单核细胞趋化蛋白—1和糖尿病肾病

糖尿病肾病（DN）往往存在着血糖、血脂的代谢紊乱及某些细胞因子（白介素－1、肿瘤坏死因子－α）和血管紧张素Ⅱ水平的升高，这些改变均可使体内单核细胞趋化因子－1（MCP－1）水平上升。MCP-1一种对单核细胞有强烈趋化作用的细胞因子，它的增多使肾小球中单核浸润，导致细胞外基质在肾小球和肾小管中堆积。因此MCP-1在DN的发生、发展中起重要作用。     

单核细胞趋化蛋白-1和糖尿病肾病

糖尿病肾病 (DN)往往存在着血糖、血脂的代谢紊乱及某些细胞因子 (白介素 1、肿瘤坏死因子 α)和血管紧张素Ⅱ水平的升高 ,这些改变均可使体内单核细胞趋化因子 1(MCP 1)水平上升。MCP 1是一种对单核细胞有强烈趋化作用的细胞因子 ,它的增多使肾小球中单核细胞浸润 ,导致细胞外基质在肾小球和肾小管中堆积。因此MCP 1在DN的发生、发展中起重要作用。     

单核细胞趋化蛋白-1与糖尿病动脉粥样硬化的关系

糖尿病慢性并发症遍及全身各重要器官,与非糖尿病人群相比,糖尿病人群中心血管疾病患病率升高2～4倍,在血管病变过程中,单核细胞趋化蛋白-1(MCP-1)起了重要作用.MCP-1是细胞因子趋化因子亚家族中的一员,MCP-1在生理情况下呈低水平表达,糖尿病时在高血糖、蛋白非酶糖化产物、血管紧张素Ⅱ、氧化应激、炎症等刺激因素影响下表达明显上调.MCP-1可促使外周血单核细胞向血管内皮细胞黏附、趋化并迁移至内皮下,导致血管平滑肌细胞异常增殖,参与动脉粥样硬化发生的病理过程.本文就糖尿病时MCP-1表达上调的因素、MCP-1促进动脉粥样硬化的机制、干预治疗对MCP-1的影响作一综述,进一步认识MCP-1与糖尿病动脉粥样硬化的关系.     

单核细胞趋化蛋白-1与糖尿病肾病

糖尿病肾病(DN)是终末肾功能衰竭的主要原因,主要的病理改变是肾小球肥大、细胞外基质积聚以及肾小球硬化.多种机制参与了DN的发生、发展,其中肾脏被炎性反应细胞如单核/巨噬细胞浸润是DN的标志之一.单核细胞趋化蛋白-1(MCP-1)是一种对单核细胞具有特异趋化功能的细胞因子,参与单核/巨噬细胞的浸润,在DN的发生、发展中起重要作用.     

贝那普利对糖尿病肾病大鼠MCP-1的影响

本研究证实糖尿病肾病(DN)大鼠的肾小球上有明显单核/巨噬细胞浸润，但机制尚不清楚。单核细胞趋化蛋白(MCP-1)是针对单核细胞的趋化因子，可能在DN的发生中起重要作用。     

C-C亚族趋化因子与糖尿病肾病

C-C亚族趋化因子主要趋化和激活单核细胞及某些T细胞亚群,对嗜酸性粒细胞、嗜碱性粒细胞以及自然杀伤细胞亦有不同作用,进而参与炎症过程。其中单核细胞趋化蛋白(MCP)-1和正常T细胞活化后表达和分泌的调节蛋白(RANTES)是巨噬细胞的特异性趋化因子,高糖、糖化血红蛋白及肾素-血管紧张素系统可促进其高表达,从而使巨噬细胞在肾脏聚集和活化,在糖尿病肾病肾小球硬化以及肾小管间质纤维化的发生、发展中发挥着重要作用。其中,核因子-κB可能参与了高糖对MCP-1的上调作用。     

氯沙坦对血管平滑肌细胞内单核细胞趋化因子-1表达的影响

为了探讨血管紧张素Ⅱ受体拮抗剂氯沙坦对血管平滑肌细胞内单核细胞趋化蛋白 1表达的影响 ,以培养幼兔主动脉平滑肌细胞为研究对象 ,分别给予不同浓度血管紧张素Ⅱ和 或血管紧张素Ⅱ受体拮抗剂氯沙坦 ,采用免疫组织化学、原位杂交与酶联免疫吸附技术检测不同处理组平滑肌细胞内单核细胞趋化蛋白 1蛋白及其mR NA表达和平滑肌细胞培养介质中单核细胞趋化蛋白 1含量的变化。结果发现 ,10 - 6 ～ 10 - 1 0 mol L血管紧张素Ⅱ呈剂量依赖性地增加平滑肌细胞内单核细胞趋化蛋白 1蛋白及其mRNA表达水平 ,增高培养介质中单核细胞趋化蛋白 1蛋白含量 (P均 <0 .0 0 1)。 10 - 5 ～ 10 - 7mol L氯沙坦预处理使血管紧张素Ⅱ刺激的平滑肌细胞内单核细胞趋化蛋白 1蛋白及其mRNA表达水平及培养介质中单核细胞趋化蛋白 1蛋白含量明显减低 (P均 <0 .0 0 1)。以上结果提示 ,氯沙坦可拮抗血管紧张素Ⅱ所致的平滑肌细胞内单核细胞趋化蛋白 1的表达与分泌 ,这可能有助于减轻或防治某些病理状态下血管平滑肌细胞的增殖与迁移。     

血管紧张素(1-7)对血管紧张素Ⅱ诱导脐静脉内皮细胞表达E-选择素和单核细胞趋化蛋白1的影响

目的 研究血管紧张素(1-7)对血管紧张素Ⅱ诱导的脐静脉内皮细胞E-选择素和单核细胞趋化蛋白1表达的影响,并初步探讨血管紧张素(1-7)的作用机制,阐明血管紧张素(1-7)对血管紧张素Ⅱ在炎症方面的拮抗作用.方法 经形态学及抗VⅢ因子抗体免疫荧光染色鉴定的人脐静脉内皮细胞,按以下分组加入不同干扰因素进行实验.实验分组:①对照组:不加干预因素;②血管紧张素Ⅱ组:加入血管紧张素Ⅱ100 nmol/L;③血管紧张素(1-7)组:加入血管紧张素(1-7)1 000 nmol/L;④血管紧张素Ⅱ+血管紧张素(1-7)组:分别用血管紧张素(1-7)10、100、1 000、10 000 nmol/L预处理30 min后,再加入血管紧张素Ⅱ100 nmol/L;⑤血管紧张素Ⅱ+血管紧张素(1-7)+血管紧张素(1-7)受体拮抗剂A-779组:先用1 000 nmol/L A-779预处理30 min后,再用终浓度为1 000 nmol/L血管紧张素(1-7)预处理30 min,最后加入终浓度100 nmol/L血管紧张素Ⅱ.各组用酶联免疫吸附法和逆转录聚合酶链反应从蛋白和mRNA水平检测E-选择素和单核细胞趋化蛋白1的表达情况.结果 正常细胞生长良好,呈鹅卵石样镶嵌排列,细胞透明度大,轮廓不清.荧光免疫组化染色法,可检测到培养的人脐静脉内皮细胞的VⅢ因子相关抗原为阳性.①与对照组比,血管紧张素Ⅱ(100 nmol/L)使E-选择素(25.39±1.97μg/L)和单核细胞趋化蛋白1(238.71±5.51 ng/L)的蛋白分泌量明显增加, E-选择素和单核细胞趋化蛋白1 mRNA的表达显著升高(均P<0.01);②血管紧张素(1-7)(1 000 nmol/L)使E-选择素(3.72±0.95μg/L)和单核细胞趋化蛋白1(90.24±9.82 ng/L)的蛋白分泌量降低,E-选择素和单核细胞趋化蛋白1 mRNA表达亦降低(均P<0.01);③混合刺激组中血管紧张素(1-7)(10～10 000 nmol/L)减少E-选择素蛋白合成,分别为21.15±1.31、17.41±1.94、12.71±1.84、9.46±1.40μg/L,均低于血管紧张素Ⅱ组(均P<0.01);同时也减少单核细胞趋化蛋白1蛋白合成,分别为214.57±7.16、196.83±8.20、176.63±8.93、155.52±8.19 ng/L,均低于血管紧张素Ⅱ组(均P<0.01);④混合刺激组中,与AngⅡ组比较,血管紧张素(1-7)(10～10 000 nmol/L)呈剂量依赖性的抑制AngⅡ刺激E-选择素、单核细胞趋化蛋白1 mRNA的表达(均P<0.01);⑤加入血管紧张素(1-7)受体拮抗剂A-779后,血管紧张素(1-7)的作用消失.结论 血管紧张素(1-7)通过其特异性受体Mas拮抗血管紧张素Ⅱ诱导的人脐静脉内皮细胞E-选择素和单核细胞趋化蛋白1的表达,并呈浓度依赖性.     

高浓度葡萄糖条件下血管紧张素Ⅱ对内皮细胞核因子κB和单核细胞趋化蛋白1的影响

观察高糖环境下血管紧张素Ⅱ对内皮细胞核因子κB活性、单核细胞趋化蛋白1表达及氯沙坦的干预作用。应用激光共聚焦显微镜观察核因子κB活性变化，逆转录．聚合酶链反应测定内皮细胞单核细胞趋化蛋白1mRNA表达，酶联免疫吸附法检测培养基中单核细胞趋化蛋白1含量变化。结果发现，高糖(25mmol/L)、10^-7mol/L血管紧张素Ⅱ均能显著刺激内皮细胞核因子κB活化、单核细胞趋化蛋白1mRNA表达，培养基中单核细胞趋化蛋白1含量及其对单核细胞趋化活性亦显著增强，高糖环境显著增加血管紧张素Ⅱ诱导的核因子κB活化、单核细胞趋化蛋白1表达，氯沙坦有显著抑制作用。提示高糖促进血管紧张素Ⅱ对内皮细胞的刺激作用，氯沙坦通过抑制内皮细胞核因子κB活化和单核细胞趋化蛋白1的表达．对动脉粥样硬化发展起到防治作用．     

氯沙坦通过下调单核细胞趋化蛋白1受体表达抑制单核细胞活化

目的探讨血管紧张素Ⅱ对单核细胞趋化蛋白1受体CCR2表达的影响及氯沙坦的干预作用。方法人单核细胞株与血管紧张素Ⅱ(10-7mol/L)孵育,加或不加氯沙坦(10-7、10-6和10-5mol/L),检测上清液中单核细胞趋化蛋白1水平、单核和内皮细胞粘附情况以及CCR2mRNA的表达。结果与对照组比较,血管紧张素Ⅱ明显增加单核细胞培养上清液中单核细胞趋化蛋白1水平(26.46±3.58ng/L比10.56±2.34ng/L,P<0.01),增加单核内皮细胞间粘附(596±27比268±16,P<0.01)。血管紧张素Ⅱ刺激细胞后明显上调CCR2mRNA表达,氯沙坦能显著抑制血管紧张素Ⅱ的作用,降低单核细胞趋化蛋白1的水平,减少单核内皮细胞间粘附,下调CCR2 mRNA表达。结论氯沙坦通过下调单核细胞趋化蛋白1受体CCR2基因表达抑制单核细胞活化。     

The immunoneuroendocrine role of melatonin

Abstract: A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as -γ-interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.     

Response of rat pineal melatonin to calcium, magnesium, and lithium is circadian stage dependent

Abstract: Herein we documented the response of pineal melatonin production to electrolytes known to be effective on pineal function in view of a possible circadian stage dependence. We studied the release of melatonin by perifused rat pineal glands at 2 different circadian stages corresponding to the middle of the light and dark periods, i.e., respectively, 7 and 19 HALO (Hours After Light Onset, L:D = 12:12). The initial efflux rates were, as expected, much higher in the perifusates of glands removed from rats sacrificed during the dark phase than of those removed during the light phase. After 3 hr of perifusion, melatonin release reached similar levels which were found constant up to the 8th hr of perifusion, whatever the circadian stage. Perifusion of the glands with physiological concentrations for the rat of calcium (5.2 mmol/1) and magnesium (1.34 mmol/1) resulted in a stimulatory effect on the pineal glands removed from rats sacrificed in the middle of the dark period (19 HALO), whereas no effects were observed on the pineal glands removed from rats sacrificed during the light (7 HALO). Lithium (0.28 and 0.55 mmol/1) was ineffective on melatonin release in pineal glands removed 7 and 19 HALO. Our results show differences in the initial efflux rates of melatonin and in the response of perifused pineal glands to calcium and magnesium according to the circadian stage.     

Changes in connexin43, the gap junction protein of astrocytes, during development of the rat pineal gland

Abstract: The abundance of gap junctions between rat pineal astrocytes formed by connexin43 (Cx43) was studied during development. Levels and distribution of Cx43 were measured by immunoblotting and indirect immunofluorescence, respectively. The amount of Cx43 in cells located within the gland was low until about the 7th postnatal day and increased to adult values between the 14th and 21st days postpartum. Although astrocytes, recognized by their vimentin immunoreactivity, were scarce before birth, they were abundant by the 7th postnatal day suggesting that the low levels of Cx43 found at this age corresponded to a low expression of this protein. Localization of the immunoreactivity to Cx43 and vimentin showed a close correlation, indicating that mature or immature pineal astrocytes form gap junctions made of Cx43. Since Cx43 levels attained their adult values at about the time the innervation and the functional state of the gland reached maturity (2–3 weeks after birth), it is proposed that astrocyte gap junctions are involved in the function of the adult rat pineal gland.     

Conservative management of perforated duodenal diverticulum： A case report and review of the literature

Duodenal diverticula are a relatively common condition. They are asymptomatic, unless they become complicated, with perforation being the rarest but most severe complication. Surgical treatment is the most frequently performed approach. We report the case of a patient with a perforated duodenal diverticulum, which was diagnosed early and treated conservatively with antibiotics and percutaneous drainage of secondary retroperitoneal abscesses. We suggest this method could be an acceptable option for the management of similar cases, provided that the patient is in good general condition and without septic signs.     

Presence of immunoreactive growth hormone and prolactin in the ovine pineal gland

Abstract: The use of antisera raised against bovine growth hormone (GH) and ovine prolactin (PRL) enabled the detection of related immunoreactive (ir) sequences of proteins in ovine pineal tissue. The isolation of PRL-like ir-material was accomplished using a 0.25 M ammonium sulphate (pH 5.5) extraction followed by ethanol precipitation, whereas the resulting 2.0 M ammonium sulphate (pH 7.0) precipitate contained a GH-like immunoreactivity. Gel chromatography of the GH-like immunoreactivity (Sephadex G-100) indicated the presence of several GH-like fragments ranging in the M_r range of 7,000 to 55,000. Analyses of the PRL-like ir-material found in pineal tissue on HPLC using a TSK 545-DEAE column led to the resolution into a single peak of immunoreactivity. A single peak of activity was also observed following chromatofocusing and hydrophobic interaction chromatography of the ir-peak from the TSK 545-DEAE column. The PRL-like ir-material inhibited the binding of [¹²⁵I]ovine PRL-S14 to anti-ovine PRL antibodies without showing an affinity for binding to anti-rat PRL or anti-bovine GH antibodies. Scatchard analysis of the binding of pineal PRL-like ir-material and pituitary ovine PRL-S14 to liver membranes from day-20 pregnant rats revealed similar affinity constants (K_a of 4.7 ± 0.2 × 10⁹ M^-1). In addition, the replication of Nb 2 Node rat lymphoma cells was stimulated by pineal PRL-like ir-material, an effect known to be specific for lactogenic hormones. The pineal PRL-like immunoreactivity appeared on sodium dodecyl sulfate polyacrylamide gels as a single major band of M_r 24,000. The functional status of PRL-and GH-like ir-material in the ovine pineal remains to be determined, but evidence is presented that the overall protein synthesis rate of the rat pineal responded to circulating concentrations of PRL.     

Microbiology of human immunodeficiency virus anorectal disease

PURPOSE: Individuals who are seropositive for the human immunodeficiency virus are at high risk for opportunistic infection and anorectal disorders. Little prospective information is available regarding anorectal pathogens in these patients. METHODS: One hundred sixty-three HIV-seropositive patients presented to the colorectal clinic between 1989 and 1992. Forty-seven (29 percent) patients were thought to have an infectious process and were prospectively studied using a standardized multiculture protocol. RESULTS: Mean age was 33 (range, 19–59) years. All were male; high-risk behavior accounted for 87 percent of HIV transmissions. Presenting complaints included anorectal pain (79 percent), pus per anum (28 percent), and blood per anum (26 percent). Examination revealed perianal tenderness (60 percent), condyloma (38 percent), perianal ulcers (38 percent), and anal fissures (34 percent). Sixty-six sets of cultures were performed; 28 patients had one set, 15 had two sets, and 4 had three sets. Thirty-two of these 47 patients (68 percent) had positive cultures including herpes (50 percent), cytomegalovirus (25 percent),Neisseria gonorrhoeae (16 percent), chlamydia (16 percent), acidfast bacilli (2 percent), and others (9 percent). Six of 32 patients with positive cultures had more than one organism cultured. Sixteen (50 percent) patients with positive cultures were treated medically, 8 (25 percent) were treated surgically and 8 (25 percent) were treated with both modalities. Sixty-one procedures were performed on 17 patients for condylomata. Eighteen patients had 20 procedures for abscesses, 50 percent of whom had positive cultures for other than common bowel flora; all improved. Fourteen patients underwent 33 procedures for perianal fistulas.Mycobacterium fortuitum was cultured from one patient who required 13 procedures for abscesses and fistulas. Forty-five (96 percent) patients were followed for an average of 12.5 months ±2.9 SEM (range, 1–94 months). Symptoms were improved or resolved in 22 of 32 (69 percent) patients with positive cultures and in 11 of 13 (84 percent) with negative cultures. CONCLUSIONS: Specific pathogens may often be identified in human immunodeficiency virus-seropositive patients with anorectal disorders if aggressively sought. Although patients without specific pathogens identified may be expected to improve with planned empiric treatment, positive identification allows more directed therapy.