蛋白的表达,全自动生化分析仪测定各组ALT、AST、TBil值,并观察各组生存率,多组样本间比较采用单因素方差分析.结果微囊化肝细胞腹腔移植可较裸肝细胞更好地降低ALF大鼠ALT、AST、TBil水平(P<0.05).造模36 h时,ALF模型组、裸肝细胞移植组和微囊化肝细胞移植组肝中Skp2-标记指数分别为(28.2±6.1)%、(41.4±10.5)%和(68.0±10.8)%(F=29.08,P<0.05),三组各15只大鼠168 h时各有4、6和11只存活.结论 动态观察Skp2表达可较好地判断ALF肝细胞的再生情况.     

Effect evaluation of interleukin-1 receptor antagonist nanoparticles for mesenchymal stem cell transplantation

AIM: To study the efficacy of marrow mesenchymal stem cells (MSCs) transplantation combined with interleukin-1 receptor antagonist (IL-1Ra) for acute liver failure (ALF). METHODS: Chinese experimental miniature swine were randomly divided into four groups (n = 7), and all animals were given D-galactosamine (D-gal) to induce ALF. Group A animals were then injected with 40 mL saline via the portal vein 24 h after D-gal induction;Group B animals were injected with 2 mg/kg IL-1Ra via the ear vein 18 h, 2 d and 4 d after D-gal induction; Group C received approximately 1 × 108 green fluorescence protein (GFP)-labeled MSCs (GFP-MSCs) suspended in 40 mL normal saline via the portal vein 24 h after D-gal induction; Group D animals were injected with 2 mg/kg IL-1Ra via the ear vein 18 h after D-gal induction, MSCs transplantation was then carried out at 24 h after D-gal induction, and finally 2 mg/kg IL-1Ra was injected via the ear vein 1 d and 3 d after surgery as before. Liver function, serum inflammatory parameters and pathological changes were measured and the fate of MSCs was determined.RESULTS: The optimal efficiency of transfection (97%) was achieved at an multiplicity of infection of 80, as observed by fluorescence microscopy and flow cytometry (FCM). Over 90% of GFP-MSCs were identified as CD44+ CD90+ CD45-MSCs by FCM, which indicated that most GFP-MSCs retained MSCs characteristics. Biochemical assays, the levels of serum inflammatory parameters and histological results in Group D all showed a significant improvement in liver injury compared with the other groups (P < 0.05). The number of GFP-MSCs in Group D was also greater than that in Group B, and the long-term cell proliferation rate was also better in Group D than in the other groups.CONCLUSION: MSCs transplantation is useful in ALF, IL-1Ra plays an important role in alleviating the inflammatory condition, and combination therapy with MSCs transplantation and IL-1Ra is a promising treatment for ALF.     

猪急性肝衰竭模型的建立及猪纤维介素的表达

目的 建立一个模拟人类疾病进程的猪急性肝衰竭(ALF)模型,用于ALF治疗药物的临床前安全性评价及疗效评价,检测模型中猪纤维介素(pfg12)的表达情况,为针对fg12的基因治疗提供基础和依据. 方法造模组耳静脉快速注射D-氨基半乳糖盐酸盐,剂量1.2 g/kg;对照组耳静脉快速注射5%的葡萄糖,剂量12 ml/kg.观察两组动物临床表现,肝功能指标和肝组织病理学改变,实时定量PCR检测肝组织中pfg12 mRNA表达,免疫组织化学检测肝组织中pfg12蛋白的表达.采用重复测量数据的方差分析和独立样本t检验进行统计学处理.结果 成功建立了与人在临床表现、肝脏生物化学指标、组织病理学改变相似的猪ALF模型;实时定量PCR检测结果显示造模组猪肝组织中pfg12的mRNA表达水平显著增加,与对照组比较,差异具有统计学意义(t=7.695,P＜0.05).免疫组织化学显示造模组猪肝组织中有明显的pfg12蛋白的表达,主要分布在肝细胞坏死区域的肝细胞、炎症浸润细胞、肝血窦内皮细胞及血管内皮细胞,对照组动物肝组织未见pfg12阳性着色.结论 以D-氨基半乳糖盐酸盐诱导的猪ALF模型可用于评价肝衰竭治疗药物的临床前疗效及安全性;pfg12在猪ALF动物模型的肝组织中异常高表达,提示其参与了ALF时肝细胞坏死的发生和发展过程.     

猪急性肝衰竭模型的建立及猪纤维介素的表达

目的 建立一个模拟人类疾病进程的猪急性肝衰竭(ALF)模型,用于ALF治疗药物的临床前安全性评价及疗效评价,检测模型中猪纤维介素(pfg12)的表达情况,为针对fg12的基因治疗提供基础和依据. 方法造模组耳静脉快速注射D-氨基半乳糖盐酸盐,剂量1.2 g/kg;对照组耳静脉快速注射5%的葡萄糖,剂量12 ml/kg.观察两组动物临床表现,肝功能指标和肝组织病理学改变,实时定量PCR检测肝组织中pfg12 mRNA表达,免疫组织化学检测肝组织中pfg12蛋白的表达.采用重复测量数据的方差分析和独立样本t检验进行统计学处理.结果 成功建立了与人在临床表现、肝脏生物化学指标、组织病理学改变相似的猪ALF模型;实时定量PCR检测结果显示造模组猪肝组织中pfg12的mRNA表达水平显著增加,与对照组比较,差异具有统计学意义(t=7.695,P＜0.05).免疫组织化学显示造模组猪肝组织中有明显的pfg12蛋白的表达,主要分布在肝细胞坏死区域的肝细胞、炎症浸润细胞、肝血窦内皮细胞及血管内皮细胞,对照组动物肝组织未见pfg12阳性着色.结论 以D-氨基半乳糖盐酸盐诱导的猪ALF模型可用于评价肝衰竭治疗药物的临床前疗效及安全性;pfg12在猪ALF动物模型的肝组织中异常高表达,提示其参与了ALF时肝细胞坏死的发生和发展过程.     

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.