Effects of Surgical Stress on Early Nonspecific Immune Response in Children

Surgery alters the body’s homeostatic balance and defense mechanisms. In adults transient postoperative cellular and humoral immunosuppression after different degrees of operative stress has been reported. In children the immunologic consequences of operations are not elaborated. This study investigates the effect of minor and major surgery on early nonspecific immune response in terms of neutrophil counts and function. Forty-three children undergoing minor and major elective procedures were studied. Blood samples were collected before, immediately after, and 72 h after surgery. Total white cell count, differential neutrophil count, and neutrophil phagocytic function were studied using nitroblue tetrazolium test. Children were divided into two groups—group 1 underwent minor surgery and group 2 major surgery. In group 1 there was a significant drop in total counts after surgery, but in group 2 total counts were not affected. In both groups, the percentage of neutrophils increased immediately after surgery but fell to near or less than preoperative levels 72 h after surgery. However, the assessment of neutrophil functions by nitroblue tetrazolium test in both unstimulated and stimulated forms revealed it to be unchanged in group 1. In group 2 the unstimulated neutrophil function was elevated 72 h after surgery, whereas stimulated function was elevated immediately after surgery. Minor surgery does not alter the early nonspecific immune response. However, major surgery seems to induce a transient increase in neutrophil phagocytic activity.     

Neutrophil activation in Alzheimer’s disease and mild cognitive impairment: A systematic review and meta-analysis of protein markers in blood and cerebrospinal fluid

Inflammation is involved in the pathophysiology of Alzheimer’s disease (AD), with multiple inflammatory processes implicated in its risk and progression. This review included original peer-reviewed studies measuring the cerebrospinal fluid or peripheral blood concentrations of protein markers specifically related to neutrophil activity in healthy controls (HC) and in patients with AD or mild cognitive impairment (MCI). A total of 35 studies (N_HC = 3095, N_AD = 2596, N_MCI = 1203) were included. Random-effects meta-analyses were used to estimate between-groups standardized mean differences (SMD) and 95 % confidence intervals. In blood, concentrations of myeloperoxidase (MPO; N_AD/N_HC = 271/209, SMD = 0.41 [0.20, 0.62]; I² = 15.7 %) and neutrophil gelatinase associated lipocalin (NGAL; N_AD/N_HC = 273/185, SMD = 0.30 [0.11, 0.49]; I² < 0.005 %) were significantly higher in AD relative to HC. Peripheral blood concentrations of NGAL were also higher in MCI compared to HC (N_MCI/N_HC = 489/145, SMD = 0.39 [0.11, 0.67]; I² = 38.6 %). None of the protein markers exhibited a significant difference between HC, MCI, or AD groups in the cerebrospinal fluid. The evidence suggests that peripheral neutrophil activation, as indicated by blood concentrations of NGAL and MPO, may be a pathological feature of cognitive impairment due to AD, evident at stages of MCI and AD dementia.     

Diagnostic value of serum neutrophil gelatinase-associated lipocalin,interleukin-6 and anti-citrullinated alpha-enolase peptide 1 for lower respiratory tract infections

ObjectivesThe aim of this study was to explore the auxiliary diagnostic value of neutrophil gelatinase-associated lipocalin (NGAL) and anti-citrullinated alpha-enolase peptide 1 (CEP-1) in lower respiratory tract infections (LRTIs).MethodsBlood samples were collected from 99 in-patients with LRTIs [62 community-acquired pneumonia (CAP), 14 acute exacerbated chronic obstructive pulmonary diseases (AECOPD), 23 other diseases] and 50 healthy subjects. NGAL, CEP-1 and IL-6 were measured and compared. IL-6 was tested by electrochemiluminescence assay kit on Roche E601 immunology analyzer, CEP-1 was assessed with enzyme-linked immunosorbent assay kit, and NGAL was detected by latex immunoturbidimetric assay kit on Beckman Coulter AU2700.ResultsCompared with healthy controls, NGAL and IL-6 levels were significantly increased in the patients with LRTIs, the area under the curves (AUC) was 0.97 and 0.88 respectively (P < 0.01). The sensitivity and specificity of NGAL at a cut-off of 86 ng/ml were 93.0% and 96.0%, respectively, in which the sensitivity was consistent with IL-6 (P = 0.21) and the specificity was better than IL-6 (P < 0.01). CEP-1 slightly increases in the patient group, however the difference was not significant (P = 0.41). The levels of NGAL and IL-6 was no differences in different diseases, the P-value was 0.50 and 0.29, respectively. LRTIs with and without underlying diseases have similar NGAL and IL-6 values.ConclusionsNGAL, rather than CEP-1, may be appealing adjuncts for diagnosis of LRTIs. NGAL proved to be a better biomarker than IL-6.     

抗磷脂抗体和子痫前期的研究进展

抗磷脂抗体是一类能与磷脂或磷脂结合蛋白结合的自身免疫性抗体,与血栓形成、不良孕产史密切相关。抗磷脂抗体中高滴度阳性的患者易有子痫前期等不良妊娠结局。子痫前期发生于妊娠期,可导致全身多脏器的损伤,严重危及母儿生命和健康。子痫前期的发病机制目前还不是很清楚,研究提示抗磷脂抗体可能通过诱导氧化应激,促进血管内炎症等作用参与子痫前期的发病;对于抗磷脂抗体阳性的患者,早期发现和早期干预对获得良好的妊娠结局至关重要。     

使用生物标志物建立机器学习模型用于菌血症的早期预测

目的 菌血症的早期识别和及时干预是降低发病率和死亡率的关键。血培养是诊断菌血症的金标准,但其敏感性低且周转时间长,难以满足临床诊断的需求。本研究的目的是通过回顾性分析,从若干与感染相关的生物标志物中筛选出最佳特征子集用于构建机器学习模型,用于菌血症的早期预测。方法 采用回顾性分析筛选出符合研究标准的菌血症和局部感染患者,并收集参与者的生物标志物数据。通过特征选择算法筛选最佳特征子集,并以此构建机器学习模型。使用精确率,召回率和准确率综合评估机器学习模型的性能。结果 本研究收集到247例菌血症患者为病例组,262例局部感染患者为对照组,并纳入12项生物标志物。通过特征选择算法,我们发现支持向量机(support vector machine, SVM)模型只须纳入5项生物标志物,其模型准确率为90.2%,AUC高达0.967。结论 通过特征选择算法与机器学习模型相结合的策略,本研究开发了3种菌血症的预测模型,其中SVM的性能最佳,为菌血症的早期诊断提供了数据支持。     

西维来司钠对体外循环中红细胞的保护作用

目的研究西维来司钠对体外循环(Cardiopulmonary bypass,CPB)期间红细胞的保护作用。方法健康成年杂种犬12条,随机分为对照组(C组)和西维来司钠组(S组)。两组动物均模拟临床开胸,建立体外循环模型,阻断升主动脉45min后开放,开放后继续转机60min。S组于开胸前静脉推注西维来司钠15mg·kg-1,再以10mg·kg-1·h-持续静脉滴注至体外循环结束。C组用生理盐水对照。分别于转机前、阻断15min、45min、开放30min以及开放60min取静脉血测定血浆弹性蛋白酶(Neutrophil elastase,NE))、丙二醛(Malondialdehyde,MDA)含量、游离血红蛋白浓度(FHB)。结果 S组CPB后各时点血浆NE、MDA含量和FHB浓度低于C组。结论 CPB可导致红细胞的损伤,这种机制与CPB期间大量弹性蛋白酶的产生有关,西维来司钠能有效地抑制CPB期间弹性蛋白酶的产生及其活性,对体外循环期间红细胞有保护作用。     

肿瘤坏死因子α调控MPO的分泌在子痫前期发病中的作用

子痫前期(PE)是引起全球孕产妇及新生儿发病率和死亡率升高的妊娠特发性疾病。目前其病因尚未完全明确,单一生物标志物也很难预测其变化。PE患者经积极治疗病情无好转或进行性恶化时,终止妊娠是其唯一有效的治疗措施。学者认为血管内皮细胞损伤是PE的主要发病机制。近年研究发现,PE患者血浆中肿瘤坏死因子α(TNF-α)的异常表达参与疾病的发生和发展。TNF-α与相关受体结合后,可活化丝裂原活化蛋白激酶(MAPK)信号通路导致下游靶蛋白髓过氧化物酶(MPO)水平上调。中性粒细胞过度活化后释放MPO,其表达水平增高是血管内皮细胞损伤的关键因素。综述TNF-α调控MPO的相关机制在PE发病中作用的研究进展。     

中性粒细胞凋亡的线粒体死亡机制的研究进展

中性粒细胞是血细胞中寿命最短的终末分化细胞,在炎症反应中发挥着重要的作用,是人体免疫防御系统的第一道防线。与其它的血细胞和组织细胞在凋亡的发生机制上有所不同,中性粒细胞从分化成熟开始,就启动它的自发性凋亡程序。中性粒细胞自发性凋亡涉及到许多复杂的生化过程,线粒体是细胞的一种重要的细胞器,也是真核生物能量代谢的中心、凋亡中心,其在中性粒细胞凋亡信号传导和病理生理过程中起着关键性的调节作用。因此,对线粒体途径的调控机制进行研究是非常重要的。     

NLR、PCT、CRP联合检测对早期COVID-19的诊断价值

目的 探讨中性粒细胞/淋巴细胞比值(NLR)、降钙素原(PCT)和C反应蛋白(CRP)对早期新型冠状病毒肺炎(COVID-19)的诊断价值.方法 选取咸宁市第一人民医院230例疑似COVID-19患者,根据胸部电子计算机断层扫描(CT)、严重急性呼吸综合征冠状病毒2(SARS-CoV-2)核酸、病毒血清学抗体和血培养检...