婴幼儿下呼吸道SIgA变化规律及其与唾液SIgA相关性的探讨

对74例正常婴幼儿和70例患下呼吸道感染的婴幼儿同时测定下呼吸道分泌物(LRS)及唾液中SIgA的含量。两组检测对象在性别和年龄分组上无明显差异。结果表明:1LRS和唾液的SIgA含量都与年龄呈正性相关,各年龄组之间SIgA含量也存在着显著性差异(P<0.01);②感染婴幼儿组及其各年龄组的SIgA含量均明显高于正常婴幼儿组及其各年龄组(P<0.01);③LRS的SIgA含量与唾液SIgA含量之间存在密切的相关性(P<0.01)。作者认为婴幼儿下呼吸道感染后局部SIgA增高是一种正常的免疫应答反应,有助于控制感染;SIgA的变化规律可作为鉴别免疫缺陷的指标;应用测定唾液中SIgA间接反映LRS中SIgA水平的方法将推进临床免疫研究开展。     

儿童支气管哮喘与唾液中SIgA相关性初步研究

目的: 探讨唾液中分泌型免疫球蛋白A(SIgA)的水平与哮喘的相互关系.方法: 用ELISA方法检测25例健康儿童,30例已确诊哮喘并正规吸入治疗患儿及30例初诊为哮喘患儿唾液中SIgA的水平.结果: 健康儿童唾液中SIgA含量水平明显升高.健康对照组唾液中SIgA含量水平与哮喘初诊组、哮喘治疗组均有统计学差异(P<0.01).哮喘初诊组唾液中SIgA含量水平与哮喘治疗组间无统计学差异.结论: 哮喘患儿存在黏膜免疫功能低下,调节其呼吸道SIgA免疫系统,恢复呼吸道局部防御功能可从根本上减少小儿哮喘的触发和改善其预后.     

唾液SIgA、溶菌酶含量与牙周病关系的探讨

目的：探讨了牙周病患者唾液SIgA和溶菌酶含量的变化及临床意义。方法：应用放射免疫分析检测32例牙周病患者唾液SIgA含量、免疫扩散法检测溶菌酶含量,并与35名正常健康人作比较。结果：牙周病患者唾液SIgA和溶菌酶含量均非常显著地高于正常人组（P〈0.01）,经治疗1个月后与正常人组比较仍有显著性差异（P〈0.05）。结论：检测牙周病患者唾液SIgA和溶菌酶含量的变化对临床观察预后有重要的临床价值。     

唾液SIgA、溶菌酶含量与慢性支气管炎关系的探讨

目的：探讨了慢性支气管炎患者唾液SIgA和溶菌酶含量的变化及临床意义。方法：应用放射免疫分析检测38例慢性支气管炎患者唾液SIgA含量,免疫扩散法测定溶菌酶含量,并与35名正常人作比较。结果：慢性支气管炎患者唾液SIgA和溶菌酶含量非常显著地高于正常人组（P〈0．01）,经2周治疗后仍有显著性差异（P〈0．05）。结论：检测慢性支气管炎患者唾液SIgA和溶菌酶含量的变化对临床观察预后有重要的临床价值。     

黏膜免疫途径的研究进展

黏膜免疫系统是机体抵御病原体入侵的首道屏障,它包括消化道、呼吸道和生殖道黏膜等.通过不同的免疫途径进行局部免疫,对系统免疫和黏膜免疫系统的各部位产生的效果不同.提高机体的免疫力必须选择最佳的免疫途径.本文仅就近年来黏膜免疫的途径及效果的研究进展作一简要综述.     

乳酸杆菌和低聚异麦芽糖对抗生素相关腹泻大鼠肠粘膜SlgA的影响

目的:研究抗生素相关腹泻(Antibiotic-associated diarrhea, AAD)大鼠肠粘膜分泌型免疫球蛋白A(SIgA)的含量变化,探讨乳酸杆菌和低聚异麦芽糖复合配方(合生元)对肠粘膜SIgA水平的调节作用.方法:以盐酸林可霉素复制AAD模型,治疗组采用不同剂量的合生元灌胃.分别在实验第6d、第9d、第13d进行肠道菌群分析和肠粘膜SIgA水平检测(放射免疫分析).结果:AAD大鼠肠道菌群失调,肠粘膜组织中SIgA水平下降;不同剂量的合生元均能调节肠道菌群失调、促进肠粘膜SIgA水平的分泌.结论:乳酸杆菌和低聚异麦芽糖组成的合生元配方可提高AAD大鼠肠粘膜SIgA的分泌,提高肠道相关淋巴组织免疫功能,对AAD肠粘膜免疫屏障具有保护作用.     

牙周病患者治疗前后血清IL-6、hs-CRP和唾液SIgA测定的临床意义

目的：探讨了牙周病患者治疗前后血清IL-6、hs-CRP和唾液SIgA水平的变化及临床意义。方法：应用放射免疫分析和免疫比浊法对42例牙周病患者进行了治疗前后血清IL-6、hs-CRP和唾液SIgA测定,并与35名正常健康人作比较。结果：在治疗前血清IL-6、hs-CRP和唾液SIgA水平均非常显著地高于正常人组（P〈0.01）,经系统治疗一个月后,除IL-6、hs-CRP水平与正常人组比较无显著差异外（P〉0.05）,唾液SIgA水平与正常人组比较仍有显著性差异（P〈0.05）。结论：血清IL-6、hs-CRP和唾液SIgA水平在牙周病的发生、发展过程中的相互作用,观察其浓度的变化对探讨其发病机理、预防和指导用药均有重要的临床价值。     

Effect of moderate exercise on salivary immunoglobulin A and infection risk in humans

The incidence of upper respiratory tract infections (URTI) and salivary immunoglobulin A concentrations [IgA_s] of nine individuals were examined during 12 weeks of moderate exercise training, and compared to ten sedentary controls. Changes in maximal oxygen uptake were assessed at initial, mid-point and final evaluations (T1–3), while changes in [IgA_s] and salivary immunoglobulin concentration-salivary albumin concentration ratio ([IgA_s]:[Alb_s]) were monitored at T1 and T3. During the 12 week period, symptoms of URTI were self-recorded daily. During the period of training the level of fitness significantly increased (P<0.05) in the exercise group. The number of days recording symptoms of influenza, but not of cold, and total light URTI symptoms was significantly reduced in the exercise group during the last weeks of training. A significant increase in [IgA_s] and in [IgA_s]:[Alb_s] was found in the exercise group after training. Both [IgA_s] and [IgA_s]:[Alb_s] were significantly related to the number of days showing symptoms of influenza (P<0.01) and the total number of days of sickness (P<0.05). These data provide quantitative support for the belief that regular, moderate exercise results in an increased [IgA_s] at rest and [IgA_s]:[Alb_s], which may contribute to a decreased risk of infection. Electronic Publication     

The association between bacteria colonizing the upper respiratory tract and lower respiratory tract infection in young children: a systematic review and meta-analysis

BackgroundBacteria colonizing the upper respiratory tract (URT) of young children play a key role in the pathogenesis of lower respiratory tract infection (LRTI).ObjectivesTo systematically review the literature on the association between bacteria colonizing the URT and LRTI among young children.Data sourcesMEDLINE, Academic Search Premier, Africa-Wide Information and CINAHL, Scopus and Web of Science.Study eligibility criteriaStudies published between 1923 and 2020, investigating URT bacteria from LRTI cases and controls.ParticipantsChildren under 5 years with and without acute LRTI.MethodsThree reviewers independently screened titles, abstracts and full texts. Meta-analysis was done using Mantel–Haenszel fixed- or random-effects models.ResultsMost eligible studies (41/50) tested nasopharyngeal specimens when investigating URT bacteria. Most studies were of cross-sectional design (44/50). Twenty-four studies were performed in children in lower- or lower-middle-income countries (LMICs). There was higher prevalence of Haemophilus influenzae (pooled OR 1.60; 95% CI 1.23–2.07) and Klebsiella spp. (pooled OR 2.04; 95% CI 1.17–3.55) from URT specimens of cases versus controls. We observed a positive association between the detection of Streptococcus pneumoniae from URT specimens and LRTI after excluding studies where there was more antibiotic treatment prior to sampling in cases vs. controls (pooled OR 1.41; 95% CI 1.04–1.90). High density colonization with S. pneumoniae (>6.9 log¹⁰ copies/mL) was associated with an increased risk for LRTI. The associations between both Streptococcus and Haemophilus URT detection and LRTI were supported, at genus level, by 16S rRNA sequencing. Evidence for the role of Moraxella catarrhalis and Staphylococcus aureus was inconclusive.ConclusionsDetection of H. influenzae or Klebsiella spp. in the URT was associated with LRTI, while evidence for association with S. pneumoniae was less conclusive. Longitudinal studies assessing URT microbial communities, together with environmental and host factors are needed to better understand pathogenesis of childhood LRTI.     

Social Cognitive Factors,Physical Activity,and Mobility Impairment in Adults with Multiple Sclerosis

Among those with multiple sclerosis (MS), mobility impairment is common and significantly affects independent functioning and quality of life. The purpose of the study was to examine the role of physical activity in mobility impairment in individuals with MS and explore the social cognitive factors of social support, outcome expectations, and self-efficacy that facilitate physical activity among those with the disease. A sample of 319 individuals with MS were assessed on the following: family and friend social support, self-efficacy, and physical and social outcome expectations. Self-reported physical activity, perceived ambulation disability, balance confidence, and fall history were also measured. The structural model fit the data (χ² (29) = 24.49, p = 0.70; Root Mean Square Error of Approximation < 0.01; Comparative Fit Index = 1.0; Normed Fit Index = 0.96; Goodness of Fit Index = 0.98; Standardized Root Mean Square Residual = 0.03). The primary findings of the study revealed that physical activity was strongly linked to mobility impairment (path coefficient, –0.43), such that increasing levels of physical activity were associated with less mobility impairment. The most important predictors of health-promoting levels of physical activity were self-efficacy (path coefficient, 0.48) and social support (path coefficient, 0.38), with support from friends being a stronger indicator of social support than support from family. It may be prudent to design interventions aimed at increasing physical activity, especially in regard to helping individuals become more efficacious and building larger social networks, as this may serve to forestall advancing mobility impairment in those with MS.     

Prospective evaluation of epidemiological, clinical, and microbiological features of pandemic influenza A (H1N1) virus infection in Italy

Since several characteristics of pandemic influenza A (H1N1) virus infection remain to be determined, this study aimed to describe clinical features and complications of patients infected with H1N1. Subjects affected by influenza-like illnesses and a control group of asymptomatic patients were enrolled prospectively at an Emergency Department from October 2009 to April 2010. At enrollment, clinical data and nasopharyngeal swabs for virological analyses were obtained. Ill subjects were followed until recovery and swabs were collected weekly in patients infected with H1N1. Of 318 patients enrolled, 92 (28.9%) were positive to H1N1. Patients infected with H1N1 were mainly young adults and complained classic influenza-like symptoms. Fever was observed for a median time of 5 (IQR 3-7) days. Hospitalization occurred in 27.7% with 2% requiring intensive care unit admission: median length of hospitalization was 6 days (IQR 5-9). Pneumonia was diagnosed in 19.6% of patients. A similar proportion of lower airways involvement and of clinical complications was observed in subjects testing positive or negative for H1N1. However, patients infected with H1N1 were younger and hospitalized for a shorter period as compared to the control group (P = 0.002 and P = 0.045, respectively). Older age, asthma/chronic obstructive pulmonary disease and hypertension were associated with an increased risk of pneumonia. Viral shedding was observed for at least 1 week in 21.3% of patients. Asymptomatic infection was uncommon (1.1%). Respiratory syndromes caused by H1N1 and factors associated with disease severity were investigated and compared to influenza-like illnesses of other origin. Such findings might contribute to improve clinical and epidemiological management of the disease.     

Epidemiology and Phylogenetic Analysis of Human Rhinovirus/Enterovirus in Odisha,Eastern India

Introduction: Human rhinovirus (HRV) and Enterovirus (ENV) are the major causes of childhood acute respiratory tract infections (ARTIs). This study sought to understand the distribution pattern of HRV subgroups, their seasonality and association with respiratory complications in patients at a tertiary care hospital. Results: Of the total 332 ARTI samples, 82 (24.7%) were positive for ENV/HRV. Twenty positive samples were processed further for phylogenetic analysis. Ten of the 20 samples were identified to be HRVs (70% HRV A and 30% HRV C) and nine were enteroviruses. HRV A clustered near three distinct HRV types (A12, A78 and A82). Four of the HRV strains (represented as SEQ 137 rhino, SEQ 282 rhino, SEQ 120 rhino and SEQ 82 rhino) had high sequence similarity. HRV C showed seasonality and was associated with disease severity. Conclusion: The genotyping and phylogenetic analysis of the HRVs in the current study shows its circulatory pattern, association with risk factors and evolutionary dynamics.     

Human metapneumovirus in patients with respiratory tract infection in Kuwait

Human metapneumovirus (hMPV) has been recognized as an important cause of respiratory tract infections in all age groups and in all geographical area. The role of hMPV in causing respiratory tract infections in Kuwait was not yet investigated. The aim of this study was to determine the prevalence of hMPV infection in Kuwait among patients with respiratory tract infection with respect to other respiratory viruses. During January–December 2009, 460 respiratory samples from 388 patients with respiratory tract infection were collected from different hospitals. They were tested for hMPV RNA by real‐time PCR, and for other respiratory viruses by conventional PCR. Out of 388 patients, 110 (28%) were positive for viral respiratory infections; 21 (5.4%) were positive for hMPV, 29 (7.5%) were positive for rhinovirus, 13 (4%) were positive for respiratory syncytial virus, and 10 (3%) were positive for adenovirus. Most (n = 19, 90.5%) of hMPV‐positive patients were admitted to the intensive care unit, 76% of them were of age 2 years and below, and 24% of age 59 years and above. All hMPV‐positive elderly patients had pneumonia while 50% of hMPV‐positive infants had bronchopneumonia. Children with hMPV/rhinovirus co‐infection (n = 3, 1%) had recurrent chest infection and frequent intensive care unit admission. The hMPV infection was mostly detected between December and May, and genotype B was more prevalent than genotype A. This is the first study demonstrating the prevalence of hMPV infection in Kuwait, and suggests that hMPV infection is prevalent in infants and elderly patients with lower respiratory tract infection. J. Med. Virol. 83:1811–1817, 2011. © 2011 Wiley‐Liss, Inc.     

2014-2016年北京市严重急性呼吸道感染病例监测研究

目的 分析2014年8月-2016年7月北京市严重急性呼吸道感染(SARI)病例监测中监测到的SARI病例的流行病学、病原学和临床特征.方法 在北京市11家哨点医院开展SARI监测,收集病例的流行病学与临床信息,采集并检测病例的呼吸道标本,分析2014年8月至2016年7月SARI病例的流行病学、病原学和临床特征.结果 11家哨点医院共监测到6144例SARI病例,收集5125名病例的临床信息,采集5885名病例的呼吸道标本.SARI病例占入院病例数的11.1％.SARI病例中流感的阳性率为13.5％.5125例SARI患者中,男性占58.3％,以＜5岁(34.1％)和≥60岁(31.6％)者为主,基础病的患病率为31.8％,平均住院时间为7天.流感患者中肺部基础病者的比例高于非流感病例(19.0％ vs 14.1％,P＜0.001).流感病例的平均住院时间短于非流感病例(7dvs 8d,P=0.001).流感与非流感病例的ICU治疗率和死亡率的差异无统计学意义.结论 开展SARI监测对于了解流感在住院病例中的分布特征,以及流感导致的重症病例的临床特征等方面具有重要的意义.