慢性酒精性胰腺炎患者体肿瘤坏死因子和肿瘤坏死因子受体的诱导

肿瘤坏死因子（ＴＮＦα）是急性胰腺炎导致全身器官损害的一种重要介质。本文研究了目的是了解慢性酒精性为ＴＮＦα和可溶性肿瘤坏死因子受体Ｐ５５、Ｐ７５（ｓＴＮＦＲｐ５５、ｓＴＮＦＲｐ７５）是否升高，及其升高是是内毒素或酒精的作用。我们对１２例慢性酒清胰腺炎患者和８例健康者用内毒素脂多糖（ＬＰＳ）和乙醇刺激后的周围血单核细胞上清液用ＥＬＩＳＡ方法进行了ＴＮＦα、ｓＴＮＦＲｐ５５、ｐ７５的检测。ＬＰＳ刺激     

脂多糖和抗炎药物对肺血管内巨噬细胞核因子κB的影响

目的观察脂多糖（ＬＰＳ）致肺血管内巨噬细胞（ＰＩＭ）核因子κＢ（ＮＦκＢ）的活化及抗炎药物地塞米松（ＤＥＸ）和阿斯匹林（ＡＳＡ）对ＮＦκＢ的影响。方法用改良法分离、培养猪ＰＩＭ,设正常对照、ＬＰＳ刺激、ＤＥＸ和ＡＳＡ干预组,共４组。用凝胶电泳迁移率改变分析（ＥＭＳＡ）法和放射免疫分析（ＲＩＡ）法,分别检测ＰＩＭ核提取物ＮＦκＢ的活性和细胞培养上清肿瘤坏死因子α（ＴＮＦα）的含量。结果ＬＰＳ刺激组ＮＦκＢ活性于刺激后０５～４小时、ＴＮＦα含量于刺激后１～２小时高于刺激前和正常对照组（Ｐ＜０．０１）;二者在刺激后１小时呈显著正相关（ｒ＝０．９９１,Ｐ＜０．０１）。ＤＥＸ组和ＡＳＡ组ＮＦκＢ活性、ＴＮＦα含量虽较刺激前和正常对照组有所升高,但均显著低于ＬＰＳ组（Ｐ＜０．０１）。结论ＬＰＳ可诱导ＰＩＭＮＦκＢ激活,并进而导致ＴＮＦα的基因转录和表达增加;ＤＥＸ和ＡＳＡ可通过抑制ＮＦκＢ的活化而减少ＴＮＦα的释放。     

肝病患者血清TNFα和sTNFαR的相关关系及临床意义初探

采用ＥＬＩＳＡ双抗体夹心法和＾３Ｈ－ＴｄＲ释放法分别对１７６例各种肝病患者及３６例正常人血清ＴＮＦα和ｓＴＮＦαＲ进行测定。结果发现各种肝病患者血清ＴＮＦα和ｓＴＮＦαＲ均明显高于正常对照组（Ｐ〈０．０５），ＴＮＦα和ｓＴＮＦαＲ呈明显正相关。ＰＨＣ和ＣＡＨ患者血清ｓＴＮＦαＲ１／ｓＴＮＦαＦαＲ２比值明显升高；而ＭＨＣ和ＣＰＨ患者血清ｓＴＭＦαＲ／ｓＴＮＦ－Ｒ呃比值则明显减小（Ｐ〈０．０５）。疗     

血透相关因素对维持性血透患者外周血单个核细胞产生IL－1β、TNFα的影响

观察了１５名正常人及１４例维持性血液透析（ＭＨＤ）患者外周血单个核细胞（ＰＢＭＣ）在脂多糖（ＬＰＳ）刺激下产生和分泌白细胞介素－Ｉβ（ＩＬ－１β）、肿瘤坏死因子α（ＴＮＦα）的情况，以及铜仿膜和血仿膜、醋酸盐和碳酸盐透析液对ＰＢＭＣ产生和分泌ＩＬ－１β、ＴＮＦα的影响。结果表明，ＭＨＤ患者ＰＢＭＣ在ＬＰＳ刺激下，产生和分泌ＩＬ－１β、ＴＮＦα的量明显高于正常人（Ｐ＜０．０５）。铜仿膜透析组，血透５ｍｉｎ时ＩＬ－１β、ＴＮＦαｍＲＮＡ的表达达高峰，与透前及正常对照组相比，有显著性差异（Ｐ＜０．０５），其生物活性或蛋白质水平也相应升高，较正常对照组及透前水平均有显著性差异（Ｐ＜０．０５）。血仿膜组ＩＬ－１β、ＴＮＦα的表达和蛋白质水平虽较正常对照组升高，但无统计学差异（Ｐ＞０．０５）。碳酸盐与醋酸盐组无明显差异。提示ＬＰＳ是引起ＰＢＭＣ产生和释放ＩＬ－１β、ＴＮＦα的重要因素；铜仿膜透析器亦可促进细胞因子的产生     

内毒素／肿瘤坏死因子所致肝细胞损害机制的体外研究

为了解内毒素（ＬＰＳ）／肿瘤坏死因子（ＴＮＦ）所致肝细胞损害的机制，以乳酸脱氢酶（ＬＤＨ）及噻唑蓝染色（ＭＴＴ）为细胞毒性指标，利用Ｗｉｓｔａｒ大鼠肝细胞进行了ＬＰＳ及其介质ＴＮＦ等的肝细胞损害机制研究。结果发现：ＬＰＳ、ＴＮＦ－α、ＩＬ－１、ＩＬ－６等对肝细胞ＬＤＨ漏出及ＭＴＴ无显著影响（Ｐ＞０．０５），仅在ＬＰＳ、ＬＰＳ／ＴＮＦ－α加入肝细胞－Ｋｕｐｆｆｅｒ细胞混合培养组后有所变化；经ＧａｌＮ／ＬＰＳ体内作用后分离的Ｋｕｐｆｆｅｒ细胞与正常肝细胞混合培养，加入ＬＰＳ、ＴＮＦ及ＬＰＳ／ＴＮＦ－α均可致ＬＤＨ漏出显著增高（Ｐ＜０．０ｌ），多粘菌素Ｂ及抗－ＴＮＦ能分别完全和部分阻断此效应；经ＬＰＳ或ＴＮＦ－α体内作用后抽取的大鼠血清，加入培养肝细胞可致ＬＤＨ漏出显著增高（Ｐ＜０．０１）与ＭＴＴ显著降低（Ｐ＜０．０５），经５６℃灭活后此细胞毒性作用完全消失。上述结果提示，ＬＰＳ及其介质ＴＮＦ无肝细胞直接毒性作用，而经其活化的Ｋｕｐｆｆｅｒ细胞可能引起一系列瀑布效应，导致肝细胞损害。     

兔内毒素休克模型中秋水仙碱对血清肿瘤坏死因子活性的影响

目的观察秋水仙碱（Ｃｏｌ）对兔受内毒素（ＬＰＳ）刺激后血清肿瘤坏死因子（ＴＮＦ）活性改变的影响。方法将１２只新西兰兔随机分为Ａ、Ｂ两组,Ａ组动物分别于ＬＰＳ注射前６７小时起腹腔注射生理盐水（ＮＳ）０．２ｍｌ／ｋｇ作为空白对照,Ｂ组则按相同时间间隔腹腔注射Ｃｏｌ０．５ｍｇ／ｋｇ。所有动物经卡介苗（ＢＣＧ）致敏后静脉注射ＬＰＳ２μｇ／ｋｇ诱发休克。结果预先注射Ｃｏｌ能显著降低动物血清ＴＮＦ峰值浓度（Ｐ＜０．０５）;治疗组平均动脉压（ＭＡＰ）和全血白细胞数（ＷＢＣ）下降程度也较对照组明显减轻。结论Ｃｏｌ对动物体内ＴＮＦ的合成或分泌具有抑制作用     

肿瘤坏死因子,白细胞介素—1在充血性心力衰竭发生发展中的作用

采用双抗体夹心ＥＬＩＳＡ法对５５例充血性心力衰竭（ＣＨＦ）患者和３０例正常对照者测定其血清肿瘤坏死因子α（ＴＮＦα）,白细胞介素１β（ＩＬ－１β）。结果：心功能Ⅲ级及Ⅳ级患者的ＴＮＦαＩＬ－１β较正常对照组和心功能Ⅱ级患者明显升高（Ｐ〈０．０１）。     

肝癌患者血清可溶性肿瘤坏死因子受体I的表达及临床意义

用ＥＬＩＳＡ方法测定了３０例肝癌患者血清可溶性肿瘤坏死因子受体Ｉ（ｓＴＮＦＲ－Ｉ）水平。结果表明，肝癌患者血清ｓＴＮＦＲ－Ｉ水平明显高于正常人（ｐ〈０．０１），且血清ｓＴＮＦＲＩ水平与临床分期相关。治疗有效者，血清ｓＴＮＦＲ－Ｉ水平均明显下降（ｐ〈０．０１）。治疗后２￣８月，３例无癌生存者，血清ｓＴＮＦＲ－Ｉ水平降至正常，而７例局部未控或复发转移者，血清ｓＴＮＦＲ－Ｉ水平则进行性上升。提示，血清ｓ     

大黄素和地塞米松对慢性肾衰患者产生肿瘤坏死因子的影响

目的：进一步探明大黄素延缓慢性肾功能衰竭（ＣＲＦ）进展的机制，观察大黄素对肿瘤坏死因子产生的影响。方法：采用Ｌ９２９细胞生物活性测定法，观察了大黄素和地塞米松对２７例ＣＲＦ患者外周血单核细胞（ＰＢＭＣ）产生肿瘤坏死因子（ＴＮＦ）的影响。结果：ＣＲＦ患者ＰＢＭＣ在有、无脂多糖（ＬＰＳ）刺激下均较正常对照组产生ＴＮＦ明显升高，大黄素、地塞米松可显著抑制ＣＲＦ患者的ＰＢＭＣ产生ＴＮＦ升高的原因之一。提示     

中国汉族系统性红斑狼疮某些易感基因的研究

为了探索我国北方汉族人群人类白细胞抗原－ＤＲ（ＨＬＡ－ＤＲ）及肿瘤坏死因子Ｂ（ＴＮＦＢ）等位基因多态性与系统性红斑狼疮（ＳＬＥ）的易感性关系，对１０６例健康人和４５例ＳＬＥ患者的ＨＬＡ－ＤＲ和对８０例健康人及４５例ＳＬＥ患者的ＴＮＦＢ等位基因，采用多聚酶链反应－限制性酶切片段长度多态性（ＰＣＲ－ＲＦＬＰ）法进行分析。结果显示：ＳＬＥ患者中频率显著升高的等位基因有ＤＲ２［Ｐ＜０．０５，相对危险性（ＲＲ）＝１．５６］及ＤＲ３（Ｐ＜０．０１，ＲＲ＝２．６９）。而ＤＲ５和对照相比呈相反结果（Ｐ＜０．０５，ＲＲ＝０．４３）。ＳＬＥ患者ＴＮＦＢ＊２等位基因频率显著增高（Ｐ＜０．０５，ＲＲ＝１．８４）。提示ＤＲ２、ＤＲ３、ＴＮＦＢ＊２可能是易感等位基因或易感等位基因标记，而ＤＲ５是一拮抗等位基因或拮抗等位基因标记。并研究了ＨＬＡ－ＤＲ、ＴＮＦＢ等位基因与患者血浆中Ｓ蛋白和补体５ｂ－９结合物的复合物（ＳＣ５ｂ－９）的水平和多种自身抗体及狼疮肾炎、狼疮肺炎、狼疮脑病等狼疮并发症之间的相关性，发现ＨＬＡ－ＤＲ２基因与狼疮肾炎的发生存在正相关（Ｐ＜０．０５，ＲＲ＝１．３２）。     

Serum p55 and p75 tumour necrosis factor receptors as markers of disease activity in juvenile chronic arthritis.

OBJECTIVE: To determine the expression of tumour necrosis factor alpha (TNF alpha) and its soluble receptors (p55 and p75) in the sera and synovial fluid of patients with juvenile chronic arthritis (JCA), and their correlation with disease activity parameters. METHODS: Ninety eight sera from 45 patients with JCA (14 systemic, 12 polyarticular, 19 pauciarticular), 20 sera from age matched healthy controls, and five synovial fluids from five antinuclear antibody (ANA) positive pauciarticular JCA patients were tested for the presence of TNF alpha, soluble TNF receptors p55 and p75 (sTNFRp55, sTNFRp75), and interleukin-6 (IL-6) by an enzyme amplified sensitivity immunoassay. Physician global estimate of disease activity, weekly fever score and joint score, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), and haemoglobin concentration were evaluated as parameters of disease activity. The expression of p55 and p75 on peripheral mononuclear cells (MNCs) from five patients with systemic JCA and synovial MNCs from five ANA positive patients with pauciarticular JCA was evaluated by flow cytometry. RESULTS: TNF alpha serum concentrations did not differ significantly between the patients with active JCA and the control group. No correlation was found between TNF alpha and parameters of disease activity, but both p55 and p75 showed a significant positive correlation with the physician global estimate of disease activity (p < 0.001), ESR (p < 0.001), CRP (p < 0.001), and serum concentrations of IL-6 (p < 0.001). Serum concentrations of haemoglobin correlated inversely with the concentrations of p55 and p75 (p < 0.001). Synovial lymphocytes selectively expressed the p75 surface receptor. CONCLUSIONS: sTNFRp55 and sTNFRp75 each represent a sensitive marker of disease activity in JCA. Their increased expression in biological fluids may support the hypothesis that TNF alpha has a role in the pathogenesis of JCA.     

日本血吸虫病宿主肿瘤坏死因子活性的研究

采用L929细胞杀伤法,对晚期日本血吸虫病(晚血)患者和感染日本血吸虫尾蚴8wk、16wk及杀虫后8wk的新西兰兔,进行了外周血单核细胞(PBMC)的肿瘤坏死因子(TNF)诱生能力和血清TNF活性测定。晚血患者PBMC的TNF诱生能力明显低于正常人,而血清中TNF活性明显增高(P<0.01)。感染8wk和16wk兔PBMC的TNF诱生能力较正常兔显著增高,尤以感染8wk时为甚,血清TNF活性亦相应增高(P<0.01);在杀虫治疗后8wk,其PBMC的TNF诱生能力和血清TNF活性均降至正常。晚血患者血清TNF活性的增高可能参与肝纤维化过程。     

Expression of proinflammatory cytokines and their inhibitors during the course of spontaneous bacterial peritonitis

The aim of this work was the evaluation, in cirrhotic patients with noninfected ascites and with spontaneous bacterial peritonitis (SBP), of serum and ascitic fluid levels of proinflammatory cytokines [interleukin (IL) 1-, tumor necrosis factor (TNF-), and IL6] and antiinflammatory compounds [IL10, soluble IL-1 receptor antagonist (sIL-1Ra), soluble receptors of TNF p55 and p75 (sTNFR55 and sTNFR75), and soluble receptor of IL6 (sIL6R)], as well as their relationship with the outcome of the infection in those with SBP. These molecules were assayed by ELISA in noninfected cirrhotic controls (n = 15), patients with SBP (n = 32), and healthy controls (n = 20). Serum levels of IL6 and of the majority of antiinflammatory mediators, sIL1Ra, sTNFR75, and sIL6R, were higher in control cirrhotic patients compared to healthy subjects. SBP was associated with significantly elevated ascitic fluid levels of every one of the proinflammatory cytokines compared to those in cirrhotic controls. Also, serum levels of IL10 and both TNF receptors and ascitic fluid levels of sIL1Ra and sTNFR55 were higher in patients with SBP compared to cirrhotic controls. Ascitic fluid levels of proinflammatory cytokines decreased rapidly after resolution of the infection; however, nonsignificant changes were detected in ascitic fluid concentrations of antiinflammatory molecules. Thus, elevated levels of antiinflammatory compounds both in noninfected cirrhotic patients and in patients with SBP suggest a regulatory control of the inflammatory process by these molecules in liver cirrhosis patients.     

Excessive in vitro bacterial lipopolysaccharide-induced production of monokines in cirrhosis

The objective of this study was to analyze monokine production by peripheral blood mononuclear cells from patients with alcoholic cirrhosis. The capacity of peripheral blood mononuclear cells and purified monocytes from these patients to produce tumor necrosis factor alpha, interleukin 1 beta, and interleukin 6 was investigated. Spontaneous production of tumor necrosis factor alpha, interleukin 6 and interleukin 1 beta was similar in cirrhotic and healthy subjects, but serum levels of interleukin 6 (less than 2 U/ml vs. 9.5 +/- 3 U/ml) and tumor necrosis factor alpha (3.1 +/- 1.2 pg/ml vs. 12.0 +/- 1.2 pg/ml) were significantly higher in cirrhotic patients. However, peripheral blood mononuclear cells or purified monocytes from patients with alcoholic liver cirrhosis, stimulated in vitro with Escherichia coli lipopolysaccharide, displayed a marked increase of tumor necrosis factor alpha, interleukin 1 beta and interleukin 6 secretions compared with healthy controls. A striking feature of this overproduction was its reversibility as assessed by allowing cells to rest in vitro without lipopolysaccharide for 1 to 7 days before stimulation. In such conditions, tumor necrosis factor alpha and interleukin 6 secretions declined to levels present in healthy subjects in whom production remained stable, whereas interleukin 1 beta secretion markedly decreased in both groups to the point where no difference could be seen. This reversible oversecretion of cytokines after lipopolysaccharide stimulation, along with the lack of abnormality of spontaneous cytokine secretion, suggests that monocytes in these patients may have undergone an in vivo activation process analogous to a priming phenomenon. The in vitro activation with lipopolysaccharide may represent the correlate of in vivo endotoxemia observed during acute events such as sepsis.(ABSTRACT TRUNCATED AT 250 WORDS)     

HLA-DRB1和肿瘤坏死因子α基因多态性与肝硬化的遗传易感性

目的探讨HLA-DRB1和肿瘤坏死因子(TNF)α基因多态性与肝硬化遗传易感性之间的关系.方法应用聚合酶链反应-序列特异性引物法、限制性片段长度多态性等技术检测106例乙型肝炎后肝硬化患者和108例健康对照者的HLA-DRB1和TNFα基因多态性.结果肝硬化组HLA-DRB1*120X等位基因频率比对照组显著升高(35.9%比11.1%,P＜0.001),TNFα中TNF2/1基因型频率比对照组明显升高(19.8%比10.2%, P＜0.05),DRB1*150X等位基因频率明显低于对照组 (13.2%比30.6% ,P＜0.05),分层分析表明,DRB1*120X等位基因与肝硬化的关联大于TNF2等位基因.结论 HLA-DRB1*120X和TNF2等位基因与乙型肝炎后肝硬化的遗传易感性相关,携带这2个等位基因的个体发生肝硬化的危险性增加.HLA-DRB1*120X等位基因可能是肝硬化的易感基因,HLA-DRB1*150X等位基因为抗性基因.     

肿瘤坏死因子受体在肾小球系膜细胞中的基因表达及蛋白合成

目的：探讨肿瘤坏死因子α（ＴＮＦα）对肾小球系膜细胞（ＭＣ）作用的机理。方法：逆转录多聚酶链反应（ＲＴＰＣＲ）、原位杂交和免疫组织化学方法检测培养大鼠和人ＭＣ肿瘤坏死因子Ⅰ型受体（ＴＮＦＲ１）的基因表达及蛋白合成；原位杂交方法观察５例系膜增生性肾小球肾炎肾穿刺组织的ＴＮＦＲ１基因表达。结果：培养的大鼠和人ＭＣ有ＴＮＦＲ１ｍＲＮＡ的表达并有ＴＮＦＲ１蛋白的合成，系膜增生性肾小球肾炎增生的ＭＣ内有ＴＮＦＲ１表达。结论：ＴＮＦα通过与ＭＣ表面特异性受体相结合而发挥作用。     

Tumor necrosis factor soluble receptor p55 and lipid peroxidation in patients with acute alcoholic hepatitis

OBJECTIVES: In experimental models, liver injury induced by ethanol, cytotoxic activity of tumor necrosis factor (TNF) -alpha is principally mediated by TNF receptor p55 (TNFRp55). Among the various mechanisms underlying the toxic effects of TNF-alpha, overproduction of reactive oxygen species seems to play a key role in mediating TNF-alpha-induced cytotoxicity. The aim of this study was to evaluate, in patients with alcoholic liver disease, whether alcohol TNFRp55-mediated hepatotoxicity could account for lipid peroxidation expressed by significant increase in serum thiobarbituric reactive acid substances (TBARS) content, and could be amplified by decrease in blood total glutathione content and decrease in plasma antioxidant protective capacity. METHODS: We studied 27 patients with histological alcoholic liver disease (five fibrosis, six acute alcoholic hepatitis (AAH) without cirrhosis, four cirrhosis without AAH, and 12 cirrhosis with AAH. TNFsRp55 and TNFsRp75 plasma levels were measured using ELISA assays. Plasma lipid peroxidation was evaluated by the content of TBARS. Total glutathione (tGSH) content in blood was determined by a kinetic assay. The sensitivity of erythrocytes to an oxidative stress and the plasma antioxidant protective capacity were simultaneously determined by a simple method. RESULTS: In the 18 patients with mild or severe AAH, the plasma levels of TNFsRp55 were negatively correlated with tGSH and were positively correlated with TBARS, with total bilirubin and with discriminant function. tGSH was positively correlated with plasma selenium. The plasma levels of TNFsRp75 were positively correlated with TBARS and with total bilirubin. There was no significant correlation with the mean inhibitory 50% plasma volume or with the percentage of hemolyzed erythrocytes. CONCLUSIONS: Our data support the notions that, in patients with AAH, TNFsRp55 probably mediates cytotoxicity of TNF-alpha, and that cytotoxic effect could be amplified by tGSH depletion in enhancing lipid peroxidation.     

Serum levels of soluble tumor necrosis factor receptors and effects of interferon therapy in patients with chronic hepatitis C virus infection

OBJECTIVE: The aim of this study was to understand the significance of the tumor necrosis factor receptor (TNFR)-mediated signaling pathway in the pathophysiology of chronic hepatitis C. METHODS: The serum levels of soluble TNFRs (sTNFRs; sTNFR p55 and sTNFR p75) were measured in 84 patients with chronic hepatitis C virus (HCV) infection (24 sustained responders and 25 nonresponders to interferon [IFN] therapy and 35 patients with persistent normal blood chemistries) and 20 healthy controls, then compared with clinical parameters. RESULTS: The serum levels of sTNFRs increased in proportion to the severity of liver disease. The levels of sTNFRs revealed significant correlations with the serum levels of alanine aminotransferase, aspartate aminotransferase, gamma-glutamyl transpeptidase, and gamma-globulin, but not with the serum levels of HCV-core protein. In the sustained responder group, the levels of sTNFR p75 showed a significant decrease (p < 0.0002) 1 yr after IFN therapy, although the levels of sTNFR p55 did not. The levels of sTNFR p75 were correlated with the serum levels of macrophage-colony stimulating factor both before and after IFN therapy. In the nonresponder group, the levels of both sTNFRs were unaltered after IFN therapy. CONCLUSIONS: The TNF alpha-TNFRs system, especially the TNFR p75-mediated pathway, is involved in the hepatic inflammation-fibrosis process in chronic hepatitis C. The serum levels of sTNFR p75, but not sTNFR p55, were correlated with the serum levels of macrophage colony stimulating factor in this process.     

Plasma Tumor Necrosis Factor α Predicts Decreased Long-Term Survival in Severe Alcoholic Hepatitis

Plasma tumor necrosis factor alpha (TNF alpha), interleukin 1 alpha (IL-1 alpha), and interleukin 1 beta (IL-1 beta) were measured in plasma samples obtained from 23 patients with severe alcoholic hepatitis on admission and after 30 days of hospitalization. Over a 2-year follow-up period, 14 patients died at a mean time of 8 months following discharge. The presence of elevated plasma TNF alpha either at admission or discharge from the hospital was associated with death in 82% (14/17) of patients. By contrast absence of elevated plasma TNF alpha was associated with survival in 100% (6/6). The difference in survival with and without detectable plasma TNF alpha was significant at p = 0.0022. Plasma TNF alpha was not elevated in alcoholic patients without clinically apparent liver disease, with alcoholic cirrhosis, or in nonalcoholic healthy controls. Plasma IL-1 alpha was also significantly increased in alcoholic hepatitis whereas IL-1 beta was not. Neither IL-1 alpha nor beta was correlated with outcome in the alcoholic hepatitis group. It is concluded that the presence of elevated plasma TNF alpha is a significant predictor of decreased long-term survival in patients with severe alcoholic hepatitis.