SLE患者T细胞和IL－2／IL－2R系统变化的临床意义

本文检测３７例（４１份）ＳＬＥ患者ＩＬ－２的产生、ｍＩＬ－２Ｒ的表达、ｓＩＬ－２Ｒ水平、淋巴细胞转化及Ｔ细胞亚群。结果表明：ＳＬＥ患者ｓＩＬ－２Ｒ水平升高，而ＩＬ－２的产生、ｍＩＬ－２Ｒ的表达、淋转率、ＣＤ４＋百分率和ＣＤ４＋／ＣＤ８＋比值均下降，由于其中仅有ｓＩＬ－２Ｒ水平与疾病活动性有关，因而ｓＩＬ－２Ｒ可作为疾病活动的一个指标。免疫指标的变化与激素治疗无关。本文认为Ｔ细胞功能及ＩＬ－２释放紊乱主要是由疾病本身的免疫调节紊乱引起。     

IL－2R水平在骨髓增生异常综合征中的意义

为了对ＭＤＳ的发生发展和免疫学异常进一步了解，我们用双抗体夹心ＥＬＩＳＡ法检测２０例ＭＤＳ患者血清中ｓＩＬ－２Ｒ水平；采用ＡＰＡＡＰ桥联酶免疫染色观察９例ＭＤＳ患者ＰＢＭＣ中ｍＩＬ－２Ｒ的表达，发现ＭＤＳ患者血清中ｓＩＬ－２Ｒ较正常人增高。在ＭＤＳ亚型中ＲＡＥＢ，ＲＡＥＢ－ｔ组较ＲＡ组增高显著，Ｐ＜０．０１；校再障组也增高。ｍＩＬ－２Ｒ阳性细胞百分率也较正常人高。血清中ｓＩＬ－２Ｒ释放水平与ＰＢＭＣ中ｍＩＬ－２Ｒ的表达比较，两者无明显相关。研究结果表明，ＭＤＳ除髓系细胞累及外，ＩＬ－２Ｒ水平增高可能是ＭＤＳ淋巴细胞异常，免疫系统功能紊乱的一种表现。     

可溶性IL－2R在选择性IgA缺乏症发病机理中的意义

白细胞介素２（ＩＬ－２）及其受体（ＩＬ－２Ｒ）系统在机体免疫调节中发挥着重要作用。本研究首先以间接免疫荧光技术检测了选择性ＩｇＡ缺乏症（ＳＩｇＡＤ）患儿活化淋巴细胞膜表面白细胞介素２受体（ｍＩＬ－２Ｒα）的表达情况及其Ｔ细胞亚类水平，继而采用双抗体夹心ＥＬＩＳＡ法检测了ＳＩｇＡＤ患儿血清可溶性白细胞介素２受体（ＳＩＬ－２Ｒα）的含量。结果表明：ＳＩｇＡＤ患儿组的Ｔａｃ阳性细胞百分率（ｍＩＬ－２Ｒα）明显高于正常对照组，其ＣＤ４＋细胞百分率明显低于正常对照组、ＣＤ８＋细胞百分率明显高于正常对照组。而其血清ＳＩＬ－２Ｒα含量亦明显高于正常对照组。研究显示：ＳＩｇＡＤ患儿ｍＩＬ－２Ｒα的表达虽高于正常对照组，但因其Ｔ细胞亚类的显著异常既有体内存在着明显的细胞免疫功能的损害，导致ＩＬ－２的生成不足，使高水平的ＳＩＬ－２Ｒα大量脱落成为ＳＩＬ－２Ｒα，而ＳＩＬ－２Ｒα又可与ＳＩＬ－２Ｒα竞争结合ＩＬ－２，从而使机体细胞免疫功能的损害进一步加剧。     

呼吸道合胞病毒下呼吸道感染对机体细胞免疫的影响

为研究呼吸道合胞病毒（ＲＳＶ）急性下呼吸道感染（ＡＬＲＩ）的细胞免疫变化，对２５例病儿外周血白细胞介素２（ＩＬ－２）和可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平、Ｔ细胞白细胞介素２受体（ＩＬ－２Ｒ）表达率和Ｔ细胞亚群百分率进行检测。结果显示，急性期病儿外周血ＩＬ－２水平明显低于恢复期和正常对照组，Ｔ细胞ＩＬ－２Ｒ表达率亦明显降低，而ｓＩＬ－２Ｒ水平却显著增高。急性期病儿ＩＬ－２水平与Ｔ细胞ＩＬ－２Ｒ表达率和ＣＤ＋４细胞百分率呈正相关，与ｓＩＬ－２Ｒ水平和ＣＤ＋８细胞百分率呈负相关；ｓＩＬ－２Ｒ水平与Ｔ细胞ＩＬ－２Ｒ表达率呈负相关，与临床严重程度呈正相关。上述各项免疫指标异常均提示ＲＳＶ感染时机体存在细胞免疫功能紊乱。     

慢性活动性乙型肝炎患者细胞免疫功能检测及其临床意义

测定了例慢性活动乙型肝炎患者外周血单个核细胞（ＰＢＭＣ）产生的白细胞介素２（ＩＬ－２）活性，其中部分病人检测了血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）水平，膜白细胞介素２受体（ｍＩＬ－２Ｒ）表达，ＬＡＫ活性及外周血Ｔ淋巴细胞亚群，并分析了它们之间的相关性，结果表明：ＩＬ－２活性，ｍＩＬ－２Ｒ表达，ＬＡＫ活性，ＣＤ４／ＣＤ８比值显著低于正常对照组（Ｐ〈０．００１），而ｓＩＬ－２Ｒ水平，ＣＤ８细胞显     

IL—2R水平在骨髓增生异常综合征中的意义

为了对ＭＤＳ的发生发展和免疫学异常进一步了解，我们用双抗体夹心ＥＬＩＳＡ法检测２０例ＭＤＳ患者血清中ＳＩＬ－２Ｒ水平；采用ＡＰＡＡＰ桥联酶免疫染色观察９例ＭＤＳ患者ＰＢＭＣ中ｍＩＬ－２Ｒ的表达，发现ＭＤＳ患者血清中ｓＩＬ－２Ｒ较正常人增高。在ＭＤＳ亚型中ＲＡＥＢ，ＲＡＥＢ－ｔ组较ＲＡ组增高显著，Ｐ＜０．０１；较再障组也增高。ｍＩＬ－２Ｒ的表达比较，两者无明显相关。研究结果表明，ＭＤＳ除髓系细胞累及     

IL—4在诱导CD4,45RA^＋和CD4,45RO^＋T细胞向IL—4产生细胞分化？…

应用ＥＬＩＳＰＯＴ（Ｅｎｚｙｍｅ－ｌｉｋｅｄｉｍｍｕｎｏｓｐｏｔａｓｓａｙ）单细胞检测技术，研究了淋巴因子在诱导ＣＤ４，４５ＲＯ和ＣＤ４，４５ＲＡＴ细胞向ＩＬ－４产生细胞分化过程中的影响，在存在ＰＭＡ和ｉｏｎｍｙｃｉｎ的情况下，ＩＬ－２和ＩＬ－４均可以诱导ＣＤ４，４５ＲＯＴ细胞分化为ＩＬ－４产生细胞，但是只有ＩＬ－４可以诱导ＣＤ４，４５ＲＡＴ细胞向ＩＬ－４产生细胞分化，ＩＦＮγ既不能诱导ＣＤ４，４     

肝癌患者LAK,IL—2活性,mIL—2R及sIL—2R表达研究

本文报道肝癌病人的ＬＡＫ、ＩＬ－２活性及ｍＩＬ－２Ｒ表达均明显低于正常人，而ｓＩＬ－２Ｒ表达则显著高于正常人。且ＩＬ－２活性与ＬＡＫ活性呈正相关，与ｓＩＬ－２Ｒ呈负相关；而ｓＩＬ－２Ｒ与ｍＩＬ－２Ｒ呈正相关，与ＬＡＫ活性呈负相关。表明肝癌病人的细胞免疫功能可能处于一种抑制或紊乱状态。同时检测ｓＩＬ－２Ｒ及ｍＩＬ－２Ｒ可作为肝癌病人免疫状态的监测指标。     

sIL－2R与SLE的临床表现和自身抗体的相关性

用双抗体夹心ＥＬＩＳＡ检测６６例ＳＩＥ病人血清叽ｓＩＬ－２Ｒ水平，ＳＬＥ病人显著高于正常人，疾病活动期高于非活动期。血清ｓＩＬ－２Ｒ水平与ＡＮＡ、抗ｄｓ－ＤＮＡ抗体、抗Ｓｍ、ＳＳ－Ａ、ＳＳ－Ｂ抗体无关，而与ＳＬＥ患者的发热、贫血、白细胞减少、关节受累及肾脏损害相关，且与ＳＬＥ疾病活动性和ＥＳＲ成正相关，与补体Ｃ＿３、Ｃ＿４和ＣＨ＿（５０）成负相关。提示血清ｓＩＬ－２Ｒ水平是监测ＳＬＥ疾病活动性的一个良好指标。     

智能低下患儿外周血T淋巴细胞亚群与sIL－2R水平的变化

本文检测５５例智能低下（ＭＲ）患儿及正常人外周血Ｔ淋巴细胞亚群及血清可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）的水平，结果表明ＭＲ患儿ＣＤ３＋、ＣＤ４＋细胞显著低于对照组，ＣＤ８＋细胞明显高于对照组，ＣＤ４＋／ＣＤ８＋比值下降。ｓＩＬ－２Ｒ活性明显高于对照组。     

慢性肾功能衰竭患者血液透析前后白细胞介素2及其受体的变化

本文报道２０例作维持性血液透析的慢性肾功能衰竭患者，其血清ｓＩＬ－２Ｒ水平以及静息期和诱导后表达ｍＩＬ－２Ｒ的活化Ｔ淋巴细胞百分率，均明显高于正常人对照组，患者经一次血透后即时检测，ｓＩＬ－２Ｒ和静息期ｍＩＬ－２Ｒ两种指标的水平均呈显著降低。此外，血透后血中ＩＬ－２水平较血透前增高。结果提示，慢性肾功能衰竭患者存在ＩＬ－２及其相应受体水平的异常，而充分透析能予以部分纠正。     

麻疹患者血清SIL-2R和T淋巴细胞亚群的相关性探讨

目的 :探讨了血清可溶性白细胞介素 - 2受体 (SIL - 2R)和T淋巴细胞亚群在麻疹感染中的作用。方法 :应用双抗体夹心ELISA法和单克隆抗体法对 37例麻疹患者进行了血清SIL - 2R和T淋巴细胞亚群测定 ,并以 35例正常人作对照。结果 :麻疹患者在出疹期血清SIL - 2R水平显著地高于正常人组 (P <0 0 1) ,至恢复期虽然血清SIL - 2R水平有所下降 ,但与正常人组比较仍有显著性差异 (P <0 0 1)。SIL - 2R水平与T淋巴细胞亚群中CD8细胞比值密切相关。结论 :检测麻疹患者血清SIL - 2R和T淋巴细胞亚群水平可作为患者病情变化、预后判断的重要检测指标。     

乙型病毒性肝炎患者血清IL-2、slL-2R、IL-13及PDGF测定的意义

目的：探讨乙型肝炎患者血清IL-2、sIL-2R、IL-13及PDGF水平的变化及测定的临床意义。方法：150例乙型肝炎患者分为3组（急性肝炎组20例、慢性肝炎组90例和重型肝炎组40例）;设健康人45名作为对照组。前2项血清标志物均采用放射免疫分析;后2项血清指标则采用酶联免疫吸附试验测定。将测定结果进行统计分析。结果：本文测定数值显示,血清IL-2水平急性肝炎患者组水平与对照组比较略有降低,但无统计学意义（P〉0.05）;慢性肝炎和重型肝炎2组患者该指标水平则均显著低于对照组（P均〈0.05）。sIL-2R水平显示急性、慢性及重型肝炎3组患者均非常显著地高于对照组（P均〈0.01）,且发现其递增规律与肝炎病情的严重程度呈明显的平行关系。IL-13水平测定结果也显示3组患者均显著高于对照组（P均〈0.05）。PDGF测定值显示,急性肝炎组水平显著高于对照组（P〈0.05）,慢性肝炎和重型肝炎2组水平则较对照组升高更为显著（P均〈0.01）。其水平的递增关系也与病情的严重程度相一致。结论：本文患者4项血清指标水平的变化与乙型肝炎的发病及病情进展有关;其测定有助于了解本病的发生机制和预后评估。     

肝硬化患者血清sIL-2R和T淋巴细胞亚群水平的探讨

目的：探讨了肝硬化患者血清可溶性白细胞介素-2（sIL-2R）和T淋巴细胞亚群的水平及意义。方法：应用ELISA和单克隆抗体法对54例肝硬化患者进行了血清sIL-2R和T淋巴细胞亚群的测定，并与30名正常健康人作比较。结果：肝硬化患者血清sIL-2R水平非常显著地高于正常人组（P〈0．01），经3个月的治疗后血清sIL-2R水平与正常人比较仍有差异（P〈0．05），且sIL-2R水平和T淋巴细胞亚群中的CD4／CD8细胞比值密切相关。结论：检测肝硬化患者血清sIL-2R和T淋巴细胞亚群水平可作为患者病情、预后判断的重要检测指标。     

IL-2 regulation of soluble IL-2 receptor levels following thermal injury.

In the immunosuppressed burn patient serum levels of both IL-2 and a soluble form of IL-2 receptor alpha (sIL-2R alpha) are significantly elevated. Strikingly, the production of these markers by the in vitro activated patients' cells is decreased. This study examines the role of IL-2 in the decreased production of the sIL-2R alpha in vitro in patients with major burns (n = 18, 30 to greater than 70% total body surface area). Peripheral blood mononuclear cell (PBMC) cultures from patients with highly elevated serum sIL-2R alpha, and from healthy controls (n = 12) were activated with concanavalin A (Con A) at initiation. In patients' cultures mitogen-induced increments of sIL-2R alpha levels were significantly lower. There was a significant negative correlation (r = 0.64, P less than 0.001) between a high serum sIL-2R alpha level and a decreased lectin-induced sIL-2R alpha release in vitro. Low levels of sIL-2R alpha in patients' samples were not normalized by increasing the number of T lymphocytes. Also exogenous rIL-1 was without effect, whereas rIL-3 increased sIL-2R alpha release in some cultures. However, sIL-2R alpha levels were significantly increased in patients' cultures by (i) addition of exogenous IL-2; (ii) removal of adherent cells; (iii) addition of cyclooxygenase inhibitor, indomethacin; (iv) bypassing cell surface activation by the combination of the calcium ionophore A23187 and the phorbol ester 12-o-tetradecanoyl acetate. The cyclic AMP-elevating drug, forskolin, abrogated the ability of exogenous IL-2 to increase sIL-2R alpha production. Thus, in the burn patient, the reduced in vitro sIL-2R alpha release appears to relate to abnormalities in IL-2 production and action mediated through its functional surface receptor. Elevated levels of sIL-2R alpha in vivo may, therefore, reflect systemic activation of T lymphocytes in response to biologically active IL-2.     

The role of interleukin 2 (IL-2) and serum-soluble IL-2 receptor cells in idiopathic IgA nephropathy.

Interleukin 2 (IL-2) plays a central role in the immune response and may be involved in the derangement of cellular immunoregulation of idiopathic IgA nephropathy (IgAN). The aim of this study was to investigate the serum levels and production of IL-2 from peripheral blood mononuclear cells (PBMC) and the distribution of IL-2 receptor cells and serum-soluble IL-2 receptor cells (sIL-2R) in patients with IgAN. Twenty-four patients with IgA nephropathy and 11 healthy controls (age and sex matched) were studied during an infection-free period without signs of clinical activity at the moment of the study. Serum IL-2 concentrations did not differ between patients and controls. The supernatant levels of IL-2 taken from 24-hr cultures of PBMC stimulated with phytohemagglutinin or tumor necrosis factor increased significantly in the patients but not in the controls. The percentage of IL-2R positive cells (CD25+) was increased in patients compared with controls. Moreover, IgAN patients had increased activated CD4+ lymphocytes when compared with the controls. Serum levels of sIL-2R were significantly higher in patients than in controls. There were no correlations among renal function, serum IgA levels, and urinary findings with cellular subsets or with IL-2 levels. However, sIL-2R was higher in the subgroup of patients with episodic macrohematuria and was closely related with the presence of red blood cells in the urinary sediment. We conclude that PBMC of IgA nephropathy patients have an overproduction of IL-2 after mitogenic stimulation, an increased helper T cell activity, increased IL-2R+ cells, and elevated serum levels of sIL-2R. These alterations are present in periods of apparent clinical inactivity. Finally, sIL-2R is closely related with hematuria, providing a good marker for disease activity. Our results suggest a pivotal role of IL-2 in cellular immune responses with regard to T cell activation in patients with IgAN.     

普乐可复对难治性肾病综合征患者血清IL-2、sIL-2R的影响及其临床意义

目的:研究普乐可复(FK506)对难治性肾病综合征患者血清IL-2、sIL-2R的影响及其临床意义。方法:应用酶联免疫吸附法检测难治性肾病综合征患者经普乐可复治疗前后血清IL-2、sIL-2R水平变化,并监测患者24小时尿蛋白、血浆白蛋白、血脂的变化。结果:难治性肾病综合征患者经普乐可复治疗前血清IL-2、sIL-2R水平均显著高于正常对照组(P<0.05)。治疗后血清IL-2、sIL-2R水平较治疗前明显下降(P<0.05)。治疗前24小时尿蛋白水平显著高于正常对照组(P<0.01),血浆白蛋白显著低于正常对照组(P<0.01),血脂水平显著高于正常对照组(P<0.01);与治疗前比较,治疗后24小时尿蛋白水平显著下降(P<0.05),血浆白蛋白水平显著升高(P<0.01),血脂水平显著下降(P<0.05)。治疗后组与正常组比较,除IL-2外,余各项指标均无显著性差异(P>0.05)。结论:在难治性肾病综合征患者体内存在IL-2、sIL-2R的异常,普乐可复对其有明确的抑制作用,从而调节T细胞活性,有效降低24小时尿蛋白,提高血浆白蛋白含量,降血脂,缓解难治性肾病综合征的病情。     

In Vivo CD3+CD25+ Lymphocyte Subpopulation Is Down-regulated Without Increased Serum-Soluble Interleukin-2 Receptor (sIL-2R) by Gonadotropin Releasing Hormone Agonist (GnRH-a)

PROBLEM: To test further whether the suppression of the CD3⁺CD25⁺ lymphocyte sub-population by gonadotropin-releasing hormone agonist (GnRH-a) is related to the change in levels of cytokines and soluble interleukin-2 receptor (sIL-2R). METHOD: Twenty-seven infertile patients were enrolled under the long protocol of GnRH-a agonist (buserelin acetate) and superovulation with gonadotropin from our IVF-ET program. Peripheral B cells, NK cells, CD4⁺ and CD8⁺ T cells and the expression of CD69, CD25, HLA-DR, and CD71 antigens on the T cells were serially examined by dual-color flow cytometry. Serum levels of cytokines and sIL-2R were measured. RESULTS: The B cells, NK cells, T cells, CD4⁺, CD8⁺ T cells, CD3⁺DR⁺, and CD3⁺CD71⁺ lymphocyte subpopulations were not changed after the use of GnRH-a. The CD25⁺ T cell subpopulation was significantly down-regulated, but the CD69⁺ T cell subpopulation was increased when the GnRH-a was used for approximately 2 wk. The serum levels of interleukin-lp (IL-1β), interleukin-2 (IL-2), interleukin-4 (IL-4), interferon-γ (IFN-γ), and sIL-2R were not changed. CONCLUSION: The GnRH-a had a transiently suppressive effect on CD25⁺ T cells, but a stimulatory effect on CD69⁺ T cells. However, the serum level of cytokines or sIL-2R did not change. These immunological modulations seems to be the result of interaction between GnRH-a and estrogen.