Local synthesis of IgA in the cerebrospinal fluid of patients with neurological diseases

To date qualitative studies of IgA in the cerebrospinal fluid in neurological disease, particularly multiple sclerosis, have been few and given mixed results. The aim of this study was to identify local synthesis of IgA by detection of clonal IgA bands, in a large cohort of patients with a variety of neurological disorders, using polyacrylamide gel electrophoresis, transfer of protein to nitrocellulose membranes and specific staining. Of 2,097 sequentially analysed patients with suspected neurological disease 54 (2.6%) had locally synthesised IgA; most notably, IgA was present in 39 of 291 (13%) patients with suspected multiple sclerosis. The latter group also had a significant excess of light-chain production, particularly free kappa, when compared to multiple sclerosis patients without local synthesis of IgA. Locally synthesised IgA was also demonstrated in inflammatory, infectious and autoimmune diseases of the central nervous system. This qualitative technique is simple and suitable for routine analysis of cerebrospinal fluid, and further qualitative studies of IgA may be useful in investigating the pathophysiology of certain neurological disorders.     

梗死前心绞痛诱发的免疫炎症反应对心肌保护作用的临床研究

目的通过对有无梗死前心绞痛的急性心肌梗死患者免疫标志物的测定,研究梗死前心绞痛诱发的免疫炎症反应对心肌的保护作用。方法观察梗死前心绞痛组(48例)和无梗死前心绞痛组(40例)在住院期间严重心律失常、心功能不全、心源性休克的发生情况及住院期间的病死率;比较两组心肌梗死面积、心室功能、冠状动脉造影结果;测定两组免疫炎症反应标志物水平。结果梗死前心绞痛组严重心律失常发生率、心功能不全发生率、住院期间病死率明显低于无梗死前心绞痛组;梗死前心绞痛组肌酸激酶(CK)、肌酸激酶同工酶MB(CK-MB)、左室收缩末容量(LVESV)、左室舒张末容量(LVEDV)明显低于无梗死前心绞痛组,左室射血分数(LVEF)高于无梗死前心绞痛组;冠状动脉造影显示梗死前心绞痛组冠状动脉多支病变多,梗死区周围侧支循环丰富;梗死前心绞痛组白细胞计数、C-反应蛋白明显低于无梗死前心绞痛组,IgE明显高于无梗死前心绞痛组。结论梗死前心绞痛诱发的免疫炎症反应对心肌有保护作用。     

穴位注射乙型肝炎免疫球蛋白阻断乙型肝炎病毒母婴传播的临床研究

目的探计乙型肝炎病毒（HBV）阳性孕妇孕期足三里穴位注射乙型肝炎免疫球蛋白（HBIG）预防HBV宫内感染的效果。方法2001年11月至2003年10月烟台毓璜顶医院将190例乙型肝炎表面抗原（HBsAg）阳性孕妇随机分为两组：足三里穴位注射组92例，于孕20、24、28、32、36周足三里穴位注射HBIG共5次，每次200IU。肌肉注射组98例，同剂量、同时间应用HBIG。采用酶联免疫法，检测用药前后孕妇血清及新生儿脐血清HBsAg、HBeAg及HBsAb，采用核酸扩增（PCR）荧光定量检测HBV-DNA含量。结果92例足三里穴位注射者，新生儿HBV官内感染8倒，宫内感染率为8．7％，低于肌肉注射组（P〈0．01）。穴位注射组新生儿脐血清HBsAb检出率显著高于肌肉注射组（P〈0.05）。穴位注射组临产前血清中HBV—DNA显著低于肌肉注射组（P〈0.05）．结论通过孕妇足三里穴位注射HBIG，可更有效地减少HBV的宫内感染，未发现任何副反应。     

Immunoglobulin G4-positive staining of orbital lesions in thyroid eye disease: Report of two cases

We report two cases with immunoglobulin G4 (IgG4)-positive staining of orbital lesions and thyroid eye disease (TED). Case 1 was a 63-year-old male with right upper eyelid swelling due to right lacrimal gland enlargement. Case 2 was a 49-year-old male with bilateral proptosis due to multiple orbital masses. Both the biopsied right lacrimal gland in Case 1 and the orbital masses on both sides in Case 2 showed infiltration of immunoglobulin-G4-positive plasma cells.     

食管癌中特异表达的人类omega蛋白(Igll3)基因的序列分析及意义

目的筛选食管癌中差异表达的基因,进一步了解食管癌发生的分子机制。方法利用荧光差异显示技术(DD-PCR)从食管癌组织相对癌旁组织中获得差异表达片段,对这些片段进行克隆和序列分析。通过在GenBank中同源性检索,查找差异片段相对应的同源基因。利用定量PCR检测验证该基因表达的差异性。设计引物获得该基因全长。结果通过DD-PCR得到3个差异片段,分别为人类10号常染色体上的开放阅读框99;人类信号转导和激活转录因子2及人类omega蛋白(Igll3)。定量PCR验证的结果表明,Igll3在食管癌组织中的表达量高于癌旁组织。设计引物得到该基因全长,测序表明该基因长为711bp,编码236aa。结论 Igll3在食管癌组织中异常表达,可能在食管癌发生过程中起着重要的作用。     

Diagnostic Value of Positive Findings of Toxoplasma gondii-Specific Immunoglobulin M Serum Antibody in Uveitis Patients to Confirm Ocular Toxoplasmosis

Purpose: To assess the value of positive immunoglobulin (Ig) M serum antibody (Ab) findings in uveitis patients.

Methods: We reviewed medical records of patients who had a positive serological test for Toxoplasma gondii-specific IgM Ab. Their clinical data, including history, demographic characteristics, laboratory findings, clinical findings, treatment outcomes, and recurrences, were reviewed retrospectively.

Results: Of 2919 uveitis patients who underwent a serological test for suspected ocular toxoplasmosis (OT), 18 presented with positive Ig M results. All 18 patients (100.0% specificity) were clinically diagnosed with OT. None had any retinochoroidal scar at the initial visit, indicating the OT was a recent and primary infection. However, 15 patients (83.3%) had no history suspected to account for the Toxoplasma transmission.

Conclusions: The T. gondii IgM serum Ab is a specific biomarker for diagnosis of primary OT. Epidemiological studies are warranted to investigate the non-classic transmission routes of T. gondii in OT.     

A case of Mikulicz’s disease with Th2-biased cytokine profile: possible feature discriminable from Sjögren’s syndrome

Abstract

This article concerns a male patient with Mikulicz’s disease (MD) accompanied with marked elevation of serum immunoglobulin (Ig)G4 and IgE levels. His peripheral blood mononuclear cells (PBMC) showed markedly enhanced in vitro production of interleukin (IL)-4, IL-5, IL-13, but not interferon gamma (IFN-γ) compared with patients with Sjögren’s syndrome (SS) and healthy donors, suggesting distinct Th2 bias in this MD patient. Besides the prominent infiltration of IgG4-producing plasma cells, the enhanced expression of both CD40 and CD40 ligand (CD40L) were observed in the swollen salivary gland of the MD patient, suggesting enhanced signaling pathways for the induction of IgG4 and IgE switching. Possible differences between MD and SS in light of their underlying pathogenesis are discussed.