99th Dahlem Conference on Infection,Inflammation and Chronic Inflammatory Disorders: Induction and control of regulatory T cells in the gastrointestinal tract: consequences for local and peripheral immune responses

Regulatory T cells play a crucial role in normal gut homeostasis, as well as during infection with microbial or parasitic pathogens. Prior to infection, interactions with the commensal microflora are essential to differentiation of a healthy steady‐state level of immunoregulation, mediated through both Toll‐like receptor‐dependent and ‐independent pathways. The ingress of pathogenic organisms may, according to the context, promote or reverse the regulatory environment, with onward consequences for inflammation in both the intestinal and extra‐intestinal settings. Appropriate regulation of gut immunity thus depends upon a complex three‐way interplay between host cells, commensals and pathogens, and can exert a major impact on systemic responses including allergy and autoimmunity.     

Relationship among circulating leukocytes, platelets, and microvascular responses during induction of chronic colitis

The mechanisms by which microvascular alterations contribute to the pathogenesis of the inflammatory bowel diseases (IBDs; Crohn's disease, ulcerative colitis) have not been clearly delineated. The purpose of the current study was to characterize the inflammatory events, microvascular alterations, and blood cell changes that occur in a mouse model of IBD. In this model, CD4⁺ T-lymphocytes obtained from interleukin-10-deficient mice were injected intraperitoneally into lymphopenic, recombinase-activating gene-1 deficient (RAG^−/−) mice. Two groups of control mice were also included: RAG^−/− mice and C57BL/6 mice that were injected with phosphate-buffered saline but did not receive the T-cells. Four weeks later, the RAG^−/− mice that had received the T-cell transfer showed significant signs of colonic inflammation, but without significant decreases in either body weight or mean arterial blood pressure. T-cell transfer increased the volume % of circulating platelets, while decreasing the number of circulating red blood cells. Additionally, the T-cell transfer tended to increase the circulating numbers of both lymphocytes and neutrophils when compared to unmanipulated RAG^−/− mice. First-order colonic arterioles and venules tended to dilate in the colitic mice; however, the dilation was considerably more substantial with higher numbers of circulating leukocytes. The possibility that circulating inflammatory cells initiate the microvascular alterations in colitis warrants further investigation.     

芪仙汤治疗大鼠溃疡性结肠炎的药效学机制探讨

目的:观察芪仙汤治疗大鼠溃疡性结肠炎的效果并探讨其作用机制。方法:将60只SD大鼠随机分为6组(即正常组、模型组、芪仙汤低、中、高剂量组、柳氮磺吡啶对照组)。除正常组外其他各组均用兔黏膜免疫法造模,治疗组给药18d后处死动物,分离结肠对其进行肉眼组织损伤评分及光镜下病理损伤评分以判断其疗效,并运用免疫组化染色法观察结肠黏膜的T淋巴细胞亚群、肿瘤坏死因子(TNF-α)及IL-4的表达。结果:模型组结肠可见黏膜充血、水肿、炎症细胞浸润、溃疡形成,各治疗组溃疡减少,黏膜充血、水肿、炎症细胞浸润程度减轻,伴轻度肉芽组织增生。与模型组比较,各治疗组肉眼及光镜下损伤评分均明显下降(P<0.05 orP<0.01),同时结肠黏膜局部CD4淋巴细胞升高,CD8淋巴细胞减少,TNF-α阳性细胞表达降低及IL-4阳性细胞表达升高(P<0.05 orP<0.01);结论:芪仙汤在一定剂量下通过调节结肠局部淋巴细胞亚群的平衡及炎症因子的表达治疗溃疡性结肠炎。     

肠内营养在溃疡性结肠炎治疗中的应用

目的:研究EN支持在溃疡性结肠炎(UC)治疗中的适应证、耐受性、不良反应和疗效.方法:回顾分析220例活动期UC病人,有85例应用EN支持.结果:应用EN支持者,全结肠型占(70.6%)明显多于左半结肠型(18.8%)、直肠乙状结肠型(9.4%)和直肠型(1.2%);重度(56.5%)多于中度(32.9%)及轻度(10.6%).EN组病人BMI<18 kg/m2比例明显高于对照组(P<0.05);ALB水平(28.91±6.64)g/L低于对照组(36.03±6.59)g/L.不同类型EN制剂增加至3 347 kJ/d时间无显著性差异(P>0.05).在不良反应中,腹泻的发生率为14.1%,占所有不良反应的57.1%;EN组与对照组比较,激素减量时间、手术率和缓解率无显著性差异(P>0.05).总蛋白、ALB、PA水平在EN支持后有显著提高(P<0.05).结论:①对病变范围广,中、重度的UC病人,应给予充足的EN;②对存在中、重度营养不良UC病人,应补充EN;③UC病人对不同类型营养制剂耐受性无差异,腹泻是最常见的不良反应;④EN可作为UC活动期的一种辅助治疗.     

溃疡性结肠炎临床用药聚类分析

目的:通过临床数据分析,探索总结溃疡性结肠炎(UC)常用有效中药、复方,归纳临床分型和配伍规律。方法:通过检索筛选获得溃疡性结肠炎口服治疗的处方,采用聚类分析探索常用有效中药、复方及其配伍规律。结论:UC病机以脾虚湿盛、寒热错杂为主,证型可归结为寒热错杂,方药以四君子汤合乌梅丸为基础方。     

针灸治疗溃疡性结肠炎的Meta分析

目的:评价针灸治疗溃疡性结肠炎的有效性和安全性。方法:检索近10年针灸干预溃疡性结肠炎的随机对照试验或临床对照试验,并对文献结果进行Meta分析。结果:共11篇临床研究文献入选。对11项研究结果进行异质性检验,结果χ2=8.55,P=0.67,采用固定效应模型进行统计分析,合并后OR=3.82,95%可信区间为2.65-5.52,菱形位于中间线的右侧,经Z检验,Z=7.14,P<0.01,试验组和对照组疗效比较差异有非常显著性意义,即针灸治疗组疗效明显优于对照组,痊愈率高于对照组。结论:针灸治疗溃疡性结肠炎疗效优于西药,且副作用少,具有安全性。     

姜连清肠煎治疗慢性溃疡性结肠炎42例

[目的]探讨姜连清肠煎在治疗慢性溃疡性结肠炎中的疗效。[方法]采用姜连清肠煎对42例慢性溃疡性结肠炎患者进行临床观察。[结果]治愈16例,好转24例,无效2例,总有效率95.2%。[结论]本病多病程长,本虚标实多见。姜连清肠煎采取标本同治,故有较好疗效。