自制苏芪合剂联合治疗Ⅲ～Ⅳ级IgA肾病的临床疗效观察

目的 探讨自制苏芪合剂对Ⅲ～Ⅳ级IgA肾病患者的疗效及患者T细胞功能的改善.方法 28例Ⅲ～Ⅳ级IgA肾病患者随机分为两组,对照组:醋酸泼尼松-日1mg,kg,隔日晨起顿服,盐酸苯那普利-日10mg;治疗组:在上述用药的基础上加用自制苏芪合剂.8周后,观察患者缓解率、T细胞功能及不良反应.结果 治疗组患者在缓解率、T细胞功能改善等方面优于对照组,且因糖皮质激素的使用而出现的不良反应少于对照组.结论 苏芪合剂联合治疗Ⅲ～Ⅳ级IgA肾病疗效显著并能有效改善T细胞功能.     

In Vivo Anergized T Cells Form Altered Immunological Synapses In Vitro

T cells contact allogeneic antigen presenting cells (APCs) and assemble, at their contact interface, a molecular platform called the immunological synapse. Synapse-based molecules provide directional signals for the T cell--either positive signals, resulting in T-cell activation, or negative signals causing T-cell inactivation or anergy. To better understand the molecular basis of in vivo T-cell anergy we analyzed the contacts made between in vivo anergized T cells and APCs, and determined which signaling molecules were included or excluded from their immunological synapses. Anergy was induced in TCR transgenic mice by the intravenous injection of semiallogeneic donor spleen cells. T cells from anergized mice were mixed with APCs, the T-cell/APC synapses imaged using deconvolution microscopy, and their molecular compositions were determined. T cells from anergic mice formed unstable immunological synapses in vitro with allogeneic APCs and failed to recruit the signaling proteins necessary to initiate T-cell activation. These findings suggest that T-cell anergy induced by exposure to semiallogeneic donor cells is associated with defects in the earliest events of T-cell activation, immunological synapse formation and recruitment of TCR-mediated signaling proteins.     

Differential Effects of Immunosuppressive Drugs on T-Cell Motility

The best-characterized mechanism of the action of immunosuppressive drugs is to prevent T-cell clonal expansion, thus containing the magnitude of the ensuing immune response. As T-cell recruitment to the inflammatory site is another key step in the development of T-cell-mediated inflammation, we analyzed and compared the effects of two commonly used immunosuppressants, cyclosporin A (CsA) and the rapamycin-related compound SDZ-RAD, on the motility of human CD4+ T cells. We show that CsA, but not SDZ-RAD, inhibits T-cell transendothelial migration in vitro. CsA selectively impaired chemokine-induced T-cell chemotaxis while integrin-mediated migration was unaffected. The inhibition of T-cell chemotaxis correlated with reduced AKT/PKB but not ERK activation following exposure to the chemokine CXCL-12/SDF-1. In addition, CsA, but not SDZ-RAD, prevents some T-cell receptor-mediated effects on T-cell motility. Finally, we show that CsA, but not SDZ-RAD inhibits tissue infiltration by T cells in vivo. Our data suggest a prominent antiinflammatory role for CsA in T-cell-mediated tissue damage, by inhibiting T-cell trafficking into tissues in addition to containing clonal expansion.     

支原体肺炎肺外损伤患儿T细胞亚群、IFNγ、TNFα的变化及意义

目的 探讨支原体肺炎肺外损伤患儿细胞免疫、细胞因子状况和胸腺肽的治疗效果。方法 采用流式细胞仪和酶标仪检测31例支原体肺炎肺外损伤组患儿急性期、恢复期血中CD3CD4、CD8、CD4／CD8干扰素γ（IFNγ）、肿瘤坏死因子α（TNFα水平，并与支原体肺炎组比较。结果 ①急性期支原体肺炎肺外损伤组和支原体肺炎组比较，CD3、CD4显著降低（P〈0．05），TNFα显著升高（P〈0．01），CD8、IFNγ无统计学意义（P〉0．05）；②支原体肺炎肺外损伤组急性期和4周后比较，CD3、CD4、IFNγ升高（P〈0．05），TNFα显著降低（P〈0．01），CD8无变化。用胸腺肽治疗患者以上指标变化更明显。结论 支原体肺炎肺外损伤患儿细胞免疫功能低于支原体肺炎患儿；细胞因子中TNFα早期升高，而IFNγ不明显；恢复期TNFα下降，而IFNγ升高明显。用胸腺肽治疗能缩短病程。     

Role of Integrin CD103 in Promoting Destruction of Renal Allografts by CD8+ T Cells

Infiltration of CD8(+)TCRalphabeta(+) T-effector populations (CD8 effectors) into graft epithelial compartments has long been recognized as a key lesion in progression of clinical renal allograft rejection. While the afferent phase of allograft immunity is increasingly well-defined, the efferent pathways by which donor-reactive CD8-effector populations access and ultimately destroy the graft renal tubules (rejection per se) have received remarkably little attention. This is an important gap in our knowledge of transplantation immunology, because epithelial compartments comprise the functional elements of most commonly transplanted organs including not only kidney, but also liver, lung, pancreas, and intestine. Furthermore, there is increasing evidence that attack of graft epithelial elements by CD8-effector populations not only causes short-term graft dysfunction but is also a major contributor to development of chronic allograft nephropathy and late graft loss, which now represent the salient clinical problems. Recent studies of the T-cell integrin, alpha(E)beta(7) (CD103), have provided insight into the mechanisms that promote interaction of CD8 effectors with graft epithelial compartments. The purpose of this communication is to review the known properties of the CD103 molecule and its postulated role in the efferent phase of renal allograft rejection.     

胶片剂量测量和验证方法的研究

目的设计和实现基于通用激光扫描仪的胶片剂量测量和验证系统。方法采用胶片饱和冲洗、非线性光学校正、多分辨率阈值滤波、离散傅里叶逆变换图像复原等方法,消除了普通扫描仪用于胶片剂量学定量处理中的各种伪影、噪声和畸变;采用过响应系数校正方法消除测量胶片对低能散射光子的过响应,改善了胶片剂量测量的准确性;采用γ结合NAT指标的方法对放疗计划进行二维定量验证,给出可视化图形表达和具有定量数据的验证结果。结果和三维水箱系统、VeriSoft胶片测量系统相比较,研制系统对放疗剂量的测量结果在±2%内符合一致,对IMRT放疗计划的定量验证结果在±3%内符合一致。结论该系统能够实现对放疗剂量的高精度测量和对适形调强放疗计划剂量的可靠验证。     

Oral administration of an edible-mushroom-derived protein inhibits the development of food-allergic reactions in mice

BACKGROUND: Food allergy is a common disease without effective treatment. Since strict elimination of food allergens may be difficult, strategies for effective intervention are urgently needed. OBJECTIVE: The aim was to investigate the prophylactic use of orally administrated FIP-fve, an immunomodulatory protein isolated from the edible mushroom Flammulina velutipes, in a murine model of food allergy. METHODS: BALB/c mice were immunized twice intraperitoneally with ovalbumin (OVA), at an interval of 2 weeks. Before and during each period of immunization, FIP-fve (200 microg per mouse) or phosphate-buffered saline was given orally every other day with a total of five doses. Then OVA-specific antibodies and cytokine profiles were determined. Subsequently, the mice were orally challenged with OVA. Symptoms of anaphylaxis, levels of plasma histamine, and histology of intestines were examined. RESULTS: Mice receiving oral FIP-fve treatment during sensitization to OVA had an impaired OVA-specific IgE response with a Th1-predominant cytokine profile. These mice were protected from systemic anaphylaxis-like symptoms induced by subsequent oral challenge with OVA. CONCLUSION: Oral administration of FIP-fve has a Th1-skewing effect on the development of the allergen-specific immune response, and may serve the purpose of immunoprophylaxis for food allergy and other allergic diseases.     

哮喘患者CD8+T细胞对单核/巨噬细胞抗原递呈功能的影响

目的：探讨支气管哮喘患者CD8⁺T细胞对单核/巨噬细胞抗原递呈功能的影响。方法：哮喘患者20例，健康对照22例，分别取静脉血5 mL，并分离MΦ、CD8⁺T细胞和B细胞。每份血样分成4组：MΦ递呈抗原组、CD8⁺T细胞参与MΦ递呈抗原组、CD8⁺T细胞体外活化后对MΦ递呈抗原影响组及自然状态下CD8⁺T细胞对MΦ细胞递呈抗原影响组。各组用CTLL₂P抗原刺激18 h后，洗去刺激原，与自体B细胞共同孵育10 d，吸取上清液，测定特异性IgM、IgE、IgG含量。 结果:①哮喘患者MΦ单独递呈抗原，自体B细胞特异性IgM(A490值)（0.034±0.022）明显低于健康人(0.116±0.080)（P<0.05）；CD8⁺T细胞与MΦ共同培养递呈抗原时，产生的特异性IgM(A490值)(0.031±0.021)低于健康人(0.079±0.064)（P<0.05）；②哮喘患者CD8⁺T细胞与MΦ共同培养递呈抗原时，产生的特异性IgG(A490值)(0.102±0.041)明显高于健康人(0.081±0.067)（P<0.05），自然状态下及体外活化后CD8⁺T细胞与递呈抗原MΦ共同培养，产生的特异性IgG(A490值)(0.105±0.066, 0.079±0.059)与健康人(0.066±0.038, 0.069±0.047)无明显差别(P>0.05)；③哮喘患者CD8⁺T细胞与MΦ共同培养递呈抗原产生的特异性IgE(A490值)(0.171±0.154)高于健康人(0.147±0.059)（P<0.05）。 结论:哮喘患者CD8⁺T细胞对MΦ递呈抗原产生免疫球蛋白有调节作用,而且参与哮喘发病。     

Reduced expression of CD69 and adhesion molecules of T lymphocytes in asthmatic children receiving immunotherapy

T lymphocytes play a fundamental role in the initiation and regulation of chronic inflammatory responses in patients with asthma. CD69 is an early marker of T‐cell activation. The levels of intercellular adhesion molecule‐1 (ICAM‐1, CD54) and L ‐selectin have been reported to increase in patients with allergic diseases and asthma. The present study was therefore undertaken to investigate the expression of CD69, CD54, and L ‐selectin by T lymphocytes of children with asthma, before and after immunotherapy. Eighteen children newly diagnosed with asthma, 11 good and nine poor responders to immunotherapy, and 16 normal subjects, were enrolled in this study. The percentages of CD69⁺, CD54⁺, and CD62L⁺ cells in T lymphocytes were measured by using flow cytometry. The levels of CD69, CD54, and CD62L in serum and culture supernatants were determined by using enzyme‐linked immunosorbent assay (ELISA). The expression of CD69 and CD54 on CD3⁺ T lymphocytes was significantly higher in children with asthma than in control patients. All the patient groups expressed (spontaneously and following stimulation with phorbol myristate acetate and ionomycin together with mite‐extract proteins) greater amounts of CD69 and CD54 than did control subjects. With long‐term immunotherapy, the percentages of CD69⁺ and CD54⁺ T lymphocytes were significantly lower in patients with a good response to immunotherapy. Our results also showed significantly lower serum L ‐selectin levels following immunotherapy. In conclusion, successful immunotherapy resulted in decreased expression and production of CD69 and CD54. These results may explain, in part, the clinical efficacy of immunotherapy.     

100例SARS患者外周血T淋巴细胞亚群分析

目的 :探讨SARS患者外周血T淋巴细胞亚群变化。方法 :采用流式细胞仪检测10 0例SARS住院患者外周血T淋巴细胞亚群。结果 :与正常组比较 ,SARS组白细胞总数显著下降 ,淋巴细胞百分数和绝对数显著下降 ,粒细胞绝对数显著下降 ,CD3 、CD4 、CD8 细胞绝对数显著下降 ,CD4 细胞百分数 ,CD8 细胞百分数及CD4 /CD8 比值差异无统计学意义。比较SARS患者各病程CD3 、CD4 、CD8 ,于病程第一至第三周较第四周下降明显 (P <0 .0 5 ) ,病程第一至第三周之间差别无显著性 (P >0 .0 5 ) ;结论 :SARS患者外周血T淋巴细胞亚群的变化对阐明SARS的发病机制有一定意义。