Vaccination Decreases the Infectious Viral Load of Delta Variant SARS-CoV-2 in Asymptomatic Patients

The Delta variant of SARS-CoV-2 has caused many breakthrough infections in fully vaccinated individuals. While vaccine status did not generally impact the number of viral RNA genome copies in nasopharyngeal swabs of breakthrough patients, as measured by Ct values, it has been previously found to decrease the infectious viral load in symptomatic patients. We quantified the viral RNA, infectious virus, and anti-spike IgA in nasopharyngeal swabs collected from individuals asymptomatically infected with the Delta variant of SARS-CoV-2. Vaccination decreased the infectious viral load, but not the amount of viral RNA. Furthermore, vaccinees with asymptomatic infections had significantly higher levels of anti-spike IgA in their nasal secretions compared to unvaccinated individuals with asymptomatic infections. Thus, vaccination may decrease the transmission risk of Delta, and perhaps other variants, despite not affecting the amount of viral RNA measured in nasopharyngeal swabs.     

Longitudinal Dynamics of HPV16 Antibodies in Saliva and Serum among Pregnant Women

Oral infections with high-risk (hr)HPV genotypes are associated with a subset of head and neck squamous cell carcinomas. Oral hrHPV infections may result from having oral sex, but also from horizontal infection from mouth to mouth. In such cases, saliva can serve as a vehicle for HPV transmission. Still, the prevalence and dynamics of salivary HPV antibodies in healthy non-vaccinated individuals are poorly known and the role of the salivary antibodies in protection from oral HPV infection is unclear. We used an ELISA assay to evaluate the dynamics and correlation of oral HPV16 infection and HPV16L1 and E7 specific antibody levels in saliva and serum samples among 39 women, 13 of which had persistent oral HPV16 infection. The women were mothers-to-be, sampled before delivery and followed up for 36 months postpartum. HPV16L1 IgG and sIgA antibodies were regularly detected in saliva. Antibody levels in serum remained stable during the 36-month follow-up, while antibody levels in saliva fluctuated. There was considerable individual variation in salivary HPV16L1 antibody levels, and some women had persistent oral HPV16 infection but no salivary antibodies. No differences in salivary HPV16L1 levels were found between the women with persistent or transient oral HPV16 infection.     

Idiopathic Membranous Nephropathy with Solitary Immunoglobulin A Deposition: A Case Report and a Review of the Literature

A 63-year-old man with an 8-year history of proteinuria was diagnosed with nephrotic syndrome, and a renal biopsy was performed. Light and electron microscopic analyses showed classic features of idiopathic membranous nephropathy (IMN). However, immunofluorescence tests revealed solitary polyclonal granular IgA deposition along the glomerular capillary walls, rather than IgG, which is often dominant in IMN. The combined use of corticosteroids and calcineurin inhibitor was noticeably effective in reducing proteinuria and improving edema in the current case. Two additional rare cases of IMN with solitary IgA deposition were reviewed, and long-term surveillance is still warranted to characterize its clinicopathological features and outcome.     

厄贝沙坦联合肾炎康复片治疗IgA肾病蛋白尿的临床研究

目的：观察厄贝沙坦联合肾炎康复片治疗慢性肾脏病的疗效。方法：慢性肾脏病患者43例随机分为两组,厄贝沙坦组（21例）应用厄贝沙坦150mg,1次／d,联合治疗组（22例）在上述治疗的基础上加用肾炎康复片5粒,3次／d。治疗时间为3个月,观察临床症状,血肌酐、血钾、24h尿蛋白定量。结果：治疗3个月后比较,厄贝沙坦组与厄贝沙坦联合肾炎康复片,两组治疗前比较,收缩压,舒张压,肌酐,血钾,蛋白尿,均P〉O．05,无显著性差异。厄贝沙坦组治疗前后,收缩压、舒张压、蛋白尿,P〈O．05,有显著性差异;肌酐、血钾,P〉O．05,无显著性差异。联合组,治疗前后,收缩压、舒张压,有显著性差异,P〈O．05;肌酐、血钾,P〉O．05,无显著性差异;蛋白尿,P〈O．05,有显著性差异。两组治疗后,蛋白尿,P〈O．05,有显著性差异,联合组较厄贝沙坦组下降。结论：单用厄贝沙坦及联合应用厄贝沙坦和肾炎康复片均能减少尿蛋白,合用肾炎康复片疗效更显著。     

鬼箭羽对IgAN肾小球硬化大鼠生化及病理形态学的影响

目的：本研究通过建立大鼠IgA肾病（IgAN）肾小球硬化模型,通过生化、病理切片观察中药鬼箭羽对IgA肾病肾小球硬化大鼠的治疗作用。方法：以SD大鼠为实验动物,通过一侧肾切除,反复尾静脉注射葡萄球菌肠毒素B的方法,制作IgA大鼠肾病肾小球硬化模型。1周后,同时予以鬼箭羽水煎液灌胃治疗为中药组,苯那普利为西药对照组,从而观察生化指标、病理改变。详细内容包括：检测尿红细胞计数、24h尿蛋白定量、血肌酐、血尿素氮;应用光镜、电镜观察肾脏组织形态学的变化,运用免疫荧光技术观察模型大鼠肾小球系膜区免疫沉积;运用HPIAS-2000计算机病理图象分析系统分析毛细血管开放面积、系膜区基质沉积相对面积。结果：①生化指标结果显示,鬼箭羽组的尿红细胞计数,24h尿蛋白定量,与模型组相比明显降低（P〈0．01）,鬼箭羽还可降低IgA大鼠的血尿素氮（BuN）、血肌酐（CRE）（P〈0．05）。②病理图象方面鬼箭羽、苯那普利治疗对保护毛细血管襻开放、减少系膜基质沉积,尤其在电镜下鬼箭羽组与模型组相比显示出使。肾小球基底膜增厚减轻,内皮下及基底膜致密电子沉积物减少,上皮细胞足突融合现象减轻,都说明鬼箭羽对降低肾小球病理改变有明显作用。结论：鬼箭羽能减轻肾小球硬化大鼠的尿红细胞计数、24h尿蛋白定量,BUN、CRE,减轻肾小球的病理损害,并改善。肾功能,是防治IgA肾病性。肾小球硬化的有效中药。     

柴芩肾安方对IgA肾病大鼠肾小球足细胞podocin表达的影响

目的观察柴芩肾安方对IgA肾病（IgAN）大鼠肾小球足细胞podoc in表达的影响。方法雄性SD大鼠随机分为正常组、切肾组、IgAN组、柴芩肾安方组和氯沙坦组,通过切除单侧肾并反复静脉注射葡萄球菌肠毒素B（SEB）建立大鼠IgAN模型,分别进行药物干预。第12周末,检测各组大鼠24h尿蛋白量（Upr）,观察肾小球病理变化,并采用免疫组化和实时定量PCR检测足细胞podo-c in蛋白及mRNA的表达。结果与正常组比较,IgAN组大鼠Upr、肾小球系膜细胞、系膜基质相对含量均显著升高（P〈0.01）,大部分足突融合,足细胞podoc in蛋白及mRNA表达均明显下调（P〈0.01）。柴芩肾安方组上述指标均明显改善,与IgAN组比较差异显著（P〈0.01）,且其podoc in蛋白表达高于氯沙坦组（P〈0.01）。结论柴芩肾安方能减轻IgAN大鼠蛋白尿及肾小球病变,这可能与其恢复足细胞podoc in表达有关。     

Glomerular Membranopathy in Children with IgA Nephropathy and Henoch Schönlein Purpura

We evaluated renal biopsies from 34 children with IgA nephropathy or Henoch Schönlein purpura to further characterize the ultrastructural features of the glomerular membranopathy that occurs in these disorders. Focal glomerular basement membrane damage was identified in 29 children and was severe in 4 of the children. Alterations included focal and segmental attenuation, splitting, duplications, and spike-like subepithelial protrusions of the lamina densa, along with saccular glomerular microaneurysms arising at the paramesangium. Those cases with extensive glomerular basement membrane lesions had either moderate or severe glomerular alterations apparent by light microscopy. Over half of the cases with glomerular membranopathy had immunohistological or ultrastructural evidence of focal peripheral glomerular capillary wall immune deposits and electron-dense deposits occurred at sites of glomerular basement membrane splitting. Despite the focal attenuation of the glomerular basement membrane, we did not identify any biopsy with findings of thin basement membrane disease. The glomerular basement membrane ultrastructural findings we describe are characteristic of IgA nephropathy and Henoch Schönlein purpura, are common in children with these disorders, and are similar to the ultrastructural alterations of the basement membrane that occur in other glomerulonephritides. These basement membrane injuries may be inflammatory cell or immune mediated but their pathogenesis requires further study.     

肾络宁对IgA肾病肾小球硬化大鼠治疗作用的实验研究

目的:研究肾络宁治疗IgA肾病(IgAN)肾小球硬化模型大鼠的治疗作用。方法:通过切除一侧肾脏,反复注射较大剂量的葡萄球菌肠毒素B(SEB),制作IgAN肾小球硬化大鼠模型,观察肾络宁对大鼠肾脏功能以及病理形态的影响。结果:肾络宁可显著减少尿蛋白、红细胞,改善肾脏功能,减轻肾小球损伤,促进肾脏组织的修复。结论:肾络宁对IgAN肾小球硬化具有较好的防治作用。     

加味当归补血汤对肾虚血瘀型IgA肾病的疗效与对免疫功能的影响

目的:观察加味当归补血汤治疗肾虚血瘀性IgA肾病的临床疗效及对患者免疫系统的影响,分析其预后并探讨其相关机制。方法:选取2010年1月至2012年1月陕西中医肝肾病医院肾内科门诊及住院的肾虚血瘀型IgA肾病患者126例。按照随机数表法将患者分别纳入对照组和观察组,各63例,对照组在基础治疗上使用科素亚50 mg/d,观察组在对照组基础上加以口服汤剂加味当归补血汤。分别检测治疗前后患者24 h尿蛋白量、尿红细胞计数及血肌酐、血清IgA及T淋巴细胞亚群CD4~+/CD8~+值,同时进行肾穿刺活检,评估肾小球病变病理评分,比较2组临床疗效及预后。结果:经治疗后,2组24 h尿蛋白定量、尿红细胞计数、血肌酐较治疗前明显降低(P0.05),2组CD4~+/CD8~+、血清IgA值均降低(P0.05),且观察组优于对照组(P0.05),2组临床疗效进行比较,观察组总有效率(93.44%)优于对照组(83.33%)(P0.05)。随访后,2组预后分析中1年肾存活率差异无统计学意义(P0.05),3年、5年肾存活率观察组明显优于对照组(P0.05)。结论:加味当归补血汤可以增加治疗肾虚血瘀型IgA肾病患者的临床效果,提高IgA肾病患者的免疫功能,提高生存率,改善预后。     

安肠胶囊对慢性溃疡性结肠炎患者黏膜局部免疫细胞的影响

目的　探讨安肠胶囊对慢性溃疡性结肠炎 (ulcerativecolitis,UC)黏膜局部免疫细胞的影响。方法　应用兔抗人IgA、兔抗人IgG、兔抗人IgM多克隆抗体及鼠抗人肥大细胞类胰蛋白酶单克隆抗体 ,通过免疫组化技术 ,对 13例UC患者结直肠黏膜标本及 10例正常黏膜进行Ig细胞和肥大细胞密度检测。结果　UC患者黏膜固有层的IgA细胞数量低于正常黏膜 ,IgG细胞和肥大细胞密度均高于正常黏膜 ,经安肠胶囊治疗后 ,IgA细胞的数量较治疗前有所增加(P <0 .0 0 1) ,IgG和肥大细胞下降 (P <0 .0 5 ) ;治疗后IgA细胞、IgG细胞和肥大细胞与正常黏膜相比无显著性差异 (P >0 .0 5 ) ;治疗前后的IgM细胞数量和正常黏膜相比无显著性差异。结论　结直肠黏膜局部体液免疫细胞 (浆细胞 )亚群的活化与溃疡性结肠炎的活动密切相关 ,安肠胶囊通过对局部IgA ,IgG细胞和肥大细胞数量的调节而达到治疗目的