Terminal deoxynucleotidyl transferase-containing cells in peripheral blood: implications for the surveillance of patients with lymphoblastic leukemia or lymphoma in remission

An indirect immunofluorescence assay was used to quantitate TdT- containing (TdT+) cells in the mononuclear leukocyte fraction of peripheral blood from normal subjects and patients with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LL). In normal children (10) and adults (10), 0.036% +/- 0.014% (mean +/- SD) and 0.030% +/- 0.015% TdT+ cells were found. In peripheral bloods from 10 children receiving chemotherapy for tumors other than ALL or LL, 0.040% +/- 0.039% TdT+ cells were found. Serial determinations were performed on 15 patients with ALL or LL who were in clinical remission. Eight of these patients remained in continuous remission and always had fewer than 0.11% TdT+ cells in their peripheral blood. Three patients who developed systemic relapse were found to have progressively rising numbers of TdT+ cells in their peripheral blood prior to clinical evidence of relapse. All 3 of these patients had greater than 0.1% TdT+ cells in their peripheral blood from 3 to 8 wk prior to clinical relapse. In 3 other patients, localized extramedullary relapse developed, but no trend was found on serial TdT determinations. Thus, the indirect immunofluorescence assay for TdT detects a small population of cells in normal peripheral blood. In patients with ALL, progressive increases above this normal level were associated with subsequent bone marrow relapse.     

Inhibition of CD4 cross-linking-induced lymphocytes apoptosis by vesnarinone as a novel immunomodulating agent: vesnarinone inhibits Fas expression and apoptosis by blocking cytokine secretion

Evidence is accumulating that T cells from human immunodeficiency virus type 1 (HIV-1)-infected individuals show accelerated cell death through apoptosis. We have recently demonstrated that the cross-linking of CD4 molecules (CD4XL) results in death of normal peripheral T cells through apoptosis and imbalanced cytokine secretion (ie, induction of tumor necrosis factor-alpha [TNF-alpha] and interferon-gamma [IFN-gamma] in the absence of interleukin-2 [IL-2] or IL-4 secretion). These upregulated cytokines (TNF-alpha/IFN-gamma) largely contributed to upregulation of the apoptosis-inducing cell surface molecule, Fas (APO- 1/CD95) and apoptosis induction. The present study investigated the effect of vesnarinone as a novel immunomodulating agent on CD4XL- induced T-cell apoptosis. The addition of vesnarinone to peripheral blood mononuclear cells (PBMC) significantly inhibited CD4XL-induced lymphocyte apoptosis. This apoptosis-inhibitory effect of vesnarinone was associated with the blocking of CD4XL-induced TNF-alpha IFN-gamma secretion and of Fas antigen upregulation. However, vesnarinone did not block effects of exogenously supplemented TNF-alpha/IFN-gamma on Fas induction. These data suggest that vesnarinone inhibits CD4XL-induced TNF-alpha/IFN-gamma secretion, thereby blocking subsequent Fas upregulation and apoptosis induction. Given the potent pathogenic role of imbalanced cytokine secretion observed in HIV-infection, an agent such as vesnarinone may be of therapeutic value in slowing disease progression.     

FasL^＋组织工程化猪软骨细胞的同种异体移植

目的:探讨表达FasL的猪组织工程化软骨细胞在同种异体内的生长状况和免疫排斥反应。方法:实验于2002-09/2004-03在上海交通大学医学院,上海市免疫学研究所进行。①分离制备猪软骨细胞。②制备FasL 软骨细胞,构建重组pGCEN-FasL反转录病毒载体,转染PA317细胞。经G418筛选获得分泌pGCEN-FasL病毒颗粒的PA317细胞克隆,选择高滴度的病毒液,感染猪软骨细胞。再经过G418筛选获得FasL 的软骨细胞克隆,扩增培养。③FACS检测FasL的表达,应用JAM试验测定FasL 的软骨细胞诱导Fas 的Jurkat细胞及活化的T细胞的凋亡率。同时制备转染pGCEN反转录病毒空载体的软骨细胞为对照。④取FasL 的软骨细胞与可注射性生物材料PluronicF127混合,注射于同种异体猪的腹壁皮下。在第4,5周取材,通过组织病理和免疫组织化学等方法,检测软骨细胞生长和免疫排斥反应。结果:①经转染的软骨细胞表面FasL的表达率为57%。②FasL 的软骨细胞具有明显诱导Fas 细胞和活化的同种异体T细胞的凋亡,最大的凋亡率分别为53.41%,30.38%(效/靶=10∶1),对照组分别为32.27%,13.16%(效/靶=10∶1)。③组织工程化猪软骨结节的结构与正常软骨组织基本一致,可见清晰的软骨凹陷和软骨膜,仅细胞排列较正常软骨略显混乱、不均匀现象。④免疫组织化学染色显示FasL 的组织工程化猪软骨结节的Ⅱ型胶原蛋白分布均匀,形状清楚,与正常软骨比较基本一致。⑤第5周的软骨细胞表面的FasL分子表达明显,周围的炎性细胞浸润相对较少。而对照组的软骨细胞周围可见到大量浸润的炎性细胞。结论:成功构建FasL 软骨细胞并有效表达,抑制免疫排斥反应,为建立同种异体软骨细胞移植的免疫耐受提供了实验依据。     

β-环糊精流动相和手性配位交换HPLC法分离药物对映体

目的:为生物样品手性药物对照体的分离测定建立手性流动相添加剂HPLC,方法:以β-环糊精和手性配位交换剂为流动相添加剂,分离测定了生物样品中羟基苯妥英、美芬妥英、叔丁喘安、氯噻酮、氧氟沙星等5种手性药物对映体.结果:测得结果各对映体之间均能得到较好的分离.以β-环糊精为流动相添加剂法测得4种手性药物对映体的分离度(R)在1.10～1.86之间,各对映体的理论板数(n)在1642～2022之间.以手性配位交换法测得氧氟沙星两对映体的R为2.10,n为2560和 2600.并于制备柱上分离获得两对映体的纯品.结论:本法无需特殊设备,可在常规高效液相仪上进行手性药物的分离测定,操作简便、手性添加剂的种类多,适用范围广、便于推广     

Non‐alcoholic fatty liver disease and type 2 diabetes: An update

The global prevalence of non‐alcoholic fatty liver disease (NAFLD) is rising, along with the epidemic of diabesity. NAFLD is present in >70% of individuals with type 2 diabetes. Although the mutually detrimental relationship between NAFLD and type 2 diabetes has been well established, a multitude of recent studies have further shown that type 2 diabetes is closely linked to the development of cirrhosis, hepatocellular carcinoma, liver‐related morbidity and mortality. In contrast, NAFLD also negatively impacts type 2 diabetes both in terms of its incidence and related adverse clinical outcomes, including cardiovascular and chronic kidney diseases. In response to these global health threats, clinical care pathways for NAFLD and guidelines for metabolic dysfunction‐associated fatty liver disease have been developed. Several antidiabetic agents have been evaluated for their potential hepatic benefits with promising results. Furthermore, type 2 diabetes patients are increasingly represented in clinical trials of novel therapeutics for NAFLD. However, despite the wealth of knowledge in NAFLD and type 2 diabetes, lack of awareness of the disease and the potential weight of this problem remains a major challenge, especially among clinicians who are outside the field of hepatology and gastroenterology. This review therefore aimed to provide all diabetes care providers with a summary of the latest evidence that supports NAFLD as an emerging diabetic complication of increasing importance, and to present the current recommendations, focusing on the assessment and therapeutic strategies, on the management of NAFLD among type 2 diabetes patients.