肠内营养对脑卒中患者胃肠道及免疫功能的影响

目的 探讨肠内营养在脑卒中患者中的应用价值。方法 脑卒中患者120例，肠内营养和肠外营养组各60例。两组在营养支持前及营养支持后1个月分别用消化道内镜检查胃肠黏膜情况，并测定和比较T淋巴细胞亚群及免疫球蛋白。结果 肠内营养组在肠内营养支持后，胃、十二指肠黏膜损害（溃疡率）21例（35．0％），肠外组为41例（68．3％），肠内组显著低于肠外组（P〈0．01），肠外组轻型15例（50．0％），肠外组重型26例（86．7％），轻型显著低于重型（P〈0．01）；肠外组重型治疗后血清免疫球蛋白IgG、IgA、IgD分别为（9．27±2．41）g／L、（2．11±0．64）g／L、（2．11±0．36）mg／L及T淋巴细胞亚群CD3^＋、CD4^＋、CD4^＋／CD8^＋分别为（51．42±3．89）％、（36．26±2．82）％、（1．17±0．29），肠内组重型治疗后IgG、IgA、IgD分别为（11．70±2．89）g／L、（2．81±0．69）g／L、（2．40±0．31）mg／L，T淋巴细胞亚群CD3^＋、CD4^＋、CD4^＋／CD8^＋分别为（60．70±4．94）％、（40．38士4．10）％、（1．49±0．58），肠内营养组显著高于肠外营养组（P〈0．01）；机体感染发生率其肠外组为23例（38．3％），肠内组总感染11例（18．3％），肠内组显著低于肠外组（P〈0．05）。结论 肠内营养在脑卒中患者中具有维护肠道屏障功能和免疫功能的作用，并能降低感染发生率，且安全可行。     

Zika virus infections imported to Italy: Clinical,immunological and virological findings,and public health implications

We report the first two cases of laboratory confirmed Zika virus (ZIKV) infections imported into Italy from French Polynesia. Both patients presented with low grade fever, malaise, conjunctivitis, myalgia, arthralgia, ankle oedema, and axillary and inguinal lymphadenopathy. One patient showed leukopenia with relative monocytosis and thrombocytopenia.The diagnosis was based on ZIKV seroconversion in both cases and on ZIKV RNA detection in one patient from acute serum sample. Sera from both patients exhibited cross-reactivity with dengue virus antigens. Our immunological analysis demonstrated that recovery from ZIKV infection is associated with restoration of normal numbers of immune cells in the periphery as well as with normal function of antigen-presenting cells. ZIKV is an emerging arbovirus, which has recently spread extensively in tourist destinations on several West Pacific islands. Returning viremic travelers may ignite autochthonous infections in countries like Italy, which are infested by Aedes albopictus, a suitable vector for ZIKV. The role of clinicians is crucial and includes early diagnosis and timely notification of public health authorities in order to quickly implement adequate focal vector control measurements.     

ShcC proteins: Brain aging and beyond

To date, most studies of Shc family of signaling adaptor proteins have been focused on the near-ubiquitously expressed ShcA, indicating its relevance to age-related diseases and longevity. Although the role of the neuronal ShcC protein is much less investigated, accumulated evidence suggests its importance for neuroprotection against such aging-associated conditions as brain ischemia and oxidative stress. Here, we summarize more than decade of studies on the ShcC expression and function in normal brain, age-related brain pathologies and immune disorders with a focus on the interactions of ShcC with signaling proteins/pathways, and the possible implications of these interactions for changes associated with aging.     

沙美特罗替卡松联合孟鲁斯特对哮喘患儿IL－4 INF－γIgE EOS 影响研究

目的：探讨沙美特罗替卡松联合孟鲁斯特治疗支气管哮喘患儿对临床疗效、免疫功能的影响。方法：选取我院自2011年1月至2013年12月收治的哮喘患儿102例,按治疗方法的不同分为试验组及对照组,各51例。对照组患儿给予沙美特罗替卡松粉吸入剂,试验组在此基础上给予口服孟鲁司特钠。观察患儿治疗前后临床疗效及免疫功能的情况。结果：试验组患儿治疗总有效率为96．1％,对照组患儿治疗后总有效率为82．4％,试验组患儿治疗后总有效率显著优于对照组,差异有统计学意义（P＜0．05）。两组患儿治疗前肺功能达标率,差异无统计学意义（P＞0．05）。试验组患儿治疗3个月及治疗后3个月肺功能达标率显著优于对照组患儿,差异有统计学意义（ P＜0．05）。两组患儿治疗前IL－4、INF－γ、IgE、EOS无显著差异,差异无统计学意义（ P＞0．05）。两组患儿治疗3个月及治疗后3个月肺功能IL－4、IgE及EOS水平均较治疗前明显降低,而INF－γ较治疗前明显升高（P＜0．05）,试验组患儿治疗3个月及治疗后3个月肺功能IL－4、IgE及EOS水平降低及INF－γ升高有显著差异,差异有统计学意义（ P＜0．05）。结论：应用沙美特罗替卡松联合孟鲁斯特治疗小儿哮喘具有明显疗效,安全性较好,依从性好,值得临床推广。     

Lysosomal phospholipase A2: A novel player in host immunity to Mycobacterium tuberculosis

Phospholipases catalyze the cleavage of membrane phospholipids into smaller bioactive molecules. The lysosomal phospholipase A₂ (LPLA₂) is specifically expressed in macrophages. LPLA₂ gene deletion in mice causes lysosomal phospholipid accumulation in tissue macrophages leading to phospholipidosis. This phenotype becomes most prominent in alveolar macrophages where LPLA₂ contributes to surfactant phospholipid degradation. High expression of LPLA₂ in alveolar macrophages prompted us to investigate its role in host immunity against the respiratory pathogen Mycobacterium tuberculosis, the causative agent of tuberculosis. Here we report that adaptive immune responses to M. tuberculosis were impaired in LPLA₂ deficient mice. Upon aerosol infection with M. tuberculosis, LPLA₂ deficient mice showed enhanced mycobacterial counts but less lung immunopathology and pulmonary inflammatory responses. Compromised T‐cell priming in the lymph nodes was associated with impaired pulmonary T‐cell recruitment and activation. Together with reduced Th1 type cytokine production, these results indicate that LPLA₂ is indispensable for the induction of adaptive T‐cell immunity to M. tuberculosis. Taken together, we identified an unexpected and novel function of a lysosomal phospholipid‐degrading enzyme.     

“肺与大肠相表里”的黏膜免疫调节机制及中药干预作用研究进展

“肺与大肠相表里”是中医学经典理论之一，揭示了肺与大肠在生理、病理上的密切相关性，在肺、肠疾病治疗上具有重要指导意义。现代医学已揭示肺与大肠在组织来源、黏膜免疫上的联系，初步明确了“肺与大肠相表里”的物质基础及可能的调节机制，并将此理论应用于2019冠状病毒病、溃疡性结肠炎等肺肠难治病的治疗，获得可靠疗效。现有研究结果表明，肺与大肠解剖上的同质性促使了肺-肠黏膜免疫功能的相关性，黏膜免疫及固有淋巴细胞的迁移归巢是肺与大肠共享生理病理的调节机制之一。部分清热解毒类中药和补益类中药通过调节肺-肠黏膜免疫功能治疗肺、肠疾病，成为“肺肠同治”创新药物研发的候选药物。然而，上述两类中药现有免疫调节相关研究主要集中于对分泌型IgA、细胞因子等表达水平及固有淋巴细胞、B淋巴细胞等免疫细胞数量的变化上，对与之相关的气道、肠道黏液高分泌、肺及肠道黏膜屏障免疫细胞功能改变、肺-肠黏膜免疫相互作用动态过程及肺-肠局部微生态的干预作用，以及清热解毒、补益功效与其调节肺-肠黏膜免疫作用间的相关性和生物学基础等尚缺乏深入研究。本文试从肺、肠共同拥有的黏膜免疫系统切入，从黏膜固有淋巴细胞归巢角度分析肺肠相关疾病的内在联系，并综述对肺、肠黏膜免疫具有调节作用的中药复方及其有效成分的作用特点和规律，为“肺与大肠相表里”理论内涵的深入阐释及相关疾病治疗药物的研发提供参考。     

阴道微环境和IL-10水平变化与高危型HPV感染的关系

目的 探讨阴道微环境和白介素-10(IL-10)水平变化与高危型HPV感染的关系。方法 选择2016年1月～2019年1月在舟山医院和甘肃省第二人民医院进行宫颈癌前筛查的患者3879例的资料进行回顾性分析,按照患者是否出现高危型HPV感染进行分组,分为病例组1346例,对照组2533例,通过单因素分析与多因素分析的方式,探讨阴道微环境和IL-10水平变化与高危型HPV感染的关系。结果 病例组患者的pH值、乳酸杆菌的量、白细胞级别与对照组比较差异均有统计学意义(t=50.598,χ2=244.382、27.604,P0.05),病例组患者的念珠菌检出率高于对照组,差异有统计学意义(χ2=284.363,P0.05),两组患者的滴虫检出率数据差异无统计学意义(χ2=2.802,P0.05),病例组患者阴道灌洗液中的IL-10浓度高于对照组患者,差异有统计学意义(t=62.260,P0.05),pH值偏高、乳酸杆菌的量偏少、白细胞偏多、念珠菌阳性、阴道灌洗液中的IL-10浓度偏高,均成为患者出现高危HPV感染的独立危险因素(P0.05)。结论 阴道微环境和IL-10水平变化与高危型HPV感染之间的关系密切,但需要更多研究对各类因素之间的因果关系进行深入分析。     

Pattern of antibodies to the Duffy binding like domain of Plasmodium falciparum antigen Pf332 in Senegalese individuals

Acquisition of antibodies against blood stage antigens is crucial in malaria immunity and the Plasmodium falciparum antigen Pf332, which is present in close association with the infected red blood cell membrane, is one such antigen. In this study, the antibody response to a Duffy binding like fragment of Pf332, termed Pf332-DBL was investigated in sera from naturally exposed individuals living in Dielmo village, Senegal, with regard to immunoglobulin classes (IgG, IgM, IgE) and IgG subclasses (IgG1–4). While the levels of IgM, IgG, IgG1 and IgG2 only displayed a moderate trend to increase with age, Pf332-DBL specific IgG3 levels increased significantly in the older villagers. In multivariate analysis, when controlling for confounding factors, and in a linear model with a Poisson distribution, anti-Pf332-DBL IgG3 as well as the ratio of cytophilic to non cytophilic anti-Pf332-DBL antibodies were found significantly associated with a reduced risk of malaria attack. This association was also present when the IgG3:IgG1 ratio was tested. Finally, two subgroups of villagers with the same mean age, were delineated by IgG3 concentrations either lower or higher than the median value. A total of 45.2% of the individuals with low anti-Pf332-DBL-IgG3 levels but only 21.4% of the villagers in the group with high levels of such antibodies had a clinical malaria attack during a period of 3 years of continuous follow-up after the blood sampling. In conclusion, Pf332-DBL induces naturally the acquisition of antibodies, and Pf332-DBL-specific IgG3 appears to be associated with protection against malaria in this endemic setting.