ELISA检测可溶性白细胞介素2受体夹心法的临床应用及其评价

应用双单克隆抗体夹心法ＥＬＩＳＡ对甲型肝炎、肾综合征出血热、小儿呼吸道合胞病毒感染以及肾移植术后患者等血清中可溶性白细胞介素２受体进行了定量检测，并对该方法的敏感性、重复性等参数进行了对比观察。结果表明，该广方法敏感性高、特异性强、重复性好，变异率低于国外同类产品，所检测的临床疾病ＳＩＬ－２Ｒ水平的变化与文献报道相符，并与病情、病程相关性良好，可用于基础和临床免疫学研究。     

血清sIL－2R检测在肺癌中的应用

可溶性白介素２受体（ｓＩＬ－２Ｒ）与白介素２（ＩＬ－２）介导的免疫反应密切相关，检测ｓＩＬ－２Ｒ取材方便、易于检测，已迅速引起临床医学重视。肺癌病人血清ｓＩＬ－２Ｒ升高，对治疗有反应者降低，是肺癌病人病情监测、疗效判定的参考指标。本文就ｓＩＬ－２Ｒ在肺癌方面的临床应用研究作一综述。     

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。     

血清sIL—2R检测在肺癌中的应用

可溶性白介素２受体（ｓＩＬ－２Ｒ）与白介素２（ＩＬ－２）介导的免疫反应密切相关，检测ＳＩＬ－２Ｒ取材方便，易于检测，已迅速引起临床医学重视。肺癌病人血清ｓＩＬ－２Ｒ升高，对治疗有反庆者降低，是肺癌病人病情监测，疗效判定的参考指标。本文就ｓＩＬ－２Ｒ在肺癌方面的临床应用研究作一综述。     

恶性肿瘤和感染性疾病患者血清sIL－2R的动态观察

本文对恶性肿瘤和感染性疾病患者血清中ｓＩＬ－２Ｒ水平进行动态观察。结果表明，手术切除恶性肿瘤后，发生转移的患者血清ｓＩＬ－２Ｒ水平较手术前升高；未发生转移的患者ｓＩＬ－２Ｒ水平较手术前降低，提示术后ｓＩＬ－２Ｒ水平的升高可能与肿瘤的转移有关。ｓＩＬ－２Ｒ与其它癌指标同步检测结果显示，ｓＩＬ－２Ｒ水平的异常升高比其它癌指标出现得早。ｓＩＬ－２Ｒ水平与感染性疾病的活动程度有关。相关分析表明，ｓＩＬ－２Ｒ与ＨＡ和ＣＧ呈显著正相关。     

伤寒患者血清TNF,IL—2,sIL—2R水平的研究

为了解肿瘤坏死因子（ＴＮＦ）、白细胞介素２（ＩＬ－２）和可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）在伤寒发病中的作用，以双抗体夹心法检测２７例伤寒患者及１６例正常人血清ＴＮＦ、ＩＬ－２和ｓＩＬ－２Ｒ水平。结果发现，伤寒患者血清ＴＮＦ水平和ｓＩＬ－２Ｒ水平均明显高于正常人水平（Ｐ＜０．０１）。而血清ＩＬ－２水平显著低于正常对照（Ｐ＜０．０１）。对１５例伤寒患者各病期血清ＴＮＦ、ＩＬ－２和ｓＩＬ－２Ｒ水平动态观察发现伤寒患者血清ＴＮＦ、ｓＩＬ－２Ｒ水平动态变化与患者体温、病期、病情变化具有密切关系。伴肝功能损伤和有诸如消化道出血、肺炎、急性肾衰等并发症及复发性伤寒的患者其血清ＴＮＦ、ｓＩＬ－２Ｒ水平明显高于无肝功能损伤及无并发症的患者。结果提示，临床检测伤寒患者血清ＴＮＦ、ｓＩＬ－２Ｒ除可协助诊断外，对于患者病情、病期、预后的判断及治疗效果的观察均具有重要意义，因此可作为临床观察伤寒病情及判断预后的监测指标。血清ＩＬ－２检测对于伤寒的诊断有一定帮助，但作为判断临床病情、病期及预后的指标意义不大     

恶性肿瘤和感染性疾病患者血清sIL－2R的动态观察

本文对恶性肿瘤和感染性疾病患者血清中ｓＩＬ－２Ｒ水平进行动态观察。结果表明，手术切除恶性肿瘤后，发生转移的患者血清ｓＩＬ－２Ｒ水平较手术前升高；未发生转移的患者ｓＩＬ－２Ｒ水平较手术前降低，提示术后ｓＩＬ－２Ｒ水平的升高可能与肿瘤的转移有关。ｓＩＬ－２Ｒ与其它癌指标同步检测结果显示，ｓＩＬ－２Ｒ水平的异常升高比其它癌指标出现得早。ｓＩＬ－２Ｒ水平与感染性疾病的活动程度有关。相关分析表明，ｓＩＬ－２Ｒ与ＨＡ和ＣＧ呈显著正相关。     

血清sIL－2R水平与晚期胃癌治疗及预后相关研究

通过ｓＩＬ－２Ｒ单克隆抗体建立了双夹心ＥＬＩｓＡ法检测了１６１例晚期胃癌（Ⅲ～Ⅳ期）在手术前后、化疗及术后复发或转移时，机体血清中ｓＩＬ－２Ｒ变化。结果表明：晚期胃癌患者血清中ｓＩＬ－２Ｒ水平显著高于正常人（ｎ＝４０），且ｓＩＬ－２Ｒ升高尤以术后复发或远处转移时明显，晚期癌较早期（Ⅰ～Ⅱ期）升高更显著，ｓＩＬ－２Ｒ＜１０００Ｕ／ｍｌ时，患者３年生存率显著高于＞１０００Ｕ／ｍｌ者；化疗有效时，其水平下降，反之无效者，ｓＩＬ－２Ｒ水平则无明显改变，甚至升高。这些结果提示ｓＩＬ－２Ｒ监测对于判断胃癌进展及临床疗效和评估其预后有重要临床价值。     

登革热患者血清sIL—2R含量的变化及意义

本文采用双抗体夹心ＥＬＩＳＡ法检测了３８例登革热（ＤＦ）患者血清中可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）的水平。结果显示ＤＦ患者血清ｓＩＬ－２Ｒ明显升高，ｓＩＬ－２Ｒ的水平与患者发热时间长短及皮疹性质（充血性和出血性皮疹）有关，且与患者尿蛋白含量呈正相关。表明ｓＩＬ－２Ｒ时判断ＤＦ的病情及肾脏损害程度有一定的临床意义，并提示ｓＩＬ－２Ｒ可能参与了ＤＦ的免疫病理过程。     

IL－2和sIL－2R在哮喘发病中的意义探讨

为了探讨ＩＬ－２和ｓＩＬ－２Ｒ在哮喘发病中的意义，对３６例哮喘患者外周血单个核细胞（ＰＢＭＣ）诱生ＩＬ－２水平和血浆ｓＩＬ－２Ｒ水平进行了检测，同时以支气管炎患者与正常人作对照。结果表明，ＰＢＭｃ诱生的ＩＬ－２活性哮喘组高于正常对照组（ｐ＜０．０５）；血浆ｓＩＬ－２Ｒ水平哮喘组高于支气管炎和正常组（ｐ＜０．０１），后两者差异无显著性。以上结果表明，哮喘发病中存在着Ｔ细胞的活化，ＩＬ－２／ＩＬ－２Ｒ在哮喘发病中起作用。     

人巨细胞病毒感染对肾移植受者血清sIL－2R水平的影响

用ＰＣＲ检测ＨＣＭＶ－ＤＮＡ，ＥＬＩＳＡ法检测ＨＣＭＶ－ＩｇＭ及ＩｇＧ，以诊断肾移植受者ＨＣＭＶ感染。用双抗体夹心法ＥＬＩＳＡ检测６５例肾移植受者血清ｓＩＬ－２Ｒ水平，结果表明：ＨＣＭＶ感染后宿主血清ｓＩＬ－２Ｒ水平明显增高（Ｐ＜０．０１），且ＨＣＭＶ疾病组ｓＩＬ－２Ｒ增高程度大于无症状感染组（Ｐ＜０．０１）；６例原发性ＨＣＭＶ感染者ｓＩＬ－２Ｒ水平与ＩｇＭ水平呈正相关（ｒ＝０．９９０８），提示随感染程度增加，血清ｓＩＬ－２Ｒ水平随之增高，还发现血清ｓＩＬ－２Ｒ水平与Ｃ９４／ＣＤ８比值是负相关（ｒ＝－０．９７８９），说明ＨＣＭｖ感染后ｓＩＬ－２Ｒ水平增高与Ｔ细胞亚群改变有关，反之也说明ｓＩＬ－２Ｒ增高程度可表明体内免疫抑制状态。对于ＨＣＭＶ感染后血清ｓＩＬ－２Ｒ水平增高的机理有待进一步探讨。     

分泌性中耳炎中耳积液和血清中sIL－2R水平的初步研究

应用酶联免疫吸附法（ＥＬＩＳＡ）对３０例正常人血清（对照组）和６０例分泌性中耳炎患者（ＳＯＭ组）中耳积液和血清中可溶性白细胞介素２受体（ｓＩＬ－２Ｒ）进行了检测。结果示ＳＯＭ组血清ｓＩＬ－２Ｒ水平明显高于对照组，ＭＥＦ中其含量明显高于血清；鼻咽癌组血清及ＭＥＦ中ｓＩＬ－２Ｒ水平明显高于─般ＳＯＭ组；粘液组高浆液组；慢性组高于急性组（均Ｐ＜０．０１）。提示：血清及ＭＥＦ中ｓＩＬ－２Ｒ水平的测定有助于对ＳＯＭ患者免疫状态的评估；ＭＥＦ中ｓＩＬ－２Ｒ可能主要由局部中耳粘膜产生；ＭＥＰ中高浓度的ｓＩＬ－２Ｒ存在可能是ＳＯＭ迁延不愈的─个原因。     

Soluble interleukin-2 receptors in plasma cell dyscrasias

Levels of the soluble form of the interleukin-2 receptor (sIL-2R) were evaluated in the peripheral blood of 69 patients with plasma cell dyscrasias. A close relationship was seen between serum sIL-2R levels and clinical features. Among patients with normal BUN and creatinine levels, the mean (+/- 1SD) level of sIL-2R in 44 patients with multiple myeloma (MM) was higher than that of normal controls (457 +/- 227 U/ml vs 288 +/- 124 U/ml, P = 0.01). The mean level of sIL-2R in eight patients with primary macroglobulinemia was 722 +/- 251 U/ml. In MM, those with active or refractory disease showed a significantly higher mean level of sIL-2R than those in the remission phase (577 +/- 240 U/ml vs 335 +/- 103 U/ml, P = 0.01). There was a negative correlation between sIL-2R and hemoglobin levels in MM patients (r = -0.45, P = 0.01). Five patients with complications of renal insufficiency had elevated levels of sIL-2R. In a longitudinal study of a patient with plasmacytoma and an extremely high sIL2-R level, the sIL-2R level showed a strong relationship with tumor burden. Patients with high sIL-2R levels generally had a poor prognosis than those with normal levels. Thus a high sIL-2R level may be an indicator of a poor prognosis in MM.     

Clinical significance of serum soluble IL-2R levels in patients with adult T cell leukaemia (ATL) and HTLV-1 carriers

The levels of soluble IL-2Ralpha (sIL-2Ralpha) in serum were measured in HTLV-1 carriers and ATL patients in order to evaluate their possible correlation with clinical status. Mean sIL-2R levels in ATL patients were found to be 9704 U/ml for the acute/lymphoma type, 1961 U/ml for the chronic type and 788 U/ml for the smouldering type. The level for asymptomatic HTLV-1 carriers was 475 U/ml, and 165 U/ml for healthy young adult HTLV-1- controls. The serial measurement of sIL-2R in ATL patients, healthy HTLV-1 carriers, and HTLV-1 carriers with diseases other than ATL showed a good correlation between serum levels of sIL-2R and the pathophysiological status of disease. Furthermore, an increase in the sIL-2Ralpha level in serum indicated the exacerbation of HTLV-1 infection and autoimmune diseases. The measurement of sIL-2Ralpha levels is therefore a very useful parameter for determining disease status.     

sIL－2R在肝癌患者血清中的高度表达

本文应用ＥＬＩＳＡ双抗体夹心法检测了正常人和早期、晚期肝癌患者血清中可溶性白细胞介素－２受体（ｓＩＬ－２Ｒ）水平。结果表明：肝癌患者血清ｓＩＬ－２Ｒ水平明显高于正常人（Ｐ＜０．０１）．早期肝癌患者治疗前后其ｓＩＬ－２Ｒ水平差异显著（Ｐ＜０．０５），从而提示血清中ｓＩＬ－２Ｒ高表达现象可能为肝癌早期诊断、疗效判断及病情转归提供重要的参考价值；同时提供了本地区人血清中ｓＩＬ－２Ｒ水平正常参考标准。     

肾移植受者血清TNF-α、IL-6和sIL-2R水平变化及临床意义

目的:探讨肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和可溶性白细胞介素-2受体(sIL-2R)在肾移植术后急性排斥反应中的变化。方法:采用固相酶标记化学发光免疫分析技术动态监测36例患者肾移植前后血清TNF-α、IL-6和sIL-2R水平,并结合临床资料作全面分析。结果:肾移植受者术后第1天血清TNF-α、IL-6和sIL-2R均明显升高,其中移植稳定组血清IL-6和sIL-2R第1天出现峰值后开始下降,而TNF-α则在术后5天达峰值后开始下降,至第10天均接近术前水平。急性排斥组血清TNF-α、IL-6和sIL-2R水平与肾功能稳定组比较,差异有显著性(P<0.05),抗排斥治疗有效后迅速下降。而环孢素A中毒组与稳定组比较,差异无显著性(P<0.05)。结论:肾移植术后受者血清TNF-α、IL-6和sIL-2R水平的检测,可在一定程度上反映肾移植受者的免疫反应状态,并为急性排斥反应的监测和诊断提供客观依据。     

Serum levels of soluble IL-2 receptor, IL-4 and IgE-binding factors in childhood allergic diseases.

The serum levels of soluble IL-2 receptor (sIL-2R), IL-4 and IgE-binding factors were examined in children with allergic diseases, and compared with those in non-allergic controls of the same age and sex. The results showed age-related decreases in the serum levels of sIL-2R and IgE-binding factors, but not in that of IL-4 in both allergic and non-allergic individuals. Significant elevation of sIL-2R was observed in sera from children with atopic eczema or history of an anaphylactic reaction to food, as compared with that in non-allergic controls. The serum concentration of IL-4 was elevated in all allergic groups, including cases of atopic eczema, bronchial asthma and anaphylaxis to food, compared with non-allergic controls, and was correlated significantly with the serum level of IgE (r = 0.59). The IgE-binding factor levels in sera from patients aged 6-10 years with bronchial asthma, or patients aged 1-5 years with a history of food anaphylaxis were elevated as compared with those in non-allergic controls of same age. There was no significant correlation between the serum levels of IgE-binding factors and IgE. Since sIL-2R is released by activated T cells, the present study is in favour of T cell activation causing allergic skin disorders. The serum levels of IL-4 as well as IgE did not differ among allergic patients of different clinical categories. The role of IgE in atopic eczema and other allergic diseases is not clearly established; however, it seems likely that IL-4 is deeply involved in the increased production of IgE seen in allergic individuals. The possible involvement of IgE-binding factors in the age-related changes of clinical manifestations in childhood allergic diseases was also discussed.     

本草九代对慢性迁延性肝炎患者血清可溶性白细胞介素2受体水平的调节作用

用ELISA方法检测了29名慢性迁延性肝炎患者和18名健康献血员血清可溶性白细胞介素2受体(sIL-2R)水平,同时进行了血清IL-2与sIL-2R的相关分析。结果发现,正常人sIL-R为147±72.1u/ml,而慢性迁延性肝炎病人sIL-2R显著升高(210.5±84).GWe治疗3个月后sIL-2水平显著下降(185.8±79);同时发现IL-2水平与sIL-2R 有一定相关性。上述结果提示GWe具有调节机体IL-2功能的独特作用。