慢性粒细胞白血病患者血清可溶性白细胞介素－2受体的研究

用双抗体夹心酶联免疫吸附试验检测５４例慢性粒细胞白血病（ＣＭＬ）患者血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平。结果显示：各期ＣＭＬ患者血清ｓＩＬ－２Ｒ水平均显著高于正常对照，且和病情的严重程度密切相关，ＣＭＬ急变治疗后，有效者血清ｓＩＬ－２Ｒ水平显著低于化疗前；无效者血清ｓＩＬ－２Ｒ不低，甚至高于化疗前。急粒变时血清ｓＩＬ－２Ｒ水平与外周血白细胞数、原始粒细胞绝对数及骨髓原始粒细胞绝对数呈正相关。血清ｓＩＬ－２Ｒ水平可作为ＣＭＬ分期、监测ＣＭＬ急变、判定预后的一个有用的指标。     

几种妇科肿瘤患者白细胞介素2受体的检测

采用Ｔａｃ的单克隆抗体（ＭｃＡｂ－Ｔａｃ）间接荧光技术及酶联免疫吸附试验夹心法，对１００例妇科肿瘤患者（良性肿瘤３１例、恶性肿瘤６９例）和６０名献血员作了外周血单个核细胞（ＰＢＭＣ）细胞膜白细胞介素２受体（ｍＩＬ－２Ｒ）表达和血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平观察。结果：恶性肿瘤患者ＰＢＭＣ，经植物血凝素刺激及７２小时培养，ｍＩＬ－２Ｒ表达低于正常对照（Ｐ＜０．０１）；ｓＩＬ－２Ｒ测定，恶性肿瘤患者检测结果高于正常对照（Ｐ＜０．０１），恶性肿瘤转移者检测结果高于非转移者（Ｐ＜０．０１）；经免疫治疗的恶性肿瘤患者，两项检测结果均高于治疗前。提示：几种妇科恶性肿瘤患者ｍＩＬ－２Ｒ表达不足及ｓＩＬ－２Ｒ水平异常升高与患者免疫调控功能紊乱及细胞免疫功能低下有关；ｓＩＬ－２Ｒ的测定，可作为对肿瘤患者病情监测及预后判断的重要参考指标。     

sIL-2R在恶性淋巴细胞增殖性疾病中的改变

目的：探讨可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）在恶性淋巴细胞增殖性疾病中的改变及其临床意义。方法：用酶联免疫吸附法测定６０例恶性淋巴细胞增殖性疾病患者血清ｓＩＬ－２Ｒ水平，用流式细胞仪（ＦＣＭ）检测其中４３例患者外周血单个核细胞中ＣＤ４＋、ＣＤ８＋细胞数。将患者以不同病期，是否伴有感染等情况分组进行比较，并对３例非霍奇金淋巴瘤（ＮＨＬ）患者进行治疗前后的ｓＩＬ－２Ｒ随访。结果：多发性骨髓瘤、ＮＨＬ及急性淋巴细胞白血病患者血清ｓＩＬ－２Ｒ含量高于正常人，其水平与疾病的临床分期、病程密切相关。上述患者外周血单个核细胞中ＣＤ４＋细胞数与ＣＤ８＋细胞数的比值明显低于正常人。血清ｓＩＬ－２Ｒ水平在此类疾病中与感染无关。结论：在恶性淋巴细胞增殖性疾病中，ｓＩＬ－２Ｒ水平随着疾病的进展及机体免疫功能的下降而明显升高，可作为一个有效的临床监测指标。     

严重型再生障碍性贫血患者血清 IL-2、sIL-2R 水平与免疫抑制治疗关系的研究

目的：探索严重型再生障碍性贫血患者自身影响免疫抑制治疗的因素。方法：采用酶联免疫法测定２２例严重型再生障碍性贫血患者治疗前及正常献血者血清中白细胞介素２（ＩＬ－２）和可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平。结果：４０．９％和６３．６％的严重型再生障碍性贫血患者血清中ＩＬ－２和ｓＩＬ－２Ｒ水平高于正常人，此组患者对环孢霉素Ａ或（和）抗淋巴细胞球蛋白治疗反应明显优于血清中ＩＬ－２和ｓＩＬ－２Ｒ水平正常或减低者（Ｐ＜０．０５）：ＩＬ－２水平增高者有效率８８．９％，ＩＬ－２水平不高者有效率５３．９％；ｓＩＬ－２Ｒ水平增高者有效率７８．６％，不增高者５０．０％。结论：严重型再生障碍性贫血患者血清中ＩＬ－２和ｓＩＬ－２Ｒ水平明显影响免疫抑制剂疗效，测定其水平对指导严重型再生障碍性贫血的治疗是有意义的。     

类风湿性关节炎患者血清白细胞介素的检测

为了解类风湿性关节炎（ＲＡ）患者的免疫损伤机理，应用酶联免疫吸附法（ＥＬＩＳＡ）检测３８例ＲＡ患者血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）和白细胞介素８（ＩＬ－８）含量，并检验其相关性。结果：（１）ＲＡ患者血清ｓＩＬ－２Ｒ和ＩＬ－８水平均比正常对照组显著升高（Ｐ＜０．０１）；血清ｓＩＬ－２Ｒ浓度在类风湿因子（ＲＦ）阳性与阴性组中差异有显著性（Ｐ＜０．０１）；（２）ＲＦ阳性患者血清ｓＩＬ－２Ｒ与ＩＬ－８浓度呈正相关（ｒ＝０．７４，Ｐ＜０．０５）。提示ＲＡ患者Ｔ细胞异常活化以及免疫调节功能紊乱。     

食管癌患者IL-2R的表达和血清SIL-2R的研究

目的观察食管癌组织ＩＬ－２Ｒ的表达和患者血清ＳＩＬ－２Ｒ的变化，探讨ＩＬ－２Ｒ和ＳＩＬ－２Ｒ与食管癌发生、发展的关系。方法采用双抗体夹心ＥＬＩＳＡ法对４２例食管癌患者血清可溶性白细胞介素２受体（ＳＩＬ－２Ｒ）水平进行测定，同时应用即用型ＳＡＢＣ免疫组织化学方法观察ＩＬ－２Ｒ在食管癌组织的表达情况。结果食管癌患者血清ＳＩＬ－２Ｒ水平显著高于正常对照组（Ｐ＜０．０５），并与临床分期有关；ＩＬ－２Ｒ在食管癌组织中阳性表达率５２．４％（２２／４２），显著高于正常食管粘膜组（Ｐ＜０．０５），并与临床分期有关。结论ＩＬ－２Ｒ表达和血清ＳＩＬ－２Ｒ水平可作为临床诊断和判断患者预后的重要参考指标。     

慢性粒细胞白血病患者血清可溶性

用双抗体夹酶联免疫吸附试验检测５４例慢性粒细胞白血病患血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平。结果显示：各期ＣＭＬ患血清ｓＩＬ－２Ｒ水平均显高于正常对照，且和病情的严重程度密切相关。ＣＭＬ急变治疗后，有效血清ｓＩＬ－２Ｒ不低，甚至高于化疗前。急粒变时血清ｓＩＬ－２Ｒ水平与外周血白细胞数，原始粒细胞绝对数及骨髓原始粒细胞绝对数呈正相关。血清ｓＩＬ－２Ｒ水平可作为ＣＭＬ分期，监测ＣＭＬ     

急性早幼粒细胞白血病全反式维甲酸治疗时IL-8及其受体表达的观察

目的：探讨白细胞介素８（ＩＬ８）及其Ａ型受体（ＩＬ８ＲＡ）的表达在全反式维甲酸（ＡＴＲＡ）诱导治疗急性早幼粒细胞白血病（ＡＰＬ）中的临床意义。方法：动态检测ＡＰＬ患者１８例ＡＴＲＡ治疗中血浆ＩＬ８水平（ＥＬＩＳＡ法），取３例骨髓单个核细胞（ＭＮＣ）加ＡＴＲＡ（１０－６ｍｍｏｌ／Ｌ）体外诱导，流式细胞仪动态检测ＭＮＣ膜ＩＬ８ＲＡ的表达。结果：ＭＮＣ加ＡＴＲＡ诱导７２小时，上清ＩＬ８水平明显下降，ＭＮＣ膜表达ＩＬ８ＲＡ增高；维甲酸综合征（ＲＡＳ）发生前血浆ＩＬ８异常升高（达１０１０～２０００ｎｇ／Ｌ），较体温及白细胞数量变化更敏感；感染时血浆ＩＬ６、ＩＬ８水平均明显升高［分别为（１１２．３４±５７．３１）×１０３Ｕ／Ｌ，２３４．１６±７２１８ｎｇ／Ｌ］；弥散性血管内凝血（ＤＩＣ）恶化时ＩＬ８与Ｄ二聚体异常同步上升。结论：ＡＴＲＡ抑制ＡＰＬ细胞分泌ＩＬ８，加强ＩＬ８ＲＡ的表达；监测ＩＬ８水平可预测ＲＡＳ及感染发生；ＩＬ８与Ｄ二聚体异常同步上升提示ＤＩＣ恶化趋势。     

多发性骨髓瘤患者血清白细胞介素2的测定及临床价值

为探讨血清白细胞介素２（ＩＬ－２）含量与多发性骨髓瘤（ＭＭ）的关系，采用固相放射免疫检测方法检测４４例ＭＭ患者血清ＩＬ－２水平。发现其血清ＩＬ－２含量明显高于正常人；血清ＩＬ－２≥５μｇ／Ｌ的ＭＭ患者３年存活率明显高于血清ＩＬ－２＜５μｇ／Ｌ的患者。所有血清ＩＬ－２≥５μｇ／Ｌ的患者血清β２微球蛋白（β２－ＭＧ）＜６ｍｇ／Ｌ。依据血清ＩＬ－２和β２－ＭＧ两项指标，将患者分为３组：Ａ组ＩＬ－２≥５μｇ／Ｌ，β２－ＭＧ＜６ｍｇ／Ｌ；Ｂ组ＩＬ－２＜５μｇ／Ｌ，β２－ＭＧ＜６ｍｇ／Ｌ；Ｃ组ＩＬ－２＜５μｇ／Ｌ，β２－ＭＧ≥６ｍｇ／Ｌ。结果３年存活率Ｃ组最低，Ａ组最高。提示血清ＩＬ－２的检测可作为估计ＭＭ预后的一项可靠指标。     

IL—2在JRA诊断中治疗过程中的临床意义

采用ＭＴＴ比色法测定了２０例不同病期幼年型类风湿性关节炎（ＪＲＡ）患儿外周血单细胞（ＰＢＭＣ）产生白血细胞介素－２（ＩＬ－２）能力的变化，并与常用实验室指标ＥＳＲ，ＣＲＰ的变化进行了比较。结果发现，活动期ＩＬ－２明显降低，ＥＳＲ，ＣＲＰ明显升高，提示三者对诊断均具重要参考价值；治疗后ＥＳＲ，ＣＲＰ组快恢复正常，而ＩＬ－２无明显变化；缓解期ＩＬ－２逐渐升高，对指导缓解期药具有指导意义。     

病毒性心肌炎、扩张型心肌病患者TNF、sIL-2R、IL-6、IL-8、T细胞亚群的改变

目的 :研究免疫反应在病毒性心肌炎 (VMC)、扩张型心肌病 (DCM )发病中所起的作用。方法 :对 30例VMC患者、40例DCM患者分别采用放免法测定血清肿瘤坏死因子 (TNF)水平 ;ELISA法测定血清可溶性白细胞介素 2受体 (sIL -2R)、白细胞介素 6 (IL -6 )、白细胞介素 8(IL -8)水平 ;ABC染色法测定外周血T淋巴细胞亚群 ,并与 30例正常人 (NC)对照。结果 :VMC组、DCM组血清TNF、sIL -2R、IL -6、IL -8水平均显著高于NC组 (P <0 0 1～ 0 0 0 1) ,T细胞亚群中CD4、CD8显著低于NC组 (P <0 0 5～ 0 0 0 1) ,CD4/CD8显著高于NC组 (P <0 0 0 1)。结论 :一系列细胞因子介导的免疫、炎症反应 ,免疫调节网络功能的失衡在VMC、DCM的发生、发展中起重要作用     

克罗恩病患者血清总25羟维生素D及细胞因子水平表达与疾病活动指数的相关性研究

目的探讨克罗恩病患者血清总25羟基维生素D、细胞因子白介素6(IL-6）、白介素8(IL-8）和肿瘤坏死因子α（TNF-α）在克罗恩病不同时期的表达水平以及其与疾病活动指数（CDAI）的相关性。方法选取2018年1月～2020年12月在北京大学深圳医院就诊的克罗恩病患者共100例纳入研究。收集患者的空腹静脉血,检测总25羟基维生素D,IL-6,IL-8和TNF-α水平;采用CDAI评估患者疾病活动情况,并根据CDAI评分将患者分为四组,缓解期21例,轻度活动期32例,中度活动期29例和重度活动期18例。比较CDAI评分不同分期患者的血清总25-羟基维生素D,IL-6,IL-8和TNF-α的表达水平。并进一步分析比较患者CDAI与血清总25-羟基维生素D水平及细胞因子IL-6,IL-8及TNF-α表达水平之间的相关性。结果四组患者血清总25-羟基维生素D及细胞因子IL-6,IL-8和TNF-α的差异均存在统计学意义（F=34.281～128.53,均P<0.05）。缓解期患者血清总25-羟基维生素D (23.49±3.46μg/L),IL-8(86.39±11.23ng/L）和TN...     

严重型再生障碍性贫血患者血清IL—2,sIL—2R水平与免疫报制…

目的：探索严重型再生笥贫血患者自身影免疫抑制的治疗的因素。方法：采用酶联免疫法测定２２例严重型再生障碍怀贫血患者治疗前后及正常献血者血清中白细胞介素２（ＩＬ－２）的可溶性白细胞介素２肥体（ｓＩＬ－２Ｒ）结果：４０．９％和６３．６％的严重型再生生贫血患者血清中ＩＬ－２和ｓＩＬ－２Ｒ水平高于正常人，此组患者对环孢霉素Ａ或（和）抗淋巴细胞球蛋白治疗反应明显优于血清中ＩＬ－２和ｓＩＬ－２Ｒｉｇｕｇｈｉｐ３     

Circulating levels of thrombopoietic and inflammatory cytokines in patients with clonal and reactive thrombocytosis.

The regulation of megakaryocytopoiesis and thrombopoiesis appears to be under the control of an array of hematopoietic growth factors. To determine the relationship between endogenous cytokine levels and circulating platelet counts, we measured the serum levels of both thrombopoietic and inflammatory cytokines in the peripheral blood and bone marrow samples from 70 patients with clonal thrombocytosis (CT) caused by myeloproliferative disorders, 28 patients with reactive thrombocytosis (RT), and 35 normal control subjects. The levels of thrombopoietin (TPO), interleukin-6 (IL-6), soluble IL-6 (sIL-6) receptor, IL-11, stem cell factor (SCF), IL-3, and IL-8 were determined by enzyme-linked immunosorbent assay (ELISA). Platelet counts were significantly higher in both CT and patients with RT (699+/-399x10(9)/L, P<.001; 642+/-200 x 10(9)/L, P<.001; respectively) as compared with the normal control subjects (240+/-47x10(9)/L). The concentrations of cytokines in the bone marrow correlated well with those in the peripheral blood. The endogenous levels of TPO, IL-6, and sIL-6 receptor were significantly higher in both CT and patients with RT than those in normal control subjects. The median level of IL-6 was significantly higher in patients with RT than in patients with CT (40 pg/mL vs. 5 pg/mL; P<.001); however, there was no detectable difference in TPO and sIL-6 receptor levels between the two groups. Significantly higher levels of SCF and IL-8 were also found in patients with CT as compared with those found in normal control subjects (median 2460 pg/mL vs 1995 pg/mL, P<.05; 20 ng/mL vs. 5 ng/mL, P = .001; respectively). Finally, IL-11 and IL-3 levels were undetectable in most patients with thrombocytosis. Our results reveal that the endogenous levels of TPO, IL-6, sIL-6 receptor, IL-8, and SCF are elevated in patients with CT or RT. These cytokines appear to be active mediators involved in the regulation of thrombopoiesis during clonal and reactive thrombocytosis.     

Effects of Viscum album extract therapy in patients with cancer: relation with interleukin-6, soluble interleukin-6 receptor, and soluble gp130

OBJECTIVES: The aim of this investigation was to determine the effects of Viscum album (VA) extract therapy on interleukin (IL)-12, IL-16, IL-6, soluble interleukin-6 receptor (sIL-6R), and soluble gp130 (sgp130) in patients with cancer. VA extract as immunomodulator is used as treatment either following or in combination with chemo/radiotherapy. Previously we showed that serum levels of IL-12 and IL-16 were significantly elevated during tumor progression in 72 patients. The serum values of IL-6 were not significantly altered, however sIL-6R and sgp130 also increased significantly. DESIGN: In this study the serum levels of the five parameters were measured during VA extract therapy in 46 of these 72 tumor patients and compared to the values before VA extract treatment. The levels of the serum parameters IL-12, IL-16, IL-6, sIL-6R, sgp130 were determined by enzyme-linked immunosorbent assay (ELISA). SETTING: Private cancer hospital in Arlesheim, Switzerland. RESULTS: Eighty percent (80%) of the tumor patients survived longer than 1 year (11 patients in stage I + II without, 8 patients after chemotherapy/radiotherapy, 10 patients in stage III + IV without, 8 patients after chemotherapy). Clinically and with laboratory investigations there was no progression in these patients. VA extract therapy did not affect serum values of IL-12 or IL-16. However both the number of patients with increased levels of IL-6, sIL-6R, and sgp130 and also the serum values decreased significantly during the treatment, (between p < 0.05 and p < 0.001). In 20% of the patients with cancer with rapid progression who died within 3 months, the serum values of IL-6 increased significantly (p < 0.05), whereas the other investigated parameters did not change. CONCLUSION: The results show that measurements of IL-6, sIL-6R, and sgp130 could be important for establishing the clinical condition and evaluating treatment in tumor patients.     

Activation of the hypothalamo-pituitary-adrenal axis in response to septic or non-septic diseases – implications for the euthyroid sick syndrome

OBJECTIVE: To determine whether cytokine release or activation of the hypothalamo-pituitary-adrenal (HPA) axis is predominantly involved in the development of the euthyroid sick syndrome (ESS). DESIGN: Prospective observational study. SETTING: Intensive care unit at a tertiary care medical center in Germany. PATIENTS: Nine patients with sepsis of different causes and eight patients with acute myocardial infarction. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: Immediately on admission and on day 7 the following parameters were determined: total thyroxine (T4), free thyroxine (FT4), total triiodothyronine (T3), thyrotropin (TSH), interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), soluble interleukin-2 receptor (sIL-2R), interleukin-6 (IL-6), tumor necrosis factor alpha (TNF-alpha), serum cortisol and plasma adrenocorticotropin (ACTH). On admission, concentrations of all thyroid hormones and TSH were significantly lower in septic patients compared to non-septic patients, whereas all cytokines except IL-2 were significantly elevated in the sepsis group. By contrast, there was no difference in serum cortisol and plasma ACTH levels between the two groups. On day 7, T4 and T3 were still lower in the septic group, whereas IL-1 beta, sIL-2R and IL-6 were still elevated. Again, no differences were found with regard to cortisol and ACTH levels. CONCLUSIONS: Euthyroid sick syndrome occurs very early during the course of septic diseases. Significantly decreased levels of total T4, FT4, T3 and TSH in septic patients suggest central suppression of TSH as well as inhibition of thyroid hormone release in ESS. The HPA axis is activated in septic patients and in non-septic patients and does not contribute to the development of ESS.     

Investigation of interleukin-6 (IL-6), soluble IL-6 receptor (sIL-6R) and soluble gp130 (sgp130) in sera of cancer patients.

The serum levels of interleukin-6 (IL-6), sIL-6R and sgp130 were investigated in 76 cancer patients in comparison with 28 healthy controls. IL-6 is a multifunctional cytokine involved in certain malignant diseases. Soluble IL-6 receptor as agonist enhances the biological effect of released IL-6. Soluble gp130 as antagonist inhibits the effect of the IL-6/sIL-6R complex. Patients with different types of tumour (breast/gastrointestinal/uterine/ovarian/renal/bladder) were divided into four groups according to tumour stage and previous therapy (stage I + II without or after chemo-/radiotherapy, stage III + IV without or after chemo-/radiotherapy). The distribution of different tumour histotypes was similar in each group of patients. The levels of the three serum parameters were determined by ELISA. At each tumour stage either without or after chemo-/radiotherapy, the serum values of IL-6 were found to be not significantly different from those of controls. The values of sIL-6R were significantly elevated in stage I + II (P < 0.02) patients, with a borderline significance in stage III + IV (P = 0.06), in both cases only when no additional therapy was initiated. The serum values of sgp130 increased significantly at each tumour stage both without and after chemo-/radiotherapy (P < 0.001). A significant correlation was found between the values of sIL-6R and sgp130 in stage I + II (P < 0.02) and III + IV (P < 0.004) patients, in both cases without chemo-/radiotherapy. There were no other significant correlations. In conclusion, the simultaneous measurement of IL-6, sIL-6R and sgp130 in sera is an important factor in evaluating the biological effect of IL-6 in malignant disease. This is the first report to investigate sgp130 in cancer patients with different types of tumour.     

恶性血液病患者血清可溶性白细胞介素6受体水平的研究

目的：探讨恶性血液病患者血清可溶性白细胞介素６受体（ｓＩＬ－６Ｒ）的临床价值。方法：采用酶联免疫法测定２６例多发性骨髓瘤（ＭＭ）、３４例急性白血病（ＡＬ）、１７例非霍奇金淋巴瘤（ＮＨＬ）患者化疗前后及正常献血员的血清ｓＩＬ－６Ｒ水平。结果：初诊时血清ｓＩＬ－６Ｒ水平，ＭＭ患者较正常对照组显著增高（Ｐ〈０．００１），Ｂ细胞系急性淋巴细胞白血病（Ｂ－ＡＬＬ）患者亦高于正常对照（Ｐ〈０．０１），急性淋巴     

缺铁性贫血合并反复呼吸道感染患儿细胞免疫功能观察

目的：测定６３例缺铁性贫血（ＩＤＡ）合并反复呼吸道感染（ＲＲＩ）患儿外周血白细胞介素２（ＩＬ－２）活性、血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平和Ｔ淋巴细胞亚群，并分析它们之间的相关性。方法：ＩＬ－２活性和ｓＩＬ－２Ｒ水平测定分别采用ＭＴＴ法和双抗体夹心法，Ｔ淋巴细胞亚群测定采用ＡＰＡＡＰ法。结果：ＩＬ－２活性，ＣＤ３＋、ＣＤ４＋细胞百分率和ＣＤ４＋／ＣＤ８＋细胞比值均显著低于对照组（Ｐ均＜０．０１），而ｓＩＬ－２Ｒ水平显著高于对照组（Ｐ＜０．０１），ＣＤ８＋细胞百分率无明显变化。结论：ＩＤＡ合并ＲＲＩ患儿细胞免疫功能低下且紊乱。