Independence of depressed lectin-dependent cell-mediated cytotoxicity from interleukin 2 production in patients with systemic lupus erythematosus.

The relationship of lectin-dependent cell-mediated cytotoxicity (LDCC) to interleukin-2 (IL-2) production was studied in healthy subjects and in patients with systemic lupus erythematosus (SLE). Profoundly depressed levels of LDCC were elicited by peripheral blood mononuclear cells (PBMC) from nine patients with active SLE in comparison to LDCC from seven controls, and eleven inactive SLE donors, using 3H-TdR-prelabelled adherent HEP-2 cells as targets in a 24 h assay with 25 micrograms/ml Con A. In parallel experiments, no individual correlation was found between LDCC activity and IL-2 production for healthy or SLE subjects. Further, no major differences were detected in IL-2 release when the three groups of donors were compared, a tendency observed at the Con A doses (5 and 25 micrograms/ml) and incubation times (24, 48, and 72 h) used to induce IL-2 production. In additional studies, impaired Con A-induced blastogenesis was noted for PBMC from active SLE patients in comparison to the PBMC from the controls or patients with inactive SLE. While strong individual correlation was obtained between blastogenesis and IL-2 secretion in controls and patients with inactive SLE, no such relationship was found in patients with active SLE. While addition of exogenous IL-2 to the cytotoxicity assay considerably enhanced LDCC by healthy donors it failed to improve LDCC by patients with active SLE. These data suggest that depressed LDCC and Con A-induced blastogenesis of patients with active SLE may not be related to impaired IL-2 production but rather to an inherent dysfunction of the effector lymphocytes, including their unresponsiveness to IL-2.     

SLE患者外周血单个核细胞分泌白细胞介素6和IgG的研究

我们研究了21例SLE患者和正常人外周血单个核细胞(PBMC)体外培养自发和丝裂原刺激后细胞增殖、IL—6产生、IgG分泌的情况。发现SLE 患者PBMC经PHA和PWM刺激后,细胞增殖的指数降低;用IL—6细胞依赖株(MH_(60)·BSF_2)检测培养上清液中的IL—6,发现活动期SLE患者PBMC自发和PHA刺激后产生的IL—6明显高于缓解期SLE患者(P<0.001)和正常人(P<0.001);活动期和缓解期SLE患者PBMC体外自发分泌IgG量增高,分别为正常人自发分泌量的5.68倍和4.48倍;我们首次用统计学方法分析了SLE患者细胞培养上清液中的IL—6水平与分泌的IgG量的关系,发现两者有显著的相关性(r=0.7046,P<0.001)。     

系统性红斑狼疮病人外周血中TNF和IL—1的检测

肿瘤坏死因子（ＴＮＦ）和白细胞介素１（ＩＬ－１）是一对介导炎性反应的主要细胞因子，用细胞生物法，ＥＬＩ０Ａ法和３Ｈ－ＴｄＲ渗入法对２０例系统性红斑狼疮（ＳＬＥ）患者的外周血单个核细胞（ＰＢＭＣ）培养上清和血清进行了ＴＮＦ和ＩＬ－１水平的检测。结果表明：ＳＬＥ病人的ＰＢＭＣ在体外对有丝分裂原的刺激不敏感。其上清液中的ＴＮＰ的活性和上清液及血清中ＴＮＦ－α蛋白含量的水平与疾病的活动性及是否合并感染均无相关性。ＳＬＥ病人ＩＬ－１的生物活性和健康人无明显差异。活动期病人ＩＬ－１的分泌水平低于恢复期患者，ＩＬ－１分泌能力的降低和病情活动有关。     

狼疮肾炎外周血单个核细胞IL-16活化的初步观察

目的:目的:观察狼疮肾炎(LN)外周血单个核细胞(PBMCs)白细胞介素16(IL-16)的分泌及IL-16mRNA的表达。方法:采用酶联免疫吸附法(ELISA)检测PBMCs IL-16分泌的水平;采用逆转录聚合酶链反应(RT-PCR)方法检测PBMCs IL-16mRNA的表达。结果:①LN患者PBMCs自发分泌IL-16,活动组较静止组、正常对照组增高,存在显著性差异(265.6±102.2vs.120.5±84.1;265.6±102.0 vs.50.9±32.4,P<0.05);②LN活动组与静止组PBMCs IL-16mRNA表达增强,较正常对照组存在显著性差异(5.090±1.815 vs.1.030 ±0.426;3.910±1.430 vs.1.030±0.426,P<0.05),但LN活动组与静止组之间IL-16-mRNA的表达差异没有显著性(5.090 ±1.815 vs.3.910±1.430)。结论:LN患者PBMCs存在IL-16mRNA的高表达和自发的IL-16过度分泌。IL-16可能参与介导LN的发病机制。     

狼疮性肾炎患者外周血IL-18水平及其基因表达

为了探讨白细胞介素 18(IL 18)在狼疮性肾炎 (LN )发生、发展中的作用。我们采用逆转录多聚酶链反应 (RT PCR )及酶联免疫吸附 (ELISA )法测定 16例正常人及 18例LN患者外周血单个核细胞 (PBMC )IL 18mRNA表达量及其血浆水平。结果提示LN患者PBMCIL 18mRNA表达量及血浆IL 18水平均较正常对照组显著增高 [IL 18mRNA表达量为 :1 2 6 2± 0 189vs0 84 4± 0 15 5 ,P <0 0 0 1;IL 18血浆水平为 :(82 2 0 9± 5 32 77)pg/mlvs (2 39 5 7± 75 0 6 )pg/ml,P <0 0 0 1]。且WHOIV型LN增高较非IV型LN更为显著 [IL 18mRNA表达量为 :1 32 9± 0 2 1vs 1 138± 0 15 2 3,P <0 0 5 ;IL 18血浆水平为 :(1135 5 4± 5 15 34)pg/mlvs (5 0 8 6 5± 341 36 )pg/ml,P <0 0 1]。另外 ,血浆IL 18水平与肾组织活动指数 ,肾小管间质损害程度呈等级相关 (r分别为 :0 6 10和 0 4 99,P均 <0 0 5 ) ,也与血清肌酐 (Scr) ,血清内生肌酐清除率 (Ccr)及 2 4h尿蛋白排泄量 (2 4hUPQ )呈直线相关 (r分别为 :0 898、 0 6 2 8和 0 5 37,P均 <0 0 5 )。本研究认为循环IL 18表达和分泌增高可能参与LN的免疫发病过程 ,并与狼疮活动有一定的关系     

系统性红斑狼疮患者外周血单个核细胞中急性期蛋白反应因子的表达

目的　探讨系统性红斑狼疮 (SLE)患者外周血单个核细胞 (PBMC)中急性期蛋白反应因子 (APRF)的活性水平 ,以及IL 6和IL 10对APRF表达的影响。方法　采用凝胶阻滞电泳 (EMSA)的方法检测 4 0例SLE患者及 2 0例正常对照组PBMC中DNA结合蛋白APRF的表达水平。结果　所有活动期SLE患者均出现APRF电泳条带 ,17例非活动期SLE患者中有 10例出现APRF条带 ,而正常人对照组无 1例出现。 7例未出现APRF电泳条带的非活动期SLE患者PBMC加IL 10处理后均出现不同程度的APRF表达 ,而加IL 6处理时仍未出现APRF电泳条带。结论　SLE患者存在APRF的异常表达。在SLE中 ,IL 10信号转导途径中的某些调控机制 (如蛋白激酶 )可能发生改变 ,从而使得核内的APRF激活转录 ,提示IL 10很可能是通过APRF在SLE的发病机制中起作用 ,相反IL 6在SLE发病的作用机制很可能与APRF无关。     

白细胞介素18受体在人类外周血单个核细胞及肾组织表达的研究

目的 :进一步明确白细胞介素 (IL 18)在肾组织免疫性损伤中的作用。方法 :应用半定量逆转录 多聚酶链反应(RT PCR)技术检测 16例正常人 ,16例原发性系膜增生性肾小球肾炎 (MsPGN)患者以及 18例狼疮性肾炎 (LN)患者外周血单个核细胞 (PBMC)白细胞介素 18受体 (IL 18R)α链mRNA的表达量 ,并用免疫组化方法检测 6例正常肾组织 ,16例MsPGN)患者及 18例LN患者肾组织IL 18Rα链蛋白表达量。结果 :MsPGN患者PBMCIL 18RmRNA表达量较正常组有所增高 ,但未达统计学意义 (P >0 0 5 ) ,LN患者PBMCIL 18RmRNA表达量较正常人显著增高 (P <0 0 0 1) ;正常肾组织存在较弱的IL 18R表达 ,MsPGN患者肾组织IL 18R表达量较正常肾组织有所增强 ,但未达统计学差异 ,而LN患者肾组织IL 18R的表达量较正常肾组及MsPGN组均显著增强 (P <0 0 0 1) ,但Pearson相关分析发现LN患者PBMC及肾组织IL 18R表达量均不与血清肌酐 (Scr)水平及 2 4小时尿蛋白排泌量 (2 4h UPE)存在相关关系。结论 :IL 18信号在全身系统及肾组织局部的免疫调节中起一定的作用 ;IL 18在肾功能未严重损害MsPGN患者的发病过程中可能所起作用不大 ;LN患者不但存在IL 18的过量产生 ,而且存在着IL 18过度作用的问题 ,抑制过强的IL 18作用信号可能是LN治疗的新途径。     

Cells with dendritic morphology and bright interleukin-1 alpha staining circulate in the blood of patients with rheumatoid arthritis.

Freshly isolated peripheral blood mononuclear cells (PBMC) from 10 healthy volunteers, 28 patients with rheumatoid arthritis (RA), eight patients with osteoarthritis, and five patients with ankylosing spondylitis were examined for interleukin-1 alpha (IL-1 alpha) and interleukin-1 beta (IL-1 beta) production using monoclonal antibodies and an indirect immunofluorescent method. In freshly isolated PBMC from healthy controls very few cells were stained for either IL-1 type. All 20 RA patients who were not receiving parenteral gold therapy had PBMC staining for IL-1 alpha. In these patients, up to 7.5% of PBMC showed bright IL-1 alpha staining (range 1.2-7.5%). No IL-1 beta staining was seen. These IL-1 alpha-staining cells had a dendritic morphology and the percentage of cells staining correlated well with levels of C-reactive protein, an index of disease activity in these RA patients. Significantly fewer IL-1 alpha-staining cells were present in the peripheral blood of RA patients receiving gold therapy and in the blood of patients with osteoarthritis and ankylosing spondylitis. These IL-1 alpha-containing cells, circulating in the blood of RA patients and correlating with disease activity have not been previously described. These results support the idea that IL-1 alpha plays an important role in the pathogenesis of rheumatoid inflammation.     

外周血单个核细胞在狼疮性肾炎病人体内高效表达IL-6的观察

为了确定狼疮性肾炎（ＬＮ）病人体内是否存在内源性ＩＬ－６表达增高及其来源，作者应用ＥＬＩＳＡ法检测５８例ＬＮ病人的血清及外周血单个核细胞（ＰＢＭＣ）内ＩＬ－６蛋白的含量，用原位杂交方法结合ＩＢＡＳ２．０图像分析系统，检测其中２０例ＬＮ病人ＰＢＭＣ在未受任何刺激时ＩＬ－６ｍＲＮＡ表达强度，并分析三者之间的关系。结果表明该三者水平在ＬＮ病人体内均异常增高，活动期尤其明显，三者之间互呈直线正相关。提示ＬＮ病人ＰＢＭＣ内源性过度表达和合成ＩＬ－６是其外周血ＩＬ－６水平增高的原因之一，异常增高的循环ＩＬ－６对狼疮性全身性病理损害，尤其对肾损害具有重要的作用。此外，血清ＩＬ－６过高还提示ＬＮ处于活动期，对临床指导治疗有一定意义。     

系统性红斑狼疮患者外周血单个核细胞中白细胞介素-10mRNA表达的研究

目的 探讨白细胞介素(IL-10)在系统性红斑狼疮(SLE)中的作用。方法 采用逆转录多聚酶链反应(RT-PCR)及酶联免疫吸附法(ELISA)测定40例SLE患者和20例正常对照组外周血单核细胞(PBMC)IL-10mRNA表达及IL-10自发分泌水平。结果 SLE患者PBMC自发分泌IL-10水平及其IL-10mRNA表达水平均显著高于正常对照组(P<0.01),其中SLE活动期明显高于非活动期(P<0.01),而非活动期又明显高于正常对照组(P<0.01)。结论 IL-10在SLE发病中起重要作用,PBMC分泌IL-10水平对SLE诊断和病情活动性监测有重要临床意义,拮抗SLE患者体内IL-10水平,将为SLE治疗开辟一条新途径。     

狼疮肾炎患者外周血单个核细胞IL-17信号转导途径的初步研究

目的:了解IL-17及其信号转导成分JNK活化状态在狼疮肾炎(LN)发病机制中作用。方法:活动期LN病人15例,分离、培养外周血单个核细胞(PBMC);ELISA法检测上清液IL-6蛋白水平;逆转录多聚酶链反应法检测IL-6mRNA水平;蛋白印迹法检测JNK活性。结果:IL-17刺激下,LN患者PBMC反应性明显增强,各浓度点IL-6蛋白水平明显高于正常对照(均P<0.05)。LN患者PBMCIL-6mRNA表达水平明显高于对照组(无刺激培养:1.80±0.11vs0.36±0.07,P<0.01;刺激培养:3.21±0.24vs1.30±0.14,P<0.05);正常对照或LN患者刺激培养组PBMCIL-6mRNA表达水平均明显高于其无刺激培养组(对照:1.30±0.14vs0.36±0.07,P<0.05;LN患者:3.21±0.24vs1.80±0.11,P<0.01)。LN患者PBMCJNK活性水平明显高于对照组(无刺激培养:3.21±0.32vs1.00,P<0.01;刺激培养:4.82±0.39vs1.21±0.35,P<0.01);LN患者的刺激培养组PBMCJNK活性水平明显高于LN对照培养组(4.82±0.39vs3.21±0.32,P<0.01)。活动性LN病人PBMCJNK活性高低与其SLEDAI和IL-6mRNA水平均呈显著正相关。结论:IL-17介导LN患者PBMC过度表达、分泌IL-6可能是其参与LN的发病机制之一,JNK的活化在IL-17信号转导中具有重要作用。     

Th22 细胞及其功能分子IL-22 在狼疮性肾炎中的作用研究

目的:观察狼疮性肾炎(LN)患者外周血中的Th22 细胞及其功能分子白细胞介素(IL)-22 的表达,并探讨其意义。方法:选择系统性红斑狼疮患者(无肾脏受累)38 例,狼疮性肾炎患者32 例,健康志愿者10 例,分别作为SLE 组、LN 组和健康对照组(HC 组)。应用流式细胞仪检测其外周血中Th22 细胞,酶联免疫吸附实验检测患者血清中IL-22 的水平。比较三组Th22 细胞和血清中IL-22 水平差异,分析LN 组Th22 细胞和IL-22 与SLE 疾病活动指数评分(SLEDAI)的相关性。结果:SLE 组和LN 组患者外周血中Th22 细胞较健康对照组明显升高(P<0.01),血清中IL-22 水平也较健康对照组明显升高(P<0.01);Th22 和IL-22 在LN 组较SLE 组要稍微高表达,但差异均无统计学意义(P>0.05);LN 组患者Th22 细胞比例和IL-22水平与对应患者的疾病活动性评分SLEDAI 呈正相关。结论:Th22 细胞和其功能分子IL-22 参与SLE 和LN 的发病和进展。     

系统性红斑狼疮患者血清IL-10和IL-18的检测及意义

目的探讨系统性红斑狼疮（SLE）患者血清IL-10和IL-18的表达及其与疾病活动的关系。方法应用ELISA法检测104例SLE患者和100例健康体检者血清IL-10和IL-18的水平,其中SLE患者根据疾病活动性指数（SLEDAI）评分标准分为活动组（56例）和缓解组（48例）,比较各组结果的差异,并分析SLEDAI与IL-10和IL-18的相关性。结果 SLE组IL-10和IL-18水平分别为（18.25±3.66）、（582.61±65.28）pg/ml,明显高于对照组的（7.12±2.36）、（186.24±60.39）pg/ml,差异有统计学意义（P〈0.01）;SLE活动组IL-10和IL-18水平分别为（25.98±4.75）、（683.72±62.48）pg/ml,高于缓解组的（14.67±3.21）、（493.51±69.17）pg/ml,差异亦有统计学意义（P〈0.01）;SLE患者血清IL-10和IL-18水平与SLEDAI呈正相关（P〈0.05）。结论 IL-10和IL-18在SLE发病机制中发挥重要作用,而且与疾病活动性相关。     

High circulating levels of free interleukin-18 in patients with active SLE in the presence of elevated levels of interleukin-18 binding protein

Systemic Lupus Erythematosus (SLE) is an autoimmune disease characterized by the production of autoantibodies particularly to nuclear antigens and by an abnormal production of proinflammatory cytokines. In the present study, we measured the levels of the proinflammatory cytokine IL-18 and its natural inhibitor, the IL-18 binding protein (IL-18BP), in sera of SLE patients at various stages of the disease. This is the first study to present IL-18BP levels in sera of SLE patients as well as the calculated, biologically active, free IL-18 concentrations that are most probably more relevant to the pathology of SLE. Sera from 48 unselective SLE patients (total of 195 samples) were obtained longitudinally with a mean follow-up period of 11.1 ± 8.9 years and were compared to sera from 100 healthy volunteers. Circulating levels of IL-18, IL-18BP and free IL-18 in the SLE patients were significantly higher than the levels of healthy controls (5 fold, 6 fold and 3 fold for IL-18, IL-18BP and free IL-18, respectively) and correlated with disease activity as scored by SLEDAI-2K. Furthermore, these levels during active disease (SLEDAI-2K ≥ 6) were higher compared to the levels measured in the sera of the same patients during remission or during mild disease (SLEDAI-2K 0–5). The high levels of IL-18 and IL-18BP in sera of active SLE patients suggest their possible role in the pathogenesis and course of the disease. However, despite the elevated levels of IL-18BP during active disease, free IL-18 remained more than 2 fold higher than the levels in healthy controls suggesting a potential benefit of administration of exogenous IL-18BP as a novel therapeutic approach for active SLE.     

TLR4介导高迁移率族蛋白致系统性红斑狼疮肾损害的作用研究

目的 探讨高迁移率族蛋白1(HMGB1)致红斑性狼疮肾损害的作用机制与Toll样受体4(Toll-like receptor 4,TLR4)表达的相关性.方法 ELISA检测12例健康对照组、16例系统性红斑狼疮(systemic lupus eqrthematosus,SLE)无肾脏损害和18例狼疮性肾炎(lupus nephritis,LN)患者血清中HMGB1、基质金属蛋白酶-2(MMP-2)和基质金属蛋白酶组织抑制剂-2(TIMP-2)的表达情况;流式细胞术检测外周血CD3/TLR4和CD14/TLR4表达情况;分离外周血单个核细胞(PBMC),RT-PCR检测HMGB1 mRNA的表达变化.结果 HMGB1 mRNA相对表达量及血清中HMGB1蛋白在LN组明显高于SLE组和健康对照组;流式细胞术显示CD14+的单核细胞表面HMGB1受体TLR4在LN组表达最高(P＜0.05),且与尿蛋白呈正相关(P＜0.01);LN患者血清中MMP-2和TIMP-2蛋白的浓度明显低于SLE和健康对照组,同时MMP-2/TIMP-2比值下降.HMGB1 mRNA及CD14+/TLR4+与MMP-2/TIMP-2比值均呈显著负相关;LN组患者血清中HMGB1蛋白水平与蛋白尿呈正相关,与MMP-2/TIMP-2比值呈显著负相关.结论 HMGB1是狼疮性肾炎发病中的重要细胞因子;HMGB1可能部分通过TLR4激活PBMC,降低MMP-2/TIMP-2的活性,从而引起蛋白尿.     

Requirement for cell-to-cell contact for the immunosuppressive activity of human alveolar macrophages

The ability of alveolar macrophages (AM) obtained by bronchoalveolar lavage of healthy volunteers to suppress T lymphocyte responses to the mitogen phytohemagglutinin (PHA) in vitro was investigated. AM but not monocytes (MN) inhibited responses of peripheral blood mononuclear cells (PBMC) to PHA as measured by incorporation of [3H]thymidine [( 3H]TdR) and interleukin-2 (IL-2) expression. Supernatants of AM generated for various periods and with various concentrations of cells did not, however, inhibit PBMC responses to PHA. To examine the role of cell contact in the inhibitory activity of AM, AM or MN were added to PBMC in 6-well plates either directly (in co-culture) or separated by a 0.45-micron filter. MN did not inhibit PBMC blastogenic responses under either condition. AM at a 1:2 ratio with PBMC inhibited blastogenesis by 75 +/- 11% (mean +/- SD, n = 3, P less than 0.01) when cultured directly with PBMC but had no inhibitory effect on blastogenesis when physically separated from target PBMC. AM in co-culture with PBMC also inhibited PHA-stimulated IL-2 production by 70% but did not inhibit IL-2 production when AM were separated from PBMC in dual chambers. To assess the role of the cell surface in the inhibitory activity of AM, AM and MN were fixed with 2% paraformaldehyde. Neither fixed nor unfixed MN inhibited PBMC blastogenic responses, but both fixed and unfixed AM inhibited responses similarly (77 to 95%).(ABSTRACT TRUNCATED AT 250 WORDS)     

Increased CCR4 expression in active systemic lupus erythematosus.

CC chemokine receptor (CCR)4 is selectively expressed on Th2-type T cells and has been shown to be responsible for Th2-dominant immune responses. In this study, we analyzed the expression of CCR4 in active systemic lupus erythematosus (SLE) patients by FACS analysis using anti-human CCR4 monoclonal antibody and determined the clinical relevance in this disease. Higher expression of CCR4 was found on peripheral blood CD4+ T lymphocytes of active SLE patients than was found with healthy controls and inactive SLE patients. The CCR4 expression significantly correlated with the SLE disease activity index (SLEDAI) scores. The expression was dramatically decreased after the corticosteroid therapy in parallel with a serum level of double-stranded DNA antibody and SLEDAI scores. Moreover, we found that serum levels of IL-10 were increased in active SLE patients and significantly correlated with the CCR4 expression. This study suggests that Th2 immune response is predominant in the active state of SLE, and CCR4 may have relevance in regard to the disease course in SLE patients.