呼吸系统疾病中SE-选择素的临床意义

目的探讨SE-选择素在呼吸系统疾病中的临床意义。方法采用酶联免疫吸附实验检测141例临床常见几种呼吸系统疾病与恶性肿瘤血清的SE-selectin水平。结果对照组E-选择素含量为(23.85±3.18)ng/ml;各病理组血清SE-selectin水平均显著高于对照组(P<0.01);慢性阻塞性肺炎合并呼吸衰竭组的血清SE-selectin水平显著高于其它各组(P<0.01)。结论SE-选择素检测可为呼吸系统疾病临床观察和判断炎症的轻重、病程的严重程度提供新的诊断指标,尤其对动态观察呼吸系统疾病是否合并呼吸衰竭时更有价值。     

原发性肝癌患者手术前后血浆可溶性P-选择素的检测及意义

目的：探讨原发性肝癌患者手术前后血浆可溶性P－选择素（sP-selectin)水平的变化及意义。方法：应用ELISA法检测39例原发性肝癌患者手术前后血浆sP-selectin的水平,结果：原发性肝癌患者术前的血浆sP-selectin含量明显高于正常对照组（P＜0．01）,术后第15d,患者血浆sP-selectin含量较术前明显降低（P＜0．01）,但仍明显高于正常对照组（P＜0．01）,术后第30天,患者浆sP-selectin含量较术后牝15d进一步降低（P＜0．01）,与正常对照组比较差异无显著性（P＞0．05）,结论：提示原发性肝癌者血浆sP-selectin水平明显高于正常人,手术切除肝癌可降低患者血浆sP-selectin的水平,血浆sP-selectin水平的检测及动态观察可能对原发性肝癌的辅助诊断,病情的发展的判断,疗效观察以及预后估计会具有较大的临床意义。     

儿童血小板减少症的可溶性选择素P、L检测

目的探讨血浆可溶性选择素在儿童血小板减少症血浆浓度变化。方法儿童ITP患者25例,自血病15例,再生障碍性贫血15例,均为初发病例,在接受治疗前采集清晨空腹全血。对照组为15例健康体检儿童,采集清晨空腹全血2ml。所有血液标本均先检测即时血小板计数,然后分离血浆检测可溶性选择素。结果ITP组和白血病组血浆sP浓度低予对照组（P〈0．05）。再生障碍性贫血组血浆sP浓度与对照组无显著差异。然而与对照组的血浆sP／Ph浓度相比,ITP组和再生障碍性贫血组均高于对照组9倍左右（P〈0．01）,白血病组则无显著差异。自血病组血浆sL浓度高于对照组3倍左右（P〈0．01）,其它两组无显著差异。结论ITP组sP浓度下降,sP／Ph浓度明显升高;白血病组sP浓度明显下降,sL明显升高;再障组sP／Plt明显升高。     

The effects of exercise stress testing on soluble E‐selectin,von Willebrand factor,and circulating endothelial cells as indices of endothelial damage/dysfunction

Background. The quantification of circulating endothelial cells (CECs) in whole blood is an increasingly recognized index of endothelial damage/dysfunction. Abnormal CECs have been linked to the severity of coronary artery disease (CAD).

Objective. We assessed the relationship of CECs to other markers of endothelial dysfunction (von Willebrand factor (vWF) and soluble E‐selectin (sEsel)) during exercise stress testing (EST) in a cohort of patients with suspected CAD.

Methods. We studied a cohort of patients referred to our chest pain clinic with a history of exertional chest pain. Treadmill EST was performed, using a full Bruce exercise protocol. Blood for CECs (immunobead method), vWF and sEsel (both ELISA) were collected immediately before (pre‐exercise), immediately following exercise, and at 30 minutes post‐EST.

Results. We studied 31 patients (84% male; mean (SD) age 58.4 (9.8) years). Of the entire cohort, 14 patients (45.2%) had a positive EST. Exercise led to significant increases in levels of CECs, sEsel, vWF, white blood cells (WBC), heart rate, mean and systolic blood pressure compared with base‐line (all P<0.05). There was a significant correlation between the change (Δ (immediate post–pre‐exercise)) in CECs and ΔvWF (r = 0.45; 95% CI 0.11–0.69: P = 0.01) and ΔsEsel (r = 0.41; 0.05–0.7: P = 0.02), as well as between ΔvWF and ΔsEsel (r = 0.55; 0.25–0.76: P = 0.001). Neither absolute nor ΔCEC counts were predictive of exercise work‐load/functional capacity, nor the presence of positive EST results.

Conclusion. EST led to a significant increase in endothelial markers (CECs, vWF, and sEsel) compared with base‐line levels. The rise in CECs correlated with the increases in other endothelial markers, but was not related to the either exercise work‐load/capacity or to the presence of a positive EST.     

冠心病患者E-选择素血清水平及其G98T、S128R基因多态性研究

目的　研究中国汉族人群E 选择素 (E selectin)基因第 2外显子G98T和第 4外显子S12 8R多态性与冠心病 (CHD)的相关性 ,以及对血清E selectin水平的影响。方法　采用聚合酶链反应 限制性片段长度多态性 (PCR RFLP)技术 ,检测 2 38例CHD患者和 199例健康人作对照者的E selectin基因多态性 ,同时采用酶联免疫吸附试验 (ELISA)检测CHD患者和对照者血清E selectin水平。结果　E selectin基因S12 8R基因型频率和等位基因频率在CHD组和对照组比较差异有显著性(P <0 0 5 ) ,基因型频率的相对风险分析发现 ,SR基因型携带者患冠心病的风险是SS基因型的 2 16 2倍 (OR =2 16 2 ,95 %CI:1 0 73～ 4 35 9) ,SR基因型携带者的E selectin血清水平显著高于SS基因型(4 2 9± 8 1比 35 7± 7 7,P <0 0 1)。E selectinG98T各基因型分布在CHD组和对照组之间比较差异无显著性 (P >0 0 5 ) ,但在心肌梗死组与心绞痛组间比较差异有显著性 (P <0 0 5 )。结论　E selectinS12 8R基因多态性与冠心病的发病有关联 ,并可影响血清E selectin水平 ,R等位基因可能是CHD发病的遗传易感基因 ;E selectin基因G98T多态性在冠心病发病中可能不起直接重要作用。     

sE‐selectin for stratifying outcome in rheumatoid arthritis

Objectives

To determine the usefulness of sE‐selectin as a marker for early diagnosis and stratification of rheumatoid arthritis.

Methods

We investigated several markers of disease activity, including circulating adhesion molecules and other standard laboratory tests, in a 2–3 year followup analysis of patients with rheumatoid arthritis.

Results

The mean ± SD levels of sE‐selectin (91.68 ± 31.8 ng/ml versus 49.83 ± 14.76 ng/ml) and rheumatoid factor (375.7 ± 394.4 U versus 44.66 ± 37.63 U) were strongly elevated in severe (n = 15) versus mild (n = 7) courses of disease. Statistical calculation of mean and standard deviation revealed that sE‐selectin represents a highly significant marker for the presence of persistent and aggressive disease over time, regardless of therapeutic intervention and observation time points (P = 0.0004). Notably, regression analysis identified constant values for all parameters analyzed and, therefore, a stable course of the disease could be predicted from the beginning.

Conclusion

sE‐selectin appears to be a powerful marker to predict the severity of rheumatoid arthritis.

     

The role of soluble P selectin in the diagnosis of venous thromboembolism

Introduction

Soluble P selectin (sPsel), a member of the selectin family of cell adhesion receptors, has been proposed as a key molecule in hemostasis and thrombosis mediating platelet rolling, generating procoagulant microparticles and enhancing fibrin deposition. The aim of this study was to examine the role of sPsel in the diagnosis of venous thromboembolism (VTE).

Materials and Methods

We performed a systematic review and we used meta-analysis to synthesize data from published studies reporting sPsel levels in patients with i) VTE (deep venous thrombosis; DVT or DVT and pulmonary embolism; PE) and ii) DVT only. Pooled Odds Ratios (ORs) with 95% Confidence Intervals (CIs) were appropriately calculated among patients and controls. Diagnostic performance of sPsel was tested with pooled sensitivity, specificity, Diagnostic Odds Ratio (DOR) and summary receiver operator characteristic (SROC) curve.

Results

Eleven studies, comprising of 586 VTE patients and 1,843 controls were deemed eligible. The sPsel was significantly increased after VTE (OR = 2.89, 95%CI = 2.31-3.61, p < 0.001), or DVT only (OR = 2.64, 95%CI = 1.95-3.56, p < 0.001). Subgroup analysis evidenced that sPsel was also increased after VTE when evaluating only studies with patients that had no prior medical history (OR = 2.88, 95%CI = 1.98-4.19, p < 0.001). Exclusion of studies including patients with solid organ tumor, HIV or lupus anticoagulants positive patients did not alter findings. Pooled sensitivity and specificity of sPsel was 0.57 (95%CI = 0.30-082, p < 0.001) and 0.73 (95%CI = 0.51-0.90, p < 0.001), respectively and DOR was 4.31 (95%CI = 2.22-8.37, p < 0.01). SROC curve yielded in significant accuracy of sPsel performance (AUC = 0.74, p = 0.05).

Conclusions

The sPsel was significantly elevated in patients with DVT, both uncomplicated and complicated with PE and presented with high levels of diagnostic performance. sPsel is a plasma biomarker that may help in the diagnosis of VTE.     

血小板对单核细胞促凝活性的影响

目的 研究血小板对单核细胞促凝活性的影响。方法 采用一期法血浆凝固时间测定单核细胞促凝活性;单抗中和法确定组织因子（TF）活性及P－选择素的作用。结果 ①内毒素激活的单核细胞促凝活性显著增高,TF单抗能明显阻断该效应;②胶原激活的血小板对单核细胞及内毒素激活的单核细胞的促凝活性均有明显的增强作用;③抗血小板P－选择素单抗能阻断活化的血小板对单核细胞促凝活性的增强效应。结论 ①单核细胞促凝活性是由于TF的表达;②血小板对单核细胞促凝活性的增强效应是通过P－选择素实现的。     

妊娠高血压综合征患者血小板/T红细胞活化抗原1的表达及意义

目的 研究血小板/T红细胞活化抗原1(PTA1)的表达与妊娠高血压综合征发生、发展的关系.方法 用流式细胞术观察妊娠高血压综合征患者血清对于体外培养血管内皮细胞表达PTA1的作用以及该血管内皮细胞和活化血小板粘附后PTA1表达的变化.结果 妊娠高血压综合征患者血清刺激血管内皮细胞表达PTA1为15.51%(24 h)、6.32%(48 h),对照组为7.81%(24 h)、4.72%(48 h),差异有统计学意义(P<0.01);活化血管内皮细胞和活化血小板孵育后,血管内皮细胞表达PTA1为6.64%(24 h)、4.13%(48 h).妊娠高血压综合征患者血清刺激血管内皮细胞表达PTA1在用PTA1/IgG阻断后为8.11%(24 h)和4.28%(48 h),与阻断前比较明显降低(P<0.01).结论 妊娠高血压综合征患者体内存在某种非正常刺激因素,使血管内皮细胞敏感性增强,更易于活化.妊娠高血压综合征患者血海活化的血管内皮细胞与活化血小板孵育后表达的PTA1明显降低,提示PTA1分子直接或间接参与了妊娠高血压综合征血管内皮细胞和血小板的粘附.     

The role of endothelial cells in tumor invasion and metastasis

Summary Metastasis is one of the most devastating aspects of cancer. It is a complex multistep processes that results in spread of tumorigenic cells to secondary sites in various organs. The actual events that are involved in metastasis are the subject of several recent reviews [1–3].Upon growth of neoplastic cells beyond a certain mass (2 mm in diameter) an extensive vascularization through angiogenesis occurs. The new capillary network provides a supply of nutrients and gas exchange that allows further growth and development of the tumor mass. The network of the blood vessels also provides an entry site into the circulation for the neoplastic cells that detach from the tumor mass. Only a small percentage of circulating tumor cells (< 0.01%) survive travel in the circulation and arrest in the capillary beds of distant organs, extravasate and proliferate within the organ parenchyma producing a successful metastasis [1].Vasculature plays an important role in several steps of the metastatic process; 1) at the site of metastasis, vessels capture the cancer cell and provide the entry route into the secondary organ, and 2) through angiogenesis, vascular endothelial cells provide the supply of nutrients for the growth of the primary tumor mass and the route of intravasation. The lining of all blood vessels are covered with endothelial cells which play an active role in both processes. The metastatic properties of cancer cells have been extensively studied. Here, we will discuss the role of endothelial cells in the metastatic process with focus on their interaction with cancer cells at the site of extravasation.