细胞粘附分子在狼疮性肾炎及膜增殖性肾炎肾组织中的表达

用免疫组化方法和计算机图像分析系统，对２５例狼疮性肾炎（ＬＮ）ＩＶ型及１５例膜增殖性肾炎（ＭＰＧＮ）Ｉ型患者肾组织内ＩＣＡＭ－１和ＶＣＡＭ－１的表达进行了定量研究。结果显示：ＭＰＧＮ及ＬＮ患者肾组织中ＩＣＡＭ－１及ＶＣＡＭ－１表达均显著增加，ＬＮ患者ＩｃＡＭ－１在肾小球内皮细胞表达最强，且与内皮细胞增殖程度显著正相关。     

慢性阻塞性肺病患者细胞粘附分子表达研究

对慢性阻塞性肺病（ＣＯＰＤ）患者外周血单个核细胞（ＰＢＭＣｓ）表面的ＣＤ１１ａ／ＣＤ１８，ＣＤ１１ｂ／ＣＤ１８（ＡＰＡＡＰ法）及ＣＤ４４（流式细胞分析法）粘附分子表达及血浆中可溶怀Ｅ．Ｐ．－选择素水平进行检测。结果：ＣＰＯＤ急性加重期患者ＰＢＭＣｓ表面ＣＤ１１ａ、ＣＤ１１ｂ及ＣＤ４４分子表达明显增高，血浆中可溶性Ｅ．Ｐ－选择素水平亦显著增高，与正常人及缓解期患者相比均有显著性差异。综合治疗可使血浆     

DM2患者HbA1C与血清E-选择素检测的临床价值

目的 探讨2型糖尿病（DM2）患者糖化血红蛋白（HbA1C）与血清E-选择素之间的相关性.方法 用高压液相色谱法检测HbA1C和酶联法检测E-选择素,分析61例DM2患者及35名正常健康人作对照的血浆HbA1C与血清E-选择素间的相关性.结果 DM2患者HbAlC水平与E-选择素水平均非常显著地高于正常人组（P〈0.01）,且HbA1C水平与E-选择素水平呈显著正相关（r=0.5714,P〈0.01）.结论 高血糖对血清E-选择素的表达可能有促进作用.     

原发性高血压患者治疗前后血浆ET和E选择素检测的临床意义

目的：探讨了原发性高血压患者治疗前后血浆ET和E选择素水平及临床意义。方法：应用放免法检测了39例原发性高血压患者治疗前后血浆ET水平,酶联免疫法检测E选择素水平,并与35名正常健康人作比较。结果：原发性高血压患者治疗前后血浆ET和E选择素水平非常显著地高于正常人组水平（P〈0．01）,经治疗3个月后则与正常人组比较无显著性差异（P〉0．05）。结论;血浆ET和E选择素的异常升高是原发性高血压发病的病理因素之一,对诊断、治疗和预后均有重要的临床价值。     

粘附分子选择素在IgA肾病中变化的临床意义

目的：为探讨ＩｇＡ肾病患者血和肾组织中Ｐ选择素必变与疾病的关系。方法：采用酶联免疫吸附法、免疫组化及原位杂交技术检测了４５例ＩｇＡ肾病患者血浆和肾组织中Ｐ选择素含量及表达水平。结果：ＩｇＡ肾病患者血浆Ｐ选择素含量明显高于正常人,其中肾病综合征组和肾功能减退组含量又较肉眼血尿组、尿检异常组和肾炎综合征组显著增高造反素在患者肾组织中广泛表达,其中在Ⅳ级和Ⅴ级ＩｇＡ肾病肾小球中表达水平明显高于Ⅱ级和Ⅲ级     

肺结核患者血清sE-选择素的水平及临床意义

目的:探讨血清可溶性E-选择素(sE-selectin)在肺结核的变化及其临床意义。方法:应用双抗体夹心ELISA法分别检测40例未治疗及20例治疗2月后肺结核患者、20例健康正常人血清sE-选择素水平。结果:肺结核血清sE-选择素水平明显高于正常对照(P<0.01),其中血行播散型肺结核(Ⅱ型)组明显高于继发型肺结核(Ⅲ型)(P<0.01)。抗结核治疗2月后血清中的sE-选择素水平明显下降(P<0.01),但仍高于对照组(P<0.05)。结论:研究表明血清sE-选择素作为重要的免疫分子可能参与肺结核发病及免疫机制,可作为肺结核患者病情判断及治疗预后的参考指标。     

肺癌患者血浆P-选择素水平和CA50联检的临床意义

目的:探讨了肺癌患者血浆P-选择素和CA50水平及临床意义。方法:应用ELISA法检测32例肺癌患者血浆P-选择素水平,采用免疫放射分析测定CA50水平,并与35名正常健康人作比较。结果:肺癌患者血浆P-选择素和CA50水平非常显著地高于正常人组水平(P<0.01),经手术治疗后1个月,与正常人组比较仍有显著差异(P<0.05)。结论:测定肺癌患者血浆P-选择素和CA50水平对临床的诊断和治疗均有重要的临床价值。     

白细胞介素—1受体拮抗剂基因多态性与狼疮性肾炎临床病…

白细胞介素－１受体拮抗剂（ＩＬ－１ｒａ）基因多态性被认为与血浆ＩＬ－１ｒａ浓度有关，为探讨ＩＬ－１ｒａ基因多态性与狼疮性肾炎（ＬＮ）之间的关系，应用ＰＣＲ方法对９８例ＬＮ患者和９８名正常人的ＩＬ－１ＲＡ基因多态性的分布进行了观察，并结合临床病理特点和随访资料进行了分析。结果：（１）ＬＮ患者与正常对照组ＩＬ１ＲＮ＾＊２等位基因携带率无统计学差异（Ｐ〉０．０５）；（２）ＬＮ患者携带ＩＬ１ ＲＮ＾＊２者     

肺癌患者手术治疗前后sE-CAd和血浆可溶性P-选择素联检的临床意义

目的:探讨了肺癌患者手术治疗前后,血清可溶性上皮钙粘蛋白(sE-CAd)和可溶性P-选择素的变化。方法:应用酶联法测定了34例肺癌患者血sE-CAd和P-选择素含量,并与35名正常健康人作比较。结果:肺癌患者在手术前sE-CAd、P-选择素水平非常显著地高于正常人水平(P<0.01),手术治疗后6个月复发者sE-CAd、P-选择素水平持续异常,未复发者sE-CAd、P-选择素水平恢复正常。结论:血sE-CAd、P-选择素含量的变化与肺癌患者的病情和预后密切相关,有一定的临床实用价值。     

妊高征患者血浆P-选择素水平的变化

目的探讨妊高征患者血浆P-选择素含量的变化及其在妊高征发病中的意义。方法采用酶联免疫吸附法测定50例妊高征患者（HDP组）,其中妊娠期高血压组12例,轻度子痫前期组20例,重度子痫前期组18例、50例正常晚孕妇女（对照组）血浆P-选择素。结果 HDP组血浆P-选择素值（75.26±24.56μg/l）显著高于对照组（46.24±12.02μg/l）（P〈0.001）,以子痫前期组增高明显。结论妊高征患者血浆P-选择素水平含量变化与妊高征发病及病情发展有关。     

Imbalance of interleukin 18 and interleukin 18 binding protein in patients with lupus nephritis

To evaluate the balance status of interleukin 18 （IL-18） and interleukin 18 binding protein （IL-18BP） in circulation in patients with lupus nephritis （LN） and primary nephrotic syndrome （PNS）, plasma levels as well as mRNA expression in peripheral blood mononuclear cells （PBMCs） of IL-18 and IL-18BP were measured by ELISA and RT-PCR respectively. The ratio of IL-18/IL-18BP was also calculated. Both plasma IL-18 and IL-18BP increased significantly in LN patients while only IL-18BP increased in PNS, which resulted in an elevated ratio of IL-18/IL-18BP in LN but not in PNS patients when compared with normal controls. In contrast, increased level of IL-18 mRNA was only detected in LN but not in PNS group, although IL-18BP mRNA expressions in PBMCs in both groups were higher than that in control. The imbalance of IL-18 and IL-18BP might be involved in the pathogenesis of LN, based on which a therapeutic approach is valuable to be developed for LN.     

Resistin as a potential marker of renal disease in lupus nephritis

Systemic lupus erythematosus (SLE) and lupus nephritis (LN) have strong concomitance with cardiovascular disease that cannot be explained fully by typical risk factors. We examined the possibility that serum or urine expression of adipokines may act as biomarkers for LN, as these proteins have been associated previously with cardiovascular disease as well as SLE. Antibody arrays were performed on serum and urine from lupus patients and matched controls using a cross‐sectional study design. From the initial array‐based screening data of 15 adipokines, adiponectin, leptin and resistin were selected for validation by enzyme‐linked immunosorbent assay (ELISA). Correlations were determined between adipokine expression levels and measures of disease activity or lupus nephritis. The expression of adiponectin and resistin was increased in both sera and urine from LN patients, while leptin was increased in LN patient sera, compared to matched controls. Serum resistin, but not urine resistin, was correlated with measures of renal dysfunction in LN. Serum resistin expression may be useful as a marker of renal dysfunction in patients with LN, although longitudinal studies are warranted. Further studies are necessary to determine if resistin has functional consequences in LN.     

Up-regulation of IL-18 and predominance of a Th1 immune response is a hallmark of lupus nephritis

There is evidence that nephritis is dominated by a Th1 immune response in systemic lupus erythematosus. Since IL-18 promotes polarization of the immune response toward Th1, we investigated the role of this cytokine in lupus nephritis (LN). A total of 133 lupus patients and 44 healthy subjects were enrolled. Demographic and clinical characteristics with renal biopsy data were recorded. IL-18 along with IFN-gamma and IL-4, two prototypical of Th1 and Th2 cytokines, were measured in serum by ELISA. Peripheral blood lymphocytes were analysed by flow cytometry for IFN-gamma and IL-4. IL-18 expression was determined by immunohistochemistry in 13 renal biopsy specimens from patients with LN and 2 controls. Serum IL-18 was higher in lupus patients than in controls. Levels of IL-18 correlated with urinary microalbumin and were increased in patients with LN when compared to those without LN. IL-18 expression was also increased within the glomeruli of nephritic patients and was primarily detected within the mesangial matrix and in infiltrating mononuclear cells. Measurement of IFN-gamma and IL-4 in either sera or peripheral blood lymphocytes showed high IFN-gamma along with low IL-4 expression in LN patients compared to patients without nephritis. A positive correlation between serum IL-18 and IFN-gamma levels was found. IL-18 may play a prominent role in the pathogenesis of LN by promoting a cytokine imbalance towards a Th1 immune response. Measurement of IL-18 may be helpful for the early identification of lupus patients with LN and may help gauge the response to treatment in patients with active LN undergoing treatment.     

LN肾功能衰竭患者血液透析前后血管活性因子变化及临床意义

目的：比较狼疮性肾炎（LN）肾功能衰竭患者血液透析前后血浆内皮素（ET）、一氧化氮（NO）及心钠素（ANP）含量变化并分析其临床意义。方法：32例LN肾功能衰竭患者采用硝酸还原法检测NO,放射免疫分析ET、ANP含量。结果：LN肾功能衰竭组NO、ET、ANP浓度明显高于正常对照组（P〈0.05）,且ET、NO及ANP水平升高的程度与肾功能损害的严重性呈正比;透析后NO和ANP显著下降（P〈0.05）,ET透析后有下降趋势,但与透析前相比无统计学意义（P〉0.05）。结论：血管活性因子ET、NO及ANP参与了LN发病并加重其病情,血浆ET、NO及ANP浓度可作为判断LN患者肾功能损害程度的指标。血液透析后可以使LN肾功能衰竭组患者血浆NO及ANP含量明显降低。     

抗核抗体系列检测对狼疮性肾炎进行鉴别诊断的临床意义

目的探讨抗核抗体(ANA)系列指标在狼疮性肾炎(LN)患者中的表达情况及临床意义.方法对406例系统性红斑狼疮(SLE)患者(其中LN 122例)和74例其他自身免疫病患者及120例健康体检者采用间接免疫荧光法测定ANA,应用欧蒙印迹法测定ANA系列.结果 SLE患者ANA阳性率为94.49%,其他自身免疫病组ANA阳...     

Clinical and functional consequences of anti-properdin autoantibodies in patients with lupus nephritis

Properdin is the only positive regulator of the complement system. In this study, we characterize the prevalence, functional consequences and disease associations of autoantibodies against properdin in a cohort of patients with autoimmune disease systemic lupus erythematosus (SLE) suffering from lupus nephritis (LN). We detected autoantibodies against properdin in plasma of 22·5% of the LN patients (16 of 71) by enzyme-linked immunosorbent assay (ELISA). The binding of these autoantibodies to properdin was dose-dependent and was validated by surface plasmon resonance. Higher levels of anti-properdin were related to high levels of anti-dsDNA and anti-nuclear antibodies and low concentrations of C3 and C4 in patients, and also with histological signs of LN activity and chronicity. The high negative predictive value (NPV) of anti-properdin and anti-dsDNA combination suggested that patients who are negative for both anti-properdin and anti-dsDNA will not have severe nephritis. Immunoglobulin G from anti-properdin-positive patients’ plasma increased the C3b deposition on late apoptotic cells by flow cytometry. Nevertheless, these IgGs did not modify substantially the binding of properdin to C3b, the C3 convertase C3bBb and the pro-convertase C3bB, evaluated by surface plasmon resonance. In conclusion, anti-properdin autoantibodies exist in LN patients. They have weak but relevant functional consequences, which could have pathological significance.     

Peripheral CD4+CD8+ double positive T cells: A potential marker to evaluate renal impairment susceptibility during systemic lupus erythematosus

Lupus nephritis (LN) has a high incidence in systemic lupus erythematosus (SLE) patients, but there is a lack of sensitive predictive markers. The purpose of the study was to investigate the association between the CD4⁺CD8⁺ double positive T (DPT) lymphocytes and LN. The study included patients with SLE without renal impairment (SLE-NRI), LN, nephritic syndrome (NS), or nephritis. Peripheral blood lymphocyte subsets were analyzed by flow cytometry. Biochemical measurements were performed with peripheral blood in accordance with the recommendations proposed by the National Center for Clinical Laboratories. The proportions of DPT cells in the LN group were significantly higher than that in the SLE-NRI group (t=4.012, P<0.001), NS group (t=3.240, P=0.001), and nephritis group (t=2.57, P=0.011). In the LN group, the risk of renal impairment increased significantly in a DPT cells proportion-dependent manner. The risk of LN was 5.136 times (95% confidence interval, 2.115–12.473) higher in cases with a high proportion of DPT cells than those whose proportion of DPT cells within the normal range. These findings indicated that the proportion of DPT cells could be a potential marker to evaluate LN susceptibility, and the interference of NS and nephritis could be effectively excluded when assessing the risk of renal impairment during SLE with DPT cell proportion.     

树突状细胞在狼疮性肾炎肾组织中的分布及其临床意义

经肾活检和临床资料确诊的LN患者 5 3例 ,采用免疫荧光双标记染色与低照度荧光图像分析检测方法 ,观察到LN患者肾组织中树突状细胞分布的面积、数量及密度均明显增多。树突状细胞主要分布于肾小管间质和肾血管 ,而肾小球基本未见分布。此外 ,树突状细胞在肾小管间质分布程度与肾小管间质病变程度及肾功能呈正相关。提示树突状细胞可能参与了狼疮性肾炎的发病机制 ,并与患者肾小管间质病变及肾功能密切相关     

Defective concanavalin A-induced suppressor cell activity in lupus nephritis

To determine whether patients with systemic lupus erythematosus (SLE) and active nephritis have more profound defects in suppressor cell activity, we studied concanavalin A (Con A)-induced suppressor cell activity (SCA) in 12 patients with lupus nephritis (LN) and 11 patients with chronic mesangial proliferative glomerulonephritis (CGN) without renal insufficiency. The levels of Con A-induced SCA were decreased in patients with LN compared with those in normal controls and those in CGN patients and lower in LN patients with the nephrotic syndrome (NS) than in those without NS. In contrast, the mean responses of Con-A-induced SCA in CGN patients with or without NS did not differ from normal subjects. These findings may lend further insight into the understanding of the immunoregulatory defect in LN.     

白细胞介素-15在狼疮性肾炎活动病变中的临床意义

目的：检测狼疮肾炎(LN)患者外周血白细胞介素15（IL-15）水平，并进一步分析其与临床有关指标的关系及治疗前后的变化。方法：用酶联免疫吸附法（ELISA）方法检测外周血IL-15水平；采用梯度密度离心法分离外周血单个核细胞(PBMCs)；并研究地塞米松对体外培养的活动期LN患者PBMCs分泌IL-15、IgG和dsDNA抗体的影响。结果：（1）LN组患者血清IL-15水平显著高于正常对照组(P<0.01)，活动期LN患者血清IL-15水平显著高于缓解期患者(P<0.05)。（2）活动期LN患者血清IL-15水平与SLE活动性指数(SLEDAI)、抗dsDNA抗体、24 h尿蛋白排泄量呈正相关关系，与补体C3呈负相关关系，而与血肌酐无相关关系。（3）激素联合环磷酰胺系统治疗活动期LN患者12周，治疗后随病情缓解血清IL-15水平明显下降。（4）体外培养的活动期LN患者PBMCs分泌IL-15、IgG、dsDNA抗体均显著高于正常对照组，而且IL-15分泌与dsDNA抗体和IgG合成呈正相关关系；地塞米松可明显抑制活动期LN患者PBMCs合成IL-15、IgG、dsDNA抗体。结论：LN患者外周血IL-15水平显著增高,IL-15可能参与LN的病理生理过程；血清IL-15水平检测可作为判断LN是否活动的指标之一。