肠道病毒71型手足口病117例临床分析

目的:分析肠道病毒71型感染所致手足口病的临床及实验室特点。方法:回顾性分析2012年7月—2012年12月收治的117例肠道病毒71感染所致手足口病住院患儿的病例资料。比较普通病例组和重症病例组的临床表现及辅助检查资料。结果:肠道病毒71型手足口病多见于1～3岁婴幼儿(64.96%),主要症状为皮疹(98.29%)、发热(98.29%)。重症病例发生率较高(占82.05%),多有肢体抖动及易惊(77.78%)。常见并发症有支气管炎、支气管肺炎。经对症及抗病毒治疗,重症者早期使用免疫球蛋白、糖皮质激素、甘露醇等治疗,治愈113例(96.58%),好转1例(0.85%),死亡3例(2.56%)。结论:肠道病毒71型手足口病多见于婴幼儿,主要症状为发热、皮疹。重症病例发生率高,多有肢体抖动及易惊。重症手足口病患儿的救治关键在于早期干预,控制进展,减少难治性并发症的发生。     

小檗碱对p38MAPK通路及COX-2mRNA表达的作用

目的研究中药小檗碱是否通过p38MAPK信号转导途径抑制人外周血单核细胞COX-2mRNA及蛋白表达。方法取人外周静脉血分离及培养单核细胞,分为对照组、脂多糖(LPS)组、LPS+小檗碱25μmol/L组、LPS+小檗碱50μmol/L组、LPS+小檗碱100μmol/L组。分别在培养后0.5、6、12、24h提取细胞,行RT-PCR法测定COX-2mRNA水平,行Westernblot法测定p38MAPK、p-p38MAPK及COX-2蛋白水平。同时加入选择性p38MAPK抑制剂,分别测定COX-2mRNA及蛋白水平。结果与对照组相比,LPS组COX-2mRNA及蛋白表达明显增强(P<0.01)。与LPS组相比,小檗碱组COX-2mRNA及蛋白表达明显抑制(P<0.05),且随着浓度增加,抑制作用更明显,在给药后12h,小檗碱对COX-2抑制作用最强,但是与LPS组相比,小檗碱组p38MAPK活性水平无明显统计学差异(P>0.05)。加入p38MAPK抑制剂之后,COX-2mRNA及蛋白水平降低明显(P<0.05)。结论小檗碱能抑制人外周血单核细胞COX-2mRNA及蛋白水平,并呈浓度依赖性,p38MAPK与人外周血COX-2表达有关,而小檗碱对p38MAPK活性蛋白表达无明显抑制作用。     

EV71非结构蛋白的结构和功能及其为靶点的药物研究进展

近年肠道病毒71型(EV71)等引起的手足口病在中国大陆呈现上升的流行趋势,其正链的RNA基因组翻译成一个多聚蛋白,进一步自剪切为结构蛋白和非结构蛋白;随着研究的深入,非结构蛋白在病毒生命周期中的功能逐一被鉴定,本文就EV71非结构蛋白的结构功能及针对这些靶点的抗病毒药物进行综述。     

Curcumin inhibits the replication of enterovirus 71 in vitro

Human enterovirus 71 (EV71) is the main causative pathogen of hand, foot, and mouth disease (HFMD) in children. The epidemic of HFMD has been a public health problem in Asia-Pacific region for decades, and no vaccine and effective antiviral medicine are available. Curcumin has been used as a traditional medicine for centuries to treat a diversity of disorders including viral infections. In this study, we demonstrated that curcumin showed potent antiviral effect again EV71. In Vero cells infected with EV71, the addition of curcumin significantly suppressed the synthesis of viral RNA, the expression of viral protein, and the overall production of viral progeny. Similar with the previous reports, curcumin reduced the production of ROS induced by viral infection. However, the antioxidant property of curcumin did not contribute to its antiviral activity, since N-acetyl-l-cysteine, the potent antioxidant failed to suppress viral replication. This study also showed that extracellular signal-regulated kinase (ERK) was activated by either viral infection or curcumin treatment, but the activated ERK did not interfere with the antiviral effect of curcumin, indicating ERK is not involved in the antiviral mechanism of curcumin. Unlike the previous reports that curcumin inhibited protein degradation through ubiquitin–proteasome system (UPS), we found that curcumin had no impact on UPS in control cells. However, curcumin did reduce the activity of proteasomes which was increased by viral infection. In addition, the accumulation of the short-lived proteins, p53 and p21, was increased by the treatment of curcumin in EV71-infected cells. We further probed the antiviral mechanism of curcumin by examining the expression of GBF1 and PI4KB, both of which are required for the formation of viral replication complex. We found that curcumin significantly reduced the level of both proteins. Moreover, the decreased expression of either GBF1 or PI4KB by the application of siRNAs was sufficient to suppress viral replication. We also demonstrated that curcumin showed anti-apoptotic activity at the early stage of viral infection. The results of this study provide solid evidence that curcumin has potent anti-EV71 activity. Whether or not the down-regulated GBF1 and PI4KB by curcumin contribute to its antiviral effect needs further studies.KEY WORDS: Curcumin, Enterovirus 71, Viral replication, GBF1, PI4KB, Ubiquitin–proteasome system, ApoptosisAbbreviations: CVB, coxsackieviurs B; DCFH-DA, dichloro-dihydro-fluorescein diacetate; ERK, extracellular signal-regulated kinase; EV71, enterovirus 71; GBF1, Golgi brefeldin A resistant guanine nucleotide exchange factor 1; GEF, guanine nucleotide exchange factor; HBV, hepatitis B virus; HCV, hepatitis C virus; HFMD, hand, foot, and mouth disease; HIV, human immunodeficiency virus; HPV, human papillomavirus; NAC, N-acetyl-l-cysteine; PARP-1, poly(ADP-ribose) polymerase; PGC-1α, peroxisome proliferator-activated receptor-gamma co-activator 1 alpha; p.i., post-infection; PI4KB, phosphatidylinositol 4-kinase class III catalytic subunit β; PI4P, phosphatidylinositol 4-phosphate; ROS, reactive oxygen species; siRNA, small interfering RNA; SLLVY-AMC, succinyl-Leu-Leu-Val-Tyr-7-amino-4-methylcoumarin; UPS, ubiquitin–proteasome system     

肠道病毒71型灭活疫苗（Vero细胞）接种5年免疫持久性观察

目的 观察肠道病毒71型（enterovirus 71,EV71）疫苗III期临床试验接种5年的免疫持久性。方法 在III期临床试验免疫原性亚组中,对完成全程两针次免疫的免前抗EV71中和抗体阴性人群进行免疫后5年采血并检测抗EV71中和抗体,对0 d、56 d、8个月、14个月、26个月、64个月同时具有抗EV71中和抗体检测数据人群评价免疫持久性。结果 共614名受试者完成5年免疫持久性血样采集并获得中和抗体检测结果,其中490名受试者同时具有0天、56 d、8个月、14个月、26个月、64个月抗EV71中和抗体检测数据,疫苗组和安慰剂对照组分别为235名和255名。EV71疫苗免疫后5年,疫苗组抗EV71中和抗体阳性率（100.00%）和抗体几何平均滴度（geometric mean titer,GMT）（369.57）均高于对照组（69.02%和55.58）。分别以抗体滴度8、16、32为阳性判定标准,疫苗组阳性率（100%、99.57%、97.87%）均高于对照组（69.02%、61.96%、59.61%）。对不同年龄亚组进行分析,6~11、12~35月龄受试者免疫后疫苗组5年抗EV71中和抗体阳性（滴度≥8）率（均为100.00%）和抗体GMT（367.14、370.64）均高于对照组（66.67%、71.27%和53.43、63.66）。在EV71疫苗免疫后的各个时间点,疫苗组抗EV71中和抗体阳性率和GMT均高于对照组。结论 该EV71疫苗两针基础免疫后能够诱导良好的免疫原性,在免疫后5年依然保持较好的免疫持久性。     

Differential inhibition of cyclooxygenase-1 (COX-1) and-2 (COX-2) by NSAIDS: Consequences on anti-inflammatory activity versus gastric and renal safety

The discovery of an inducible isoform of cyclooxygenase (COX-2) requires a refinement of the theory that inhibition of cyclooxygenase activity is responsible for both therapeutic and side-effects of nonsteroidal anti-inflammatory drugs (NSAIDs). Pharmacological results with developmental compounds suggest that COX-2 is the relevant target for the therapeutic (i.e. anti-inflammatory) effects of NSAIDs, whereas gastric and renal side-effects are related to inhibition of constitutive COX-1. However a role of COX-1 in inflammation cannot be excluded. Furthermore, more research effort is needed to investigate the functional relevance of COX-2 in normal tissue.     

环氧合酶-2及其抑制剂在胰腺癌血管靶向治疗中的作用

胰腺癌的诊治目前仍是医学界的难题,血管生成是胰腺癌生长和转移的必要因素。环氧合酶(cyclooxygenase,COX)为花生四烯酸代谢过程中的关键酶,存在COX-1及COX-2两种同工酶,其中COX-2在胰腺癌的发生发展及胰腺癌血管生成中发挥重要作用。COX-2抑制剂可分为非选择性及选择性两种,两种COX-2抑制剂都对胰腺癌及其血管形成的发生与进展存在抑制作用,COX-2抑制剂抗肿瘤血管形成的机制可能是抑制血管内皮生长因子(VEGF)、缺氧诱导因子-1及基质金属蛋白酶(MMP)的表达、降低前列腺素(PGs)及其他血管生成因子的表达、促进内皮细胞凋亡、抑制内皮细胞侵袭力和影响一氧化氮合酶(NOS)的表达。     

iNOS和COX-2在过氧化氢预处理诱导的适应性细胞保护中的作用

目的探讨H2O2预处理对PC12细胞iNOS与COX-2蛋白表达的影响及其在适应性细胞保护中的作用。方法在PC12细胞建立H2O2预处理对抗H2O2诱导细胞凋亡的实验模型,采用甲氮甲唑蓝(MTT)法检测细胞存活率,碘化丙啶(PI)染色流式细胞术检测细胞凋亡,流式细胞仪(FCM)检测iNOS与COX-2蛋白表达水平。结果用10μmol.L-1H2O2预处理PC12细胞90min可明显地抑制20～100μmol.L-1H2O2作用24h后引起的细胞毒性和细胞凋亡,并可明显地促进PC12细胞iNOS与COX-2蛋白表达;选择性iNOS抑制剂AG和COX-2抑制剂NS-398分别阻断H2O2预处理诱导的抗细胞凋亡作用。结论H2O2预处理可诱导适应性细胞保护作用,其机制之一可能与促进PC12细胞的iNOS与COX-2蛋白表达有关。     

环氧合酶-2表达水平和前列腺癌进展相关关系的研究

目的检测环氧合酶-2在前列腺癌中的表达,并探讨其与前列腺癌临床病理因素及预后的关系。方法采用免疫组织化学SP法,检测120例前列腺癌及20例前列腺增生组织(对照组)中环氧合酶-2的表达,分析检测指标与前列腺癌发病情况的相关性。结果前列腺癌组织中环氧合酶-2表达阳性率明显高于对照组。结论环氧合酶-2具有促进肿瘤细胞转化、增殖、迁移的作用,对于环氧合酶-2的检测有助于前列腺癌患者的预后评估。     

不同类型胃息肉组织中COX-2基因蛋白的表达及其意义

目的探讨不同类型胃息肉组织中环氧合酶-2(COX-2)蛋白的表达情况及其临床意义。方法对内镜下摘除129例胃息肉进行病理组织分类,并采用免疫组织化学技术检测COX-2蛋白的表达情况。结果在129例胃息肉中经HE染色病理识别有增生性息肉57例,炎性息肉39例,腺瘤样息肉33例;COX-2在它们的阳性表达率分别为29.8%(17/57)、38.5%(15/39)和63.6%(21/33),各组之间比较差异显著(P<0.05),以腺瘤样息肉组表达率最高(P<0.01)。结论检测胃息肉组织中COX-2蛋白的表达情况对它的发病机理及恶性病变倾向提供依据,对其治疗和随访具有重要的指导作用。     

ERK信号转导途径在小檗碱抑制脂多糖诱导的COX一2表达中的作用

目的探讨小檗碱是否抑制脂多糖诱导的COX-2mRNA及蛋白表达,以及小檗碱是否通过ERK信号转导途径抑制cOx-2的表达。方法取健康志愿者外周血,分离及培养单核细胞,分为五组,分别为对照组;脂多糖（Lipopolysaccharide,LPS）组;LPS＋小檗碱25μmol／L组;LPS＋小檗碱50μmol/L组;LPS＋小檗碱100μmoL／L组。分别在培养后30min,6h,12h,24h提取细胞,行RT—PCR法测定COX-2mRNA水平,行westemblot法测定ERK、P—ERK及COX-2蛋白水平。同时加入选择性ERK抑制剂,分别测定C0X-2mRNA及蛋白水平。结果与对照组相比,LPS组COX-2mRNA及蛋白表达明显增强（P〈0．01）。与LPS组相比,小檗碱组COX-2mRNA及蛋白表达明显抑制（P〈0．05）,且随着浓度增加,抑制作用更明显,在给药后12h,小檗碱对COX-2抑制作用最强。与LPS组相比,小檗碱组ERK活性水平有明显统计学差异（P〈0．05）。加入ERK抑制剂之后,COX-2mRNA及蛋白水平降低明显（P〈0．05）。结论小檗碱能抑制人外周血单核细胞cOx-2mRNA及蛋白水平,其作用程度呈浓度依赖性,小檗碱对ERK活性蛋白表达有明显抑制作用。小檗碱可能通过ERK信号转导途径抑制人外周血单核细胞C0x_2mRNA及蛋白表达。     

Endogenous N-acyl-dopamines induce COX-2 expression in brain endothelial cells by stabilizing mRNA through a p38 dependent pathway

Cerebral microvascular endothelial cells play an active role in maintaining cerebral blood flow, microvascular tone and blood brain barrier (BBB) functions. Endogenous N-acyl-dopamines like N-arachidonoyl-dopamine (NADA) and N-oleoyl-dopamine (OLDA) have been recently identified as a new class of brain neurotransmitters sharing endocannabinoid and endovanilloid biological activities. Endocannabinoids are released in response to pathogenic insults and may play an important role in neuroprotection. In this study we demonstrate that NADA differentially regulates the release of PGE₂ and PGD₂ in the microvascular brain endothelial cell line, b.end5. We found that NADA activates a redox-sensitive p38 MAPK pathway that stabilizes COX-2 mRNA resulting in the accumulation of the COX-2 protein, which depends on the dopamine moiety of the molecule and that is independent of CB₁ and TRPV1 activation. In addition, NADA inhibits the expression of mPGES-1 and the release of PGE₂ and upregulates the expression of L-PGD synthase enhancing PGD₂ release. Hence, NADA and other molecules of the same family might be included in the group of lipid mediators that could prevent the BBB injury under inflammatory conditions and our findings provide new mechanistic insights into the anti-inflammatory activities of NADA in the central nervous system and its potential to design novel therapeutic strategies to manage neuroinflammatory diseases.     

Evaluation of COX-1/COX-2 selectivity and potency of a new class of COX-2 inhibitors

A new class of selective cyclooxygenase-2 (COX-2) inhibitors has been identified by high throughput screening. Structurally distinct from previously described selective COX-2 inhibitors, these benzopyrans contain a carboxylic acid function and CF3 functionality. The compound SC-75,416 is a representative of this class. A range if in vitro and in vivo tests were employed to characterize its potency and selectivity. Using human recombinant enzymes, this compound displays a concentration that provides 50% inhibition (IC50) of 0.25 microM for COX-2 and 49.6 microM for COX-1. A mutation of the side pocket residues in COX-2 to COX-1 had little effect on potency suggesting that these inhibitors bind in a unique manner in COX-2 distinct from COX-2 inhibiting diaryl heterocycles. Using rheumatoid arthritic synovial cells stimulated with interleukin-1beta (IL-1beta) and washed platelets the compound displayed IC50 of 3 nM and 400 nM respectively. Potency and selectivity was maintained but predictably right shifted in whole blood with IC50 of 1.4 microM for lipopolysaccharide (LPS) stimulated induction of COX-2 and >200 microM for inhibition of platelet thromboxane production. SC-75,416 is 89% bioavailable and its in vivo half life is sufficient for once a day dosing. In the rat air pouch model of inflammation, the compound inhibited PGE2 production with an effective dose that provides 50% inhibition (ED50) of 0.4 mg/kg, while sparing gastric prostaglandin E2 (PGE2) production with an ED50 of 26.5 mg/kg. In a model of acute inflammation and pain caused by carrageenan injection into the rat paw, the compound reduced edema and hyperalgesia with ED50s of 2.7 and 4 mg/kg respectively. In a chronic model of arthritis the compound demonstrated an ED50 of 0.081 mg/kg and an ED(80) of 0.38 mg/kg. In a model of neuropathic pain, SC-75,416 had good efficacy. This compound's unique chemical structure and effect on COX enzyme binding and activity as well as its potency and selectivity may prove useful in treating pain and inflammation.     

RNA干扰技术抗肠道病毒71型复制

目的肠道病毒71型(Enterovirus 71,EV 71)是手足口病(hand,foot and mouth disease,HFMD)主要的病原体之一。研究RNA干扰技术抑制肠道病毒71型复制。方法以RNA干扰技术(RNAi)为干预手段,抑制病毒EV 71在人横纹肌肉瘤(rhabdomyosarcoma,RD)细胞中的复制。通过Western blot、Real-time PCR和病毒滴度3种方法验证,其抑制效果体现在感染细胞内部病毒RNA,病毒蛋白质的表达水平和培养基上清中子代病毒颗粒的数量上。结果靶向病毒基因组5'UTR和VP2的siRNAs具有明显的病毒抑制效应。结论此研究证实RNAi方法具有特异性抑制病毒复制的潜能和可行性。     

Intrathecally administered COX-2 but not COX-1 or COX-3 inhibitors attenuate streptozotocin-induced mechanical hyperalgesia in rats

Members of the cyclooxygenase (COX) family are known to catalyze the rate-limiting steps of prostaglandins synthesis and reported to be involved in neuropathic pain. Diabetic neuropathy is a type of neuropathic pain, though it is not clear if COX is relevant to the condition. Recently, spinal COX-2 protein was found to be increasing in streptozotocin-induced rats as compared to the constitutive expression. We attempted to determine which cyclooxygenase isoforms are involved in streptozotocin-induced mechanical hyperalgesia, which was induced by a single intraperitoneal injection of 75 mg/kg of streptozotocin. Intrathecal administrations of the COX-2 inhibitors SC-58125 (7-100 microg) and NS-398 (7-60 microg), as well as a high dose (100 microg) of the COX-1 inhibitor SC-560 attenuated hyperalgesia, whereas intrathecal administrations of a low dose (10 microg) of SC-560 and the COX-3 inhibitor acetaminophen (1-7 mg) did not. Further, intrathecal administration of SC-58125 (100 microg) did not produce an analgesic effect in normal rats. These results indicate that intrathecal administration of COX-2 inhibitors has an anti-hyperalgesic effect on streptozotocin-induced mechanical hyperalgesia and we concluded that spinal COX-2 is pivotal in streptozotocin-induced hyperalgesia.     

Gastrointestinal effects of COX-2 inhibitors

The developing popularity of non-steroidal anti-inflammatory drugs (NSAIDs) over the last 100 years has been paralleled by an increase in associated complications, particularly affecting the gastrointestinal (GI) tract [1]. Over this period, there have been several attempts to develop less toxic NSAIDs, most of which have been unsuccessful. Since the discovery that the enzyme cyclooxygenase (COX) exists as two isoforms, the largely constitutive COX-1 and the mainly inducible COX-2, much interest has centred on the development of drugs capable of selectively inhibiting COX-2. Early studies that investigated specific COX-2 inhibitors (with no effect on the COX-1 isoform over the whole range of concentrations achieved in clinical usage) are encouraging, as they demonstrate that these drugs have fewer effects on gastroduodenal mucosa than standard NSAIDs given at equivalent doses. Further clinical experience with these agents outside trial settings and additional studies to assess the role of COX-2 when induced in the GI tract are needed, before such agents can be safely recommended for widespread prescribing.     

胰腺癌中 COX-2、Her-2/neu 的表达及与预后的关系

目的：检测 COX-2和 Her-2/ neu 在胰腺癌中的表达情况,探讨 COX-2和 Her-2/ neu 与胰腺癌临床特征的关系及两者之间的相互关系。方法50例原发性胰腺癌组织标本和36例癌旁组织标本,应用免疫组化法及实时荧光定量 PCR 法（RT-QPCR）检测胰腺癌及癌旁胰腺组织中 COX-2和 Her-2/ neu 的表达,并计数微血管密度（MVD）;分析 COX-2和 Her-2/ neu 表达与胰腺癌病理参数的关系,并对二者之间的相关性进行研究。结果胰腺癌组织均过表达 COX-2和 Her-2/ neu;COX-2高表达与胰腺癌增殖活性、TNM 临床分期及肿瘤浸润转移等临床病理特征相关（P <0.05）,而与年龄、性别、发病部位、病理组织分级无关;Her-2/ neu 高表达与胰腺癌组织分级、TNM 临床分期及肿瘤浸润转移关系密切（ P <0.05）,与胰腺癌患者的年龄、性别、发病部位、增殖活性无关;COX-2、Her-2/ neu 在胰腺癌中的表达呈正相关,且二者均和 MVD 呈正相关（ P <0.05）。预后≤1的患者 COX-2、Her-2/ neu 阳性表达率显著低于预后>1年的患者（ P <0.05）。结论 COX-2和 Her-2/ neu 在胰腺癌中的表达呈正相关关系,联合检测二者的表达对胰腺癌的诊断、治疗和预后有一定的意义。     

Regulation of lysophosphatidic acid-induced COX-2 expression by ERK1/2 activation in cultured feline esophageal epithelial Cells

Lysophosphatidic acid (LPA), a potent bioactive phospholipid, mediates diverse cellular responses by binding to specific G protein-coupled receptors (GPCRs). We investigated the signaling mechanisms underlying LPA-induced COX-2 expression in primary cultures of feline esophageal epithelial cells. The identity of the cultures was confirmed by immunocytochemistry using a cytokeratin antibody. Western blot analysis revealed a concentration-and time-dependent induction of COX-2 in response to LPA. Of the three major MAPKs, only ERK1/2 was activated by LPA in a time-dependent manner. LPA-induced COX-2 expression was significantly attenuated by the MEK inhibitor, PD98059, but not by the JNK inhibitor, SP600125, or the p38 MAPK inhibitor, SB212090. LPA-induced COX-2 expression was repressed by pertussis toxin, GF109204X, and Ki16425, indicating the involvements of PTX-sensitive G_i/o protein, PKC, and the LPA_1/3 receptor, respectively. Our data suggest that in esophageal epithelial cells, LPA-induced COX-2 expression requires activation of PKC and ERK1/2 downstream of the LPA_1/3 receptor, Understanding the regulation of COX-2 expression induced by LPA in esophageal epithelial cells might provide a new therapeutic strategy for esophageal inflammatory diseases.