肾移植患者肿瘤坏死因子-α动态检测的临床意义

目的 :动态观察肾移植患者肿瘤坏死因子 -α(TNF -α)水平的变化 ,探讨TNF -α对肾移植预后的意义。方法 :采用放射免疫分析检测 4 5例肾移植患者术前及术后两天血清及尿液中TNF -α的水平 ,并与 4 5例正常对照者进行对比分析。对 33例术后稳定者 ,动态检测术后 2d、7d、14d、2 1d及 2 8d血清及尿液中TNF -α的水平。结果 :术前组、术后稳定组、术后排斥组、CsA中毒组血清TNF -α水平均显著高于正常对照组 (P <0 0 1) ,术后排斥组显著高于术前组及术后其他各组 (P <0 0 1) ;术前组和术后稳定组尿液TNF -α水平均显著高于正常对照组 (P <0 0 1) ,术后排斥组尿液TNF -α水平高于正常对照组 (P <0 0 5 ) ,术后两天排斥组与稳定组间尿液TNF -α水平无显著性差异 (P >0 0 5 )。 33例肾移植术后稳定者血清TNF -α水平术后 7天开始下降 ,至 2 1天时已降至与正常对照组无显著性差异 (P >0 0 5 ) ;尿液TNF -α水平下降较血清快 ,术后 7天即降至与正常对照组无显著性差异 (P >0 0 5 )。结论 :动态检测TNF -α水平可作为观察肾移植患者排斥反应的一项重要指标。     

伤寒患者血浆肿瘤坏死因子水平的观察

本文对伤寒患者血浆中TNF水平进行观察,现将结果报道如下。 对象和方法 一、对象: (一)正常人:35人。均为我院门诊体检合格的健康人,无心、肝、肺、肾等重要脏器疾患,肝、肾功能试验正常。 (二)伤寒组:32人。均为临床上明确诊断的病人,包括临床体征、血清肥达氏反应、血和粪便培养等。 二,方法:TNF RIA kit由中国人民解放军东亚免疫试剂研究所提供,操作按说明书。 结果 一、伤寒患者血浆中TNF浓度与正常人比较见表1。 二、伤寒患者病情轻重与恢复期和正常人TNF浓度测定结果见表2。 讨论 本文测定伤寒患者血浆中TNF浓度显著地高於正常人(p<0.01),重型病人含量尤甚。至恢复期虽然TNF含量有所下降,但与正常人比较,仍有显著差异(p<0.01),何时能恢复达到正常人水平,尚待进一步地观察研究。 至於伤寒患者血浆中TNF升高的机理,我们初步认为伤寒产生的内毒素可刺激单核吞噬细胞、肝脏枯否细胞等产生TNF,而内毒素血症在伤寒的发病机制中起着举足轻重的作用,因此,我们观察到重型患者TNF水平尤为升高,这很可能与内毒素血症     

人工晶体植入围手术期血浆内皮素,肿瘤坏死因子α测定的临床意义

探讨血浆内皮素－１、肿瘤坏死因子α在人工晶体植入术后动态变化的临床意义。；方法：对２４例白内障囊外摘除后房型人工晶体植入术后患者及２０名健康对照组进行血浆ＥＴ－１、ＩＮＦα测定，检测方法为放射免疫测定。     

肾移植术后检测可溶性白介素2受体和肿瘤坏死因子的临床意义

本文用ＥＬＩＳＡ和放射免疫分析检测了５７例肾移植患者血清中可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）和肿瘤坏死因子（ＴＮＦ）水平。患者术前ｓＩＬ－２Ｒ和ＴＮＦ明显高于正常对照组，术后两者都逐渐下降，排斥反应时升高，排斥组无排斥组差异显著。ＣｓＡ中毒组与无排斥组无明显差异，因此ｓＩＬ－２Ｒ和ＴＮＦ水平监测也可区别ＣｓＡ中毒和排斥反应。动态检测ｓＩＬ－２Ｒ和ＴＮＦ水平可作为肾移植后判断疗效和预后的重要观察     

肾移植术后动态监测细胞因子的临床意义

目的：探讨TNF-a、IL-6在肾移植术后急性排斥反应、感染、GsA中毒时的变化。方法：采用ELISA法,动态监测106例患者移植前后血清TNF-a、IL-6豚尿液TNF-a。结果：肾移植术前TNF-a、IL-6与对照组无显著性差别,术后第1天明显升高,TNF-a与IL-6分别于1w及2w左右降至术前水平。急性排斥反应前1～3d血清TNF-a、IL-6及尿液TNF-a即有不同程度升高 ,抗排斥治疗有效后迅速下降。并发感染时血清TNF-a、IL-6显著升高,尿液TNF-a无升高,CsA中毒时均无明显变化。结论：结合临床动态监测血清TNF-a、IL-6及尿TNF-a可做为辅助诊断急性排斥反应的免疫生物学指标。     

肿瘤坏死因子与急性心肌梗塞关系的探讨

肿瘤坏死因子α(TNFα)是由激活的巨噬细胞分泌的一种具有多种生物学效应的细胞因子,它参与介导人体多种疾病的发生和发展,最近研究发明,TNFα与急性心肌梗塞(AMI)的发生、发展及转归有关。本文通过动态观察AMI患者血清TNFα水平,以探讨TNFα与AMI的关系。     

肿瘤坏死因子α转化酶的性质及其作用

体内成熟的TNF为 17KD ,其由 2 6KD之前体蛋白在Ala76 ～Val77之间断裂产生 ,催化此过程的酶称为肿瘤坏死因子α转化酶 (TumorNecrosisFactorαConvertingEnzyme ,TACE) ,其确切性质及作用意义 ,目前尚未完全明了 ,本文就此作一简要综述。     

急性白血病患者血浆肿瘤坏死因子及抑制物

利用ＴＮＦ细胞毒生物学活性检测法和ＴＮＦ抑制物生物活性检测法，检测２２例初治急性白血病体内ＴＮＦ和ＴＮＦＩＮＨ水平。急性白血病患血浆ＴＮＦ水平明显增高。达１１．４２±６．０２ｕ／ｍｌ。抗人ＴＮＦａ单抗能完全中和Ｍ４，Ｍ５，Ｍ６型急性非淋巴细胞白血病患血浆ＴＮＦ活性。部分患血浆中同时存在ＴＮＦ和ＴＮＦＩＮＨ。ＴＮＦ阴性的患血浆中亦单独存在ＴＮＦＩＮＨ活性，和正常人相比明显增高，其对ｔｈＴＮＦ     

麻风患者血浆肿瘤坏死因子水平的观察

肿瘤坏死因子(TNF)是免疫调节系统中的一个重要细胞因子。国内外对其生物学特性、基因结构、功能、临床应用以及与疾病的关系已进行了深入的研究。有关麻风患者血浆中肿瘤坏死因子水平国内尚未见有报道。为此，我们进行了探讨，现报告如下。     

穿孔素和T细胞内抗原-1在移植肾组织中的表达及临床意义

目的 探讨移植肾组织穿孔素(perforin,P)和T细胞内抗原-1(T cell intracellular antigen-1,TIA-1)的表达及临床意义. 方法 为查找肾丧失功能的原因取42例移植肾及对照组织标本,采用竞争性PCR技术定量检测P和TIA-1mRNA水平,通过β-actin对检测结果进行校正,并与组织病理学诊断比较分析. 结果 急性排斥组、慢性排斥组和无排斥组P的检出例数分别为14、13和7例,TIA-1分别为14、10和3例;急性排斥组P和TIA-1 mRNA水平明显高于慢性排斥组(P＜0.05)和无排斥组(P＜0.05),慢性排斥组和无排斥组间P的表达亦有显著差异;急性排斥组P和TIA-1mRNA水平与组织学积分有关;二者表达综合分析判断移植肾急性排斥敏感度为96%,特异度为72%. 结论 移植肾组织P和TIA-1 mRNA水平的上调与移植肾急性排斥有关,这一结果可能有助于急性排斥的早期预测.     

类风湿关节炎患者血清sTNF—R、TNF—α的变化

目的为探讨类风湿关节炎 (RA)与可溶性肿瘤坏死因子受体 (s TNF- R)、TNF- α、TNF- α/ s TNF- R比值的关系。方法应用双抗体夹心 EL ISA法检测了活动期 RA(2 8例 ) ,稳定期 RA (12例 )及健康人 (30例 )血清中 s TNF- R 、s TNF- R 、TNF-α的水平。结果活动期 RA患者血清 s TNF- R 、s TNF- R 、TNF-α水平明显高于健康人及稳定期 RA组 ,P均 <0 .0 1。稳定期 RA患者血清 s TNF- R 、s TNF- R 、TNF-α水平亦明显高于健康人 ,P<0 .0 1。在 RA患者中 ,血清 s TNF- R 、s TNF- R 水平与 ESR、CRP、Ritchie index呈显著正相关 ,与类风湿因子 (RF)水平无相关性。RA患者治疗 3个月后 s TNF- R 、s TNF- R 及 TNF- α/ s TNF R比值显著下降。结论 RA患者血清 s TNF- R 、s TNFR- 水平显著增高 ,且与疾病活动度呈正相关。测定血清 s TNF- R 、s TNF- R 、TNF- α/ s TNF- R水平可作为 RA诊断 ,监测疾病活动、治疗及判断预后的一项有意义的实验室指标     

Significance of tumor necrosis factor microsatellite polymorphism in renal transplantation

Plasma levels of tumor necrosis factor (TNF) α are raised during acute rejection following organ transplantation. Variations in TNF á production have been found to be associated with the polymorphism of TNF microsatellite. Therefore, there is a possibility that a transplant recipient with some type of TNF microsatellite can be a high-risk patient of graft rejection. The purpose of this study was to examine whether TNF microsatellite polymorphism is related to acute allograft rejection. We investigated the relation of two microsatellites, TNFa and TNFd, to acute rejection after renal transplantation. Among 189 primary living-related renal transplantations from one haplotype-mismatched and one DRBI-mismatched donor, we analyzed TNF microsatellites of 163 patients whose DNA were available to this study. The frequency of the TNFa9 microsatellite allele was significantly higher in the rejection group compared to the rejection-free group. In contrast, the frequency of TNFd4 was significantly lower in the rejection group compared to the rejection-free group. TNFa9 and TNFd4 showed strong associations with HLA-B35 and B44, respectively. However, the TNF microsatellite locus was more closely related to acute rejection than HLA-B. It was suggested that the analysis of TNF microsatellite polymorphism can provide useful information in predicting prognosis after transplantation.     

Serum levels of the soluble receptor for tumor necrosis factor in patients with renal disease

Tumor necrosis factor- (TNF-) has been found to be elevated in patients during hemodialysis and is thought to mediate some of the immune and metabolic dysfunctions in these patients. It has been speculated that infusions of soluble TNF receptor (sTNF-R) may prevent some of the cytotoxic effects of TNF. However, little is still known about preexisting serum TNF-R levels in patients with chronic renal failure, with or without hemodialysis. Therefore we analyzed serum samples of sTNF-R in 26 patients with chronic renal failure (group I), 6I hemodialysis patients (group II), 9 renal transplant recipients with acute renal failure requiring posttransplant dialysis (group III), 13 renal transplant patients with rejection and moderate kidney dysfunction (group IV), and 21 renal transplant recipients with borderline kidney dysfunction and diverse infectious complications (group V). Control groups consisted of 34 blood donors and diseased controls (11 renal transplant recipients with normal kidney function without complications). All patient groups showed significantly higher sTNF-R levels compared to the control groups. In groups I, IV, and V comparable levels were observed. In group I there was a clear correlation between sTNF-R levels and serum creatinine. The highest sTNF-R serum levels were seen in groups II and III, but there was no correlation with creatinine. In the posttransplant cases (group III and diseased controls) there was a decrease in sTNF-R with improvement of kidney function. These data strongly suggest that sTNF-R serum levels are dependent on kidney function.Abbreviations TNF tumor necrosis factor - TNF-R tumor necrosis factor receptor - sTNF-R soluble tumor necrosis factor receptor - RTX renal transplantation - ELISA enzyme-linked immunosorbent assay Correspondence to: G. Halwachs     

TNF检测在环磷酰胺治疗狼疮性肾炎中的价值

目的 探讨肿瘤坏死因子（ＴＮＦ）检测在大剂量环磷酰胺静脉冲击治疗狼疮性肾炎（ＬＮ）中的价值。方法 用ＥＬＩＳＡ双抗体夹心法检测５１例ＬＮ患者环磷酰胺静脉冲击治疗（ＩＶ－ＣＴＸ）前后血清和尿ＴＮＦ水平。结果 活动期ＬＮ患者血清和尿ＴＮＦ水平显著高于稳定性（Ｐ〈０．００１）。血甭ＴＮＦ水平与血沉呈显著正相关（ｎ＝５１,ｒ＝０．３８６,Ｐ〈０．０５）。轻度肾功不全患者血清ＴＮＦ显著高于肾功正常（Ｐ,０．     

Obliterative airway disease in rat tracheal allografts requires tumor necrosis factor alpha

Obliterative bronchiolitis is the major complication affecting long-term lung transplant survivors. Tumor necrosis factor-alpha (TNF-alpha) promotes inflammation and fibrosis in chronic lung injury models. These experiments defined the role of TNF-alpha in an established model of obliterative airway disease (OAD). Rat tracheas were transplanted from Brown-Norway donors into Lewis recipients, and explanted on days 7 and 14. Treated groups received either anti-TNF-alpha antibodies or a novel TNF-alpha translational inhibitor, RDP-58, beginning either immediately or on post-transplant day 7. Morphometry assessed epithelial loss and luminal obliteration, while separate tracheas were processed for TNF-alpha mRNA expression by RQRT-PCR or protein localization/expression by immunohistochemistry. EMSAs evaluated NFkappaB activation. 14-day control allografts averaged 58% occlusion and 98% epithelial loss. These parameters were significantly improved with TNF-alpha inhibition, averaging 32% luminal obliteration and 37% epithelial preservation. TNF-alpha mRNA expression increased at 14-days relative to native tracheas, and was unchanged by RDP-58 treatment. However, TNF-alpha protein expression, localized to the mucosa/submucosa, was markedly reduced with RDP-58, and resulted in diminished global NFkappaB activation in allografts. Delayed RDP treatment reduced disease progression during the second week, as luminal occlusion increased from 26% to only 35%, while respiratory epithelium persisted at 21%. TNF-alpha promotes the development of OAD in tracheal allografts via an NFkappaB-dependent mechanism, and its inhibition may prove beneficial clinically.     

抗CD3单克隆抗体在预防肾移植术后急性排斥反应中的作用

目的 :观察抗CD3单克隆抗体在预防肾移植术后急性排斥反应的作用。方法 :16 4例肾移植患者分为两组 ,4 2例移植术后应用抗CD3单克隆抗体 (5mg d)为治疗组 ;其它 12 2例为对照组。观察移植术后人 肾存活率、急性排斥反应及CMV感染的发生率。结果 :治疗组 1年、2年及 3年人存活率与对照组无显著差异 ,而治疗组移植肾存活率明显高于对照组(P <0 0 5 )。治疗组急性排斥反应发生率 (18 6 % )比对照组 (2 8 7% )低 ,P <0 0 5 ,且首次急性排斥反应发生时间明显延长 ,对MP冲击治疗效果好。治疗组CMV感染的发生率 (33 3% )高于对照组 ,P <0 0 5。结论 :肾移植术后预防性使用抗CD3单克隆抗体对提高移植肾存活率 ,降低急性排斥反应发生率有较好的作用 ;用药期间应注意预防及治疗CMV感染。     

Single-center experience with tacrolimus-based immunosuppressive regimens in renal transplantation

The efficacy and safety of tacrolimus (FK506; Prograf) were determined in 28 adult kidney transplant patients (20 males and 8 females), aged 18-68 years (mean+/-S.D.: 46.9+/-4.03 years). Induction therapy was ATG-F (n=23), daclizumab (n=3), or none (n=2), and maintenance immunosuppression consisted of tacrolimus, combined with mycophenolate mofetil (MMF; n=26) or azathioprine (AZA; n=2) and prednisone (Pred). In seven patients, cyclosporine A microemulsion (Neoral) was replaced by tacrolimus for acute rejection (AR; three patients), slow graft function (SGF, two patients) and Neoral side effects (two patients). Acute rejection occurred in five patients (17.8%), three of whom were steroid-resistant treated with a second course of ATG-F. Infection occurred in 10 patients (35.7%) with a total of 15 infectious episodes, comprising bacterial (73%) and viral (27%) infections related to CMV. Other side effects related to tacrolimus were hypertension in four patients (14%) and post-transplantation hyperglycemia in nine patients (32%), three of whom required insulin therapy. In addition, hypercholesterolemia and hypertriglyceridemia occurred in six (21%) and eight patients (28.5%), respectively. The patient's hospital stay was 12.7+/-1.3 days (range: 8-24 days), and mean serum creatinine upon discharge, and at 1, 3 and 6 months following transplantation were: 2.1+/-0.5, 1.47+/-0.21, 1.41+/-0.53 and 1.23+/-0.11 mg/dl, respectively. The 6-month actuarial patient and graft survival rates were 100%. While tacrolimus is an effective calcineurin inhibitor for kidney transplantation (KT), severe acute rejection seen is related to highly sensitized patients, and the CMV infections noted were related to the presence of more CMV-negative recipients receiving kidneys from CMV-positive donors. Longer follow-up with a larger patient sample is needed to fully assess both the efficacy and safety of tacrolimus, including its metabolic effects.     

MLC上清液中细胞因子的检测与肾移植急性排斥反应的研究

探讨混合淋巴细胞培养中细胞因子水平与急性排斥反应的关系。方法随机选取２４例接受同种异体肾移植术的患者为检测对象。在其接受手术当日，分离其外周血单个核细胞（ＰＢＭＣ）与供者单个核细胞进行混合白细胞培养（反应组），同时以单纯自身ＰＢＭＣ进行培养（对照组）。在培养第１、３、５ｄ测ＭＬＣ上清中ＩＬ－２、ＩＬ－６和ＴＮＦ－α水平，并观察其分 动态变化。结果发生急性排斥反应的患者，在３次时间点上，细胞因子水平