哮喘患者外周血单个核细胞中白细胞介素-6 mRNA表达与气道炎症的研究

目的探讨外周血单个核细胞（ＰＢＭＣ）中白细胞介素（ＩＬ）６ｍＲＮＡ表达与血嗜酸细胞阳离子蛋白（ＥＣＰ）和１秒用力呼气容积占用力肺活量比值（ＦＥＶ１％）的关系。方法对１２例过敏性哮喘发作期患者、８例缓解期患者及９例健康人，采用ＲＴＰＣＲ法和图像分析半定量法检测ＰＢＭＣ中ＩＬ６ｍＲＮＡ的表达水平及ＥＣＰ和ＦＥＶ１％。结果发作期患者ＩＬ６ｍＲＮＡ的表达明显高于缓解期患者和健康人（Ｐ＜００１），而缓解期患者无明显升高。发作期患者ＩＬ６ｍＲＮＡ的表达水平与血清ＥＣＰ呈中度正相关（ｒ＝０６７９，Ｐ＜００１），而与ＦＥＶ１％呈中度负相关（ｒ＝－０５８９，Ｐ＜００５）。结论过敏性哮喘发作期患者ＰＢＭＣ中ＩＬ６ｍＲＮＡ表达水平显著增强。其气道炎症程度与ＩＬ６基因转录增强有关     

急性冠脉综合征单核细胞过氧化物酶体增生激活型受体γ基因表达及其与细胞黏附分子相关性研究

目的：检测过氧化物酶体增生激活型受体γ（PPARγ）在单核细胞的表达,观察急性冠脉综合征时PPARγ的表达状态及其与细胞黏附分子的相关性。方法：从43例急性冠脉综合征和34例政党对照中分离周围血单核细胞,抽提总RNA,应用逆转录PCR差异显示检测。结果：PPARγ可在周围血单核细胞表达,且急性冠脉综合征患周围血单核细胞表达显下调;PPARγ表达水平与可溶性血管黏附分子1、可溶性细胞间黏附分子和体重指数负相关（γ分别为－0．339、－0．331和－0．334,P＜0．05）,与载脂蛋白Al正相关。结论：急性冠脉综合征时单核细胞PPARγ表达下调,与血浆可溶性细胞黏附分子水平负相关,提示PPARγ可能参与急性冠脉综合征发病过程。     

狼疮肾炎患者循环单核细胞表达Fas和血浆可溶性Fas Ligand水平的研究

目的 探讨狼疮肾炎（LN）病人单核细胞凋亡加速的机制。方法 对17例LN病人进行观察,以15名正常人为对照。采用流式细胞仪检测单核细胞Fas和FasLigand(FasL)的表达;酶联免疫吸附法（ELISA）测定血浆中可溶性FasLigand(sFasL）的水平;单核细胞与重组人FasL共孵育,磺化丙啶染色、流式细胞仪检测单核细胞凋亡,四甲基偶氮唑蓝（MTT）法观察单核细胞体外存活率。结果 LN病人单核细胞Fas的表达较正常人明显上调（P＜0．05）;处于狼疮活动期的LN病人与狼疮静止期的LN病人之间单核细胞Fas的表达差异无显著性（P＞0．05）;处于狼疮活动期的LN病人与狼疮静止期的LN病人之间单核细胞Fas的表达差异无显著性（P＞0．05）。正常人和LN病人的单核细胞表面均未检测出FasL的表达。正常人血浆中未能检测出sFasL,但LN病人血浆存在有sFasL;sFasL的水平在狼疮活动期和静止期的LN病人之间差异无显著性（P＞0．05）;单核细胞与重组人FasL在体外共同培养2h后,LN病人单核细胞的凋亡较正常人明显增高（P＜0．05）,单核细胞与重组人FasL在体外共同培养6h后,LN病人单核细胞的存活率较正常人明显低下（P＜0．05）。结论 LN病人单核细胞表面功能在Fas表达上调,血浆中存在sFasL,这可能是LN病人单核细胞凋亡加速的原因之一。     

Role of monocytes in the inhibitory effect of calcitriol on PHA-stimulated lymphocytes

Summary The possible role played by monocytes in the inhibitory effect of calcitriol on phytohemagglutinin (PHA)-stimulated lymphocyte proliferation was assessed by testing the effect of this sterol under different cell culture conditions. Calcitriol had a dose-dependent inhibitory effect on lymphocyte proliferation in concentrations ranging from 10^–10 up to 10^–8 M. The effect of 10^–9 M calcitriol was almost completely abolished by: a) monocyte depletion, b) inhibition of prostaglandin (PG) synthesis by indomethacin, and c) addition of exogenous interleukin-2 (IL-2). These results suggested that the inhibitory effect of calcitriol was mediated through monocytes. This possibility was substantiated by the following observations: a) the calcitriol inhibitory effect was restored when autologous adherent cells were added to monocyte-depleted PBM cells; b) the supernatant of adherent cells cultured for 24 hours in the presence of calcitriol exerted a marked inhibitory effect on lymphocyte proliferation; and c) this effect was not longer evident when adherent cells were cultured in the presence of calcitriol plus indomethacin. These data support the hypothesis that calcitriol acts, at least partially, through the monocytes, inducing an increased release of PG, with subsequent inhibition of IL-2 synthesis, then resulting in a decreased lymphocyte proliferation.This work was presented in part at the VI Workshop on Vitamin D. Merano, March 1985     

Monocyte and Haemostasis

Human monocytes may play a central role in haemostasis since they are the only circulating blood cells capable to express tissue factor (TF) and therefore trigger the extrinsic pathway of coagulation. The aim of this review is to illustrate that monocytes also participate in haemostasis independently of TF expression. Indeed, the exposure of anionic phospholipids provides a procoagulant surface. Activation of factor X involves specific membrane receptor EPR-1 (Effector cell Protease Receptor-1). Mac-1 and membrane factor Va also bind factor X/Xa. In addition, monocytic proteases have been reported to modulate the coagulation cascade. Monocyte adhesion and cell—cell interactions represent important mechanisms implicated in TF expression. Furthermore, Tissue factor pathway inhibitor (TFPI), the natural inhibitor of TF activity, is expressed by monocytes. This suggests that monocytes could participate to the local regulation of coagulation initiation. The importance of monocytes in the development of vascular diseases remains to be clarified. In thrombotic disorders, it may be worthwhile not to limit the investigations to the expression of TF.     

胸腔积液腺苷脱氨酶对内科胸腔镜检查临床病例选择的意义

目的 探讨胸腔积液腺苷脱氨酶(ADA)对内科胸腔镜检查临床病例选择的意义.方法 回顾性分析2013年1月至2016年4月经内科胸腔镜检查的不明原因胸腔积液患者198例,分为青年组、中年组和老年组,以胸腔积液ADA≥45 U/L或ADA≥45 U/L联合淋巴细胞占白细胞比例≥50％作为诊断结核性胸膜炎的标准,确定其敏感度和特异度,并分析性别、年龄对ADA的影响.结果 内科胸腔镜对不明原因胸腔积液的诊断率为98.9％.胸腔积液ADA≥45 U/L诊断结核性胸膜炎的敏感度68.7％,特异度88.1％;胸腔积液ADA≥45 U/L联合淋巴细胞占白细胞比例≥50％诊断结核性胸膜炎的敏感度70.2％,特异度96.3％,尤其是在青年组,其诊断特异度达100％.结论 对于不明原因胸腔积液的青年患者,如果胸腔积液ADA≥45 U/L且淋巴细胞占白细胞比例≥50％,可考虑诊断性抗结核治疗;对中老年不明原因胸腔积液,建议常规行内科胸腔镜检查,避免误诊.     

维生素E对氧化低密度脂蛋白诱导的单核细胞/内皮细胞粘附的干预作用

目的:观察ox-LDL在体外对兔单核细胞与血管内皮细胞粘附的影响及维生素E的干预作用,初步探讨其机制。方法:培养兔主动脉内皮细胞。密度梯度离心法分离健康兔单核细胞。沉淀法制备人LDL,硫酸铜氧化制备ox-LDL。用Kim等^[1]方法并略加改良观察ox-LDL对内皮细胞/单核细胞粘附的影响及维生素E的干预。Northernblot检测内皮细胞VCAM-1mRNA的表达。结果:ox-LDL浓度为2.5mg/L、5mg/L、10mg/L时,每个视野粘附的单核细胞数分别为132.8±20.2、350.0±37.2、502.6±78.8,而正常对照组为51.2±7.7,相差非常显著(P＜0.01)。在加ox-LDL(10mg/L)前加维生素E干预,当维生素E浓度为10μmol/L、20μmol/L、40μmol/L时,粘附单核细胞数分别为422.3±32.2、298.0±21.7、205.2±36.6,均低于ox-LDL对照组的502.6±78.8,维生素E浓度为10μmol/L组与对照组相差不显著(P＞0.05),其余两组与ox-LDL对照组相差非常显著(P＜0.01)。ox-LDL对照组内皮细胞VCAM-1mRNA表达高于维生素E(40μmol/L)干预组(0.49±0.09vs0.33±0.10,P＜0.05)。结论:ox-LDL促进兔主动脉内皮细胞与单核细胞的粘附,其机制与其促进内皮细胞表达VCAM-1有关。维生素E能抑制ox-LDL的上述作用。     

Lysophosphatidylcholines modulate immunoregulatory checkpoints in peripheral monocytes and are associated with mortality in people with acute liver failure

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