环孢霉素A治疗狼疮性肾炎对血尿可溶性白介素2受体的影响

本文观察环孢霉素（ＣｓＡ）治疗１６例重症ＬＮ患者，对血尿可溶性白介素２受体（ＳＩＬ－２Ｒ）及外周血Ｔ淋巴细胞亚群（ＣＤ４＋／ＣＤ８＋细胞）的影响。结果ＣｓＡ治疗后，ＬＮ患者血尿ＳＩＬ－２Ｒ均有明显下降（Ｐ＜０．０１），外周血ＣＤ４＋细胞亦有下降趋势；同时伴有血清免疫学异常及临床肾损害的明显改善。本文提示ＳＩＬ－２Ｒ可作为ＬＮ活动度的一项敏感指标；ＣｓＡ可能通过抑制Ｔ淋巴细胞活性，减少被激活的淋巴细胞释放ＳＩＬ－２Ｒ，从而取得治疗ＬＮ的良好疗效。     

再生障碍性血患者白细胞介素－2与T细胞亚群的检测及意义探讨

本文检测了１７例再障患者外周血淋巴细胞经植物血凝素（ＰＨＡ）刺激后白细胞介素２（ＩＬ－２）的活性水平及Ｔ细胞亚群。结果：再障患者白细胞介素２的活性水平明显高于正常对照（Ｐ＜０．０１），Ｔ＿８明显增高，Ｔ＿４／Ｔ＿８比值倒置，ＩＬ－２活性水平与Ｔ＿８成正相关。表明再障患者Ｔ淋巴细胞及淋巴因子网络失衡，与再障的发病有关。     

老慢支患者T细胞亚群和sIL—2R的变化及意义

目的探讨老年慢性支气管炎（老慢支）患者外周血Ｔ细胞亚群和血清可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）的变化及意义。方法采用抗体致敏的红细胞花环法测定外周血Ｔ细胞亚群，用双抗体夹心法测定血清ｓＩＬ－２Ｒ。结果老慢支患者Ｔ细胞亚群ＣＤ４明显减少，ＣＤ８明显增多，ＣＤ４／ＣＤ８比值降低，与对照组比较均有显著性意义（Ｐ＜０．００１），而ｓＩＬ－２Ｒ水平较对照组显著增高（Ｐ＜０．００１），且与Ｔ细胞亚群ＣＤ４、ＣＤ４／ＣＤ８成负相关，与ＣＤ８成正相关，尤其以急性发作期改变最为显著。结论老慢支病程中出现某些不同程度的免疫调节紊乱，同时，本研究揭示Ｔ细胞亚群和ｓＩＬ－２Ｒ的改变可作为老慢支患者病情变化和预后判断的指标之一。     

结核病白细胞介素2受体测定和T细胞亚群分析的临床意义

采用间接酶联免疫吸附（ＥＬＩＳＡ）法检测了３９例浸润型肺结核患者的血清和尿液可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）浓度，用单克隆抗体间接免疫荧光法检测了其Ｔ细胞亚群；并与２８例健康人作正常对照。结果显示：①结核病活动期组血清及尿液ＳＩＬ－２Ｒ浓度明显高于康复期组（Ｐ＜０．０５）和对照组（Ｐ＜０．０５），而结核病康复期组血清及尿液ＳＩＬ－２Ｒ浓度与对照组间差异无显著意义（Ｐ＞０．０５）。②结核病活动期组尿液与血清ＳＩＬ－２Ｒ浓度呈正相关（Ｐ＜０．０１）。③结核病活动期组ＣＤ＋４Ｔ细胞数及ＣＤ＋４／ＣＤ＋８Ｔ细胞比值明显低于康复期组和对照组（Ｐ均＜０．０１）。提示结核病活动期患者Ｔ细胞免疫应答能力降低，ＳＩＬ－２Ｒ浓度升高可作为结核病活动期指标之一。     

乙型肝炎患者外周血T细胞亚群和可溶性IL_2R的研究

目的探讨急慢性乙型肝炎患者外周血Ｔ细胞亚群及可溶性ＩＬ＿２Ｒ水平的变化，为诊断病情演变和预后判定寻找可靠的依据．方法应用ＡＰＡＡＰ桥联酶标法和双抗体夹心ＥＬＩＳＡ法检测正常人３０例和各型乙型肝炎患者１７５例的Ｔ细胞亚群变化和血清可溶性ＩＬ＿２Ｒ（ｓＩＬ＿２Ｒ）水平．结果各组乙肝患者ＣＤ３，ＣＤ４，ＣＤ４／ＣＤ８比值明显降低，ＣＤ８则明显升高．乙肝患者血清ｓＩＬ＿２Ｒ水平均显著升高，其中慢重肝、肝硬变、急性乙肝和慢性肝炎增高最为显著，与正常对照组相比Ｐ均＜００１，且与ＨＢＶ复制有关．结论乙型肝炎患者存在Ｔ细胞比例失衡，血清ｓＩＬ＿２Ｒ水平均明显增高，其水平与机体免疫功能状态及肝细胞损伤程度相关．     

乙型慢性活动性肝炎患者外周血淋巴细胞亚群白细胞介素一2受体的初探

应用间接免疫荧光法，放射免疫分析法，微量细胞培养法及斑点杂交技术，检测了２７例乙型慢性活动性肝炎（ＣＡＨ一Ｂ）患者及７例正常对照者ＣＤ＋４、ＣＤ＋８及Ｂ细胞膜上白细胞介素一２受体（ｍＩＬ－２Ｒ，ＣＤ２５抗原为其β链），各亚群细胞培养上清及病人同期血清中可溶性白细胞介素一２受体（ｓＩＬ－２Ｒ），ＣＤ＋４细胞培养上清中ＩＬ一２活性。结果：ＣＡＨ－Ｂ病人外周血ＣＤ２５抗原阳性的ＣＤ＋４、ＣＤ＋８细胞及Ｂ细胞较正常对照者减少，且ＣＤ２５抗原阳性的ＣＤ＋４、ＣＤ＋８细胞减少较Ｂ细胞明显；ＣＤ＋细胞培养上清中ＩＬ一２活性较正常人降低，并与病情的轻重、ＣＤ＋４细胞ｍＩＬ一２Ｒ的表达呈正相关；ＣＡＨ－Ｂ病人血清ｓＩＬ－２Ｒ增高，但培养上清ｓＩＬ－２Ｒ与正常对照无显著性差异。结果提示：ＣＡＨ一Ｂ病人外周血ＣＤ＋４、ＣＤ＋８及Ｂ细胞ｍＩＬ－２Ｒ表达均减弱；ＣＡＨ－Ｂ病人体内Ｔ细胞免疫应答功能受损可能较Ｂ细胞受损明显；ＣＡＨ－Ｂ病人体内ＩＬ一２产生水平低下与病情轻重有某种关联；ＣＡＨ一Ｂ患者血清中增高的ｓＩＬ一２Ｒ可能来自肝内浸润的免疫活性细胞ｍＩＬ－２Ｒβ链脱落。     

人囊虫病T淋巴细胞亚群及血清IgE的变化

应用直接ＳＰＡ菌花环法对２７例囊虫病患者外周血Ｔ淋巴细胞亚群进行检测，同时用ＥＬＩＳＡ法测定血清ＩｇＥ水平。发现患者ＣＤ３＋，ＣＤ４＋细胞的百分率明显降低，ＣＤ４／ＣＤ８比值明显下降，血清ＩｇＥ含量显著升高。经分析，患者ＣＤ４细胞、ＣＤ４／ＣＤ８比值与ＩｇＥ对数值呈负相关。揭示囊虫病患者Ｔ细胞亚群比例失调，免疫功能紊乱。本文对可能的免疫调节机制和发病机理进行了探讨。     

强直性脊柱炎患者外周血Th1／Th2淋巴细胞类型

目的 通过检测强直性脊柱炎患者外周血中ＣＤ４＾＋和ＣＤ８＾＋Ｔ淋巴细胞分泌细胞因子的情况,探讨Ｔ淋巴细胞亚群与强直性脊柱炎发病的关系。方法 建立三色流式细胞分析法对强直性脊柱炎患者和健康志愿者外周血中淋巴细胞的胞内细胞因子（ＩＦＮγ、ＩＬ－４）和表面抗原（ＣＤ４、ＣＤ８）进行分析。同时采用夹心酶联免疫吸附法测定血清中ＩＦＮγ和ＩＬ－４的水平。结果 无论是ＣＤ４＾＋还是ＣＤ８＾＋ＡＴ淋巴细胞,分泌Ｉ     

HBV感染与肝癌患者血清可溶性IL—2受体及T淋巴细胞亚群的变化及意义

用ＥＬＩＳＡ及ＡＰＡＡＰ法分别检测了３９例乙型肝炎病毒（ＨＢＶ）感染者、１５例者ＨＢＶ感染的肝癌患者及２０例正常人的血清可溶性白细胞介素－２受体（ＳＩＬ－２Ｒ）和外周血Ｔ淋巴细胞亚群结果显示,肝癌及ＨＢＶ感染者（Ｐ〈０．０１）。吕患者及ＨＢＶ感染者ＣＤ３、ＣＤ４、ＣＤ８、ＣＤ４／ＣＤ８与对照相比均有显著差异（Ｐ〈０．０５）,而肝癌与ＨＢＶ感染者相比无显著差异（Ｐ〉０．０５）。提示ＨＢＶ感染者及肝癌     

肝硬化和肝细胞癌患者血清IL-2、sIL-2R、IL-6、T细胞亚群的变化及相互关系

目的研究肝硬化和肝细胞癌患者ＩＬ－２、ｓＩＬ－２Ｒ、ＩＬ－６、Ｔ细胞亚群的变化和相互关系。方法分别采用双抗体夹心ＥＬＩＳＡ法、ＡＢＳ－ＥＬＩＳＡ法和红细胞花环实验,对４６例肝炎肝硬化和肝癌进行了ＩＬ－２、ＩＬ－６、ｓＩＬ－２Ｒ和Ｔ细胞亚群的测定,并与６６例健康献血员进行了对照。结果肝炎肝硬化（ＬＣ）、肝细胞癌（ＨＣＣ）患者血清ＩＬ－２、ＣＤ＋４／ＣＤ＋８水平明显低于正常对照（ＮＣ）组（Ｐ＜００１）,而ＩＬ－６、ｓＩＬ－２Ｒ水平明显升高,ＨＣＣ组的平均ＩＬ－６水平高出正常１０倍以上,较肝硬化组明显升高（Ｐ＜００１）。在肝炎肝硬化和肝癌患者均发现ＩＬ－２与ＣＤ＋４／ＣＤ＋８比值、ＩＬ－６与ｓＩＬ－２Ｒ正相关,ＩＬ－６与ＣＤ＋４／ＣＤ＋８比值显著负相关,而与ＩＬ－２无相关关系。结论肝炎肝硬化和肝细胞癌患者存在免疫功能紊乱和低下、淋巴因子网络失衡,这与其病理生理机制有关,也为临床上ＬＣ、ＨＣＣ应用ＩＬ－２治疗提供了理论依据。ＩＬ－６的显著增高有助于ＨＣＣ的早期诊断     

乙肝病人T细胞亚群、mIL-2R的变化及意义

目的检测乙型病毒性肝炎病人外周血T细胞亚群和膜白介素-2受体(mIL—2R)表达水平并探讨其在乙肝发病机制中的作用。方法采用生物素-链霉亲和素法对188例乙肝病人外周血单个核细胞(PBMC)进行T细胞亚群及植物血凝素(PHA)诱导前后mIL—2R水平测定。结果乙肝病人T淋巴细胞亚群中CD3~+、CD4~+降低,CD8~+升高,CD4~+/CD8~+比值降低,外周血单个核细胞mIL—2R表达水平在PHA诱导前后均降低,与正常对照相比,差异有显著意义(P<0.01);另外,乙肝病人PBMC中HBV—DNA(+)病人与PBMC内HBV—DNA(-)病人相比,mIL—2R表达水平亦存在较大差异(P<0.01)。结论乙肝病人体内存在明显的细胞免疫功能紊乱,T细胞活化障碍,并与肝病的慢性化相关。     

Study on T-lymphocyte culture and function of T-lymphocyte subsets in patients with aplastic anemia]

T-lymphocytes form the peripheral blood of 12 patients with aplastic anemia (AA) and 4 patients with aplastic anaemia-paroxysmal hemoglobinuria syndrome (AA-PNH) were cultivated and their subsets were measured by monoclonal antibodies CD4, CD8, CD25 with indirect immunofluorescence technique. Change of the proportion of T-lymphocyte subsets was observed in 5 patients with AA after the mononuclear cells were activated with phytohemagglutinin (PHA). Its was shown that the number of CFU-T of the patients with AA was apparently decreased in comparison with that of normal controls (P less than 0.05). Disorder of T-lymphocyte subsets took place in patients with AA. The percentages of CD8 and CD25 lymphocytes were increased. The helper: suppressor T-lymphocytes (CD4:CD8) ratio was significantly increased (P less than 0.01). In the cases of AA-PNH, the number of CFU-T was significantly increased (P less than 0.01) and that of T-lymphocyte subsets did not change. The ratio of CD4/CD8 in 5 patients with AA was further decreased after activating mononuclear cells with PHA. These results showed that the increase of T-lymphocytes in patients with AA may account for the low level of CFU-T; the high level of CFU-T in patients with AA-PNH may be related to the multiplication of bone marrow cells. However, there may be a potential disorder of immune system on patients with AA at the same time.     

支气管哮喘患者痰白细胞介素16的测定及其意义

目的探讨白细胞介素１６（ＩＬ１６）在支气管哮喘发病机制中的作用。方法收集１２例过敏性哮喘患者、８例非过敏性哮喘患者、１０例过敏性体质患者和１０名正常对照者的痰液,以酶联免疫吸附测定法测定痰中ＩＬ１６的含量,并以免疫染色技术检测ＣＤ＋４细胞和活化嗜酸细胞（ＥＧ２细胞）数。结果哮喘患者无论是过敏性还是非过敏性,痰液中ＩＬ１６水平与过敏体质但无哮喘的患者和正常组比较,差异有显著性（Ｐ＜０．０１）。急性发作期哮喘患者经治疗后ＩＬ１６水平能达缓解期水平。此外,痰液中ＣＤ＋４细胞和ＩＬ１６水平比较呈显著正相关（ｒ＝０．７６,Ｐ＜０．０１）,痰液中ＥＧ２细胞数与ＩＬ１６水平呈显著正相关（ｒ＝０．６１,Ｐ＜０．０１）。结论ＩＬ１６参与了哮喘的发病过程,其机制可能是通过募集ＣＤ＋４Ｔ细胞从而在ＣＤ＋４Ｔ细胞所介导的哮喘气道嗜酸细胞炎症反应中发挥作用。     

Poor responses to recombinant HBV vaccination in patients with HIV infection.

The study was conducted with an aim to assess the efficacy of recombinant HBV vaccination in untreated HBV seronegative HIV/AIDS subjects as compared to normal controls. The second objective was to identify differences in CD4 and CD8 T cell numbers/kinetics/functions and levels of TH2 cytokines (IL4 and IL10) in different groups during the three-dose vaccination regimen. 40 HIV/AIDS patients were subdivided into groups 1A where patients had a high CD4 (> 200/mm3) count and IB where patients had a low CD4 (< 200/mm3) count. Twenty normal healthy control subjects were also recruited in the study (group II). Patients received 40 micro and controls received 20 micro of recombinant HBV vaccine in each dose. All subjects received 3 doses of the vaccine. Detection of CD4 and CD8 cells was done by flowcytometry. TH2 type of cytokines IL4 and IL10 were estimated in the culture supernatant of PHA stimulated leukocyte rich plasma by sandwich ELISA. Anti-HBs levels were estimated in the serum by ELISA. Anti-HBs response was severely compromised in patients as compared to controls. Groups II, 1A and 1B showed titers of 16906 +/- 21303, 8834 +/- 14136 and 462 +/- 814 m/U/m/ respectively. Both CD4 and CD8 cells increased significantly after vaccination in all the groups irrespective of the disease status. On the other hand, IL4/IL10 responses to PHA stimulation in the HIV-positive groups were much lower than in controls (P< 0.1). Despite a double dose of vaccine in patients, the antibody response was significantly lower which correlated with a lower CD4 count. Cytokines IL4 and IL10 which regulate antibody response, were also lower in-patients and this together with a low CD4 count possibly accounted for the low anti-HBs levels. All patients with high CD4 lymphocyte count were responders while only 47% of patients with low CD4 lymphocyte count responded to immunization. Patients with a CD4 count of less than 50 failed to respond. Thus early immunization is advocated in all HIV patients at a stage when they are still capable of mounting an adequate immune response.     

Flow cytometric analysis of gut mucosal lymphocytes supports an impaired Th1 cytokine profile in spondyloarthropathy

OBJECTIVE: To quantify the fraction of gut mucosal lymphocytes expressing the T helper type 1 (Th1) cytokines, interferon gamma (IFNgamma) and interleukin (IL)2, and the Th2 cytokines, IL4 and IL10, at the single cell level in patients with spondyloarthropathy (SpA) in comparison with healthy controls. METHODS: An improved extraction protocol was used for the enrichment of intraepithelial lymphocytes (IELs) and lamina propria lymphocytes (LPLs) from colonic and ileal biopsy specimens obtained from patients with SpA (n=20) and healthy controls (n=13). After stimulation with phorbol ester/ionomycin, expression of the intracellular cytokines IFNgamma, IL2, IL4, and IL10 was determined in CD3+, CD3+CD8+ and CD3+CD8- T cells by flow cytometry. RESULTS: In colonic LPLs, a significant decrease in IFNgamma-producing CD3+ cells was observed (p=0.02) in patients with SpA. In the CD3+CD8- subset, the proportion of cells producing IFNgamma and IL2 was decreased in patients with SpA (p=0.021 and p=0.027 respectively). In ileal LPLs, the percentage of IL10-producing CD3+CD8- cells was significantly increased (p=0.046). CONCLUSION: An impaired Th1 cytokine profile is observed in gut mucosal lymphocytes from patients with SpA. This adds to the existing evidence that the gut mucosal immune apparatus is involved in the pathogenesis of SpA.     

Impaired Th1 cytokine production in spondyloarthropathy is restored by anti-TNFα

OBJECTIVES: To evaluate the effect of anti-TNFalpha on the Th1 and Th2 cytokines in patients with spondyloarthropathy (SpA). METHODS: Peripheral blood mononuclear cells (PBMC) were obtained from 20 patients with active SpA treated with infliximab (5 mg/kg). For comparison, PBMC were also obtained from 15 healthy controls and 19 patients with active rheumatoid arthritis (RA). After stimulation with PMA/ionomycin, the intracellular cytokines interleukin (IL)2, IL4, IL10, and interferon (IFN)gamma were determined in CD3+ T cells and in CD3+/CD56+ natural killer (NK) T cells by flow cytometry. RESULTS: At baseline the percentage of T cells positive for IFNgamma (p=0.020) and IL2 (p=0.046) was decreased in patients with SpA compared with healthy controls, while IL10 (p=0.001) was increased. This cytokine profile, confirmed by the mean fluorescence intensities (MFI), was more pronounced in CD3+/CD8- cells and contrasted with higher IL2 production in RA. NK T cells, characterised by high IL4 and IL10 numbers, were also increased in patients with SpA (p=0.017). Treatment with infliximab induced a significant and persistent increase in IFNgamma and IL2 in patients with SpA. Moreover, there was a transient decrease in IL10 and NK T cells in patients with high baseline values, resulting in values comparable with those of healthy controls. This switch in cytokine profile was seen in both the CD3+/CD8- and CD3+/CD8+ subsets. CONCLUSIONS: Before treatment patients with SpA had an impaired Th1 cytokine profile compared with healthy controls and patients with RA. TNFalpha blockade induced restoration of the Th1 cytokines, resulting in a normal cytokine balance. These data confirm the effect of anti-TNFalpha on the immune changes in SpA, and provide insights into the mechanisms involved in TNFalpha blockade.     

Detection of T lymphocyte subsets and mIL-2R on surface of PBMC in patients with hepatitis B

AIM: To study the levels of T lymphocyte subsets andmembrane interleukin-2 receptor (mIL-2R) on surface ofperipheral blood mononuclear cells (PBMCs) of patients withhepatitis B and its role in the pathogenesis of hepatitis B.METHODS: The levels of T lymphocyte subsets and mIL-2R in PBMC before and after being stimulated with PHAwere detected by biotin-streptavidin (BSA) technique in 196cases of hepatitis B.RESULTS: In patients with hepatitis B, the levels of CD3+,CD4+ cells, and the ratio of CD4+ cells/CD8+ cells were lower,but the level of CD8+ cells was higher than those in normalcontrols (42.20±6.01 vs65.96±6.54, 38.17±5.93 vs41.73±6.40,0.91±0.28 vs 1.44±0.31, 39.86±6.36 vs30.02±-4.54, P＜0.01).The total expression level of mIL-2R in PBMC before andafter being stimulated with PHA was also lower than thosein normal controls (3.47±1.55 vs4.52±1.49, 34.03±2.94 vs37.95±3.00, P＜0.01). In all the patients with hepatitis B, thelevels of T lymphocyte subsets and mIL-2R in PBMC withHBV-DNA (+) were lower than those with HBV-DNA (-),which were significantly different (39.57±7.11 vs44.36±5.43,34.36±7.16 vs 40.75±5.87, 37.82±6.54 vs 41.72±6.21,0.88±0.33 vs0.99±0.27, 2.82±1.62 vs3.85±1.47, 31.56±3.00vs35.84±2.83, P＜0.01). In addition, the levels of CD3+, CD4+,CD8+ cells, the ratio of CD4+ cells/CD8+ cells and mIL-2R amongdifferent courses of hepatitis B were all significantly different(F=3 723.18, P＜0.01. F=130.43, P＜0.01. F=54.01, P＜0.01.F=2.99, P＜0.05. F=7.16, P＜0.01).CONCLUSION: Both cellular and humoral immune functionsare obviously in disorder in patients with hepatitis B, whichmight be closely associated with the chronicity in patients.     

AECOPD外周血CD3＋、CD4＋、CD8＋及CD16＋56＋细胞表达变化及胸腺五肽的干预作用

目的 探讨慢性阻塞性肺疾病急性加重期（AECOPD）患者外周血CD3＋、CD4＋、CD8＋及CD16＋ 56＋细胞的表达变化及胸腺五肽的干预作用.方法 用流式细胞术分别检测AECOPD患者21例胸腺五肽干预治疗前、后和健康人对照组20例外周血CD3＋、CD4＋、CD8＋T细胞和CD16＋ 56＋ （NK）细胞的百分率,比较AECOPD患者与对照组、AECOPD患者胸腺五肽干预前、后淋巴细胞亚群的变化.结果 AECOPD患者与对照组比较,血清CD3＋、CD4＋、CD16＋ 56＋百分率、CD4＋/CD8＋明显降低,差异有统计学意义（P＜0.05）;胸腺五肽干预后与干预前比较,血清CD3＋、CD4＋、CD16＋ 56＋及CD4＋/CD8＋比值明显升高,差异有统计学意义（P＜0.05）.结论 AECOPD患者机体存在细胞免疫功能紊乱,胸腺五肽干预可提高患者免疫功能.