Ultrastructural analysis of the Fisher to Lewis rat model of chronic allograft nephropathy

Chronic allograft nephropathy (CAN) is the leading cause of graft loss following kidney transplantation. One factor contributing to CAN is chronic alloimmune injury. However, the involvement of alloantigen-dependent and -independent factors in CAN is unclear. The pathomechanism of CAN has been extensively studied by utilizing the Fischer-to-Lewis (F344-to-LEW) rat model. Transplant capillaropathy (circumferential multiplication of the peritubular capillary basement membrane) and transplant glomerulopathy (reduplication of the glomerular basement membrane) have recently been validated clinicopathologically as ultrastructural indicators of chronic alloimmune injury. To investigate the presence of these markers, F344-to-LEW kidneys were examined by electron and light microscopy 32, 40 and 52 weeks after implantation. F344 rats with or without 30-min ischemia of the left kidney following right nephrectomy served as controls. All transplanted rats displayed marked proteinuria. On electron microscopy, transplant capillaropathy, transplant glomerulopathy, and T-cell cytotoxicity (indicator of ongoing cellular rejection) were absent. On light microscopy, the arteries were devoid of intimal fibrosis. Focal-segmental glomerulopathy resembling hyperfiltration injury was encountered, with mild interstitial infiltration, fibrosis, and tubular atrophy. The proteinuria and kidney pathology were more severe in transplanted than in ischemic or uninephrectomized rats. Because chronic-active rejection could not be detected between weeks 32 and 52, we propose that the alloantigen-dependent initial graft injury subsides, but induces the late events: glomerular hyperfiltration, proteinuria, and glomerulosclerosis. Accordingly, the model - in the late phase - is suitable to investigate alloantigen-independent factors of CAN and lacks markers of alloantigen-dependent processes.     

Relationship between geriatric nutritional risk index and subpopulation lymphocyte counts in patients undergoing hemodialysis and peritoneal dialysis

We investigated the relationship between geriatric nutritional risk index (GNRI) and subpopulation lymphocyte counts (SLCs) in hemodialysis (HD) and peritoneal dialysis (PD) patients and evaluated whether they can be helpful in the diagnosis of malnutrition in these patients. We examined the GNRI and SLCs of 50 HD patients (mean: 55.8?±?12.7 years; 28 men and 22 women) and 16 Continuous Ambulatory Peritoneal Dialysis (CAPD) patients (mean: 49.8?±?14.5 years; 10 men and six women). The GNRI is calculated based on the serum albumin level, dry weight, and ideal body weight and uses the following equation: GNRI?=?[14.89?×?albumin (g/dL)]?+?[41.7?×?(weight/ideal body weight)]. SLCs were evaluated using flow cytometry. T-tests and χ² tests were performed to compare the two groups. Logistic regression analysis was performed for predicting malnutrition in dialysis patients. The average GNRI value was 100.1?±?8.4 in HD patients and 99.2?±?8.1 in PD patients, and no significant differences in GNRI or SLC were observed between the two groups. SLCs were higher in patients with higher GNRI (GNRI?≥?100) although there was no statistical difference. Logistic regression for predicting malnutrition according to GNRI revealed that age, female sex, and CD19 counts predicted malnutrition in HD and PD patients. These results suggest that GNRI and SLCs (especially CD19 count) may be significant nutritional markers in these patients.     

Mechanisms of Tolerance Induced by Donor-Specific Transfusion and ICOS-B7h Blockade in a Model of CD4+ T-Cell-Mediated Allograft Rejection

The inducible co-stimulatory molecule (ICOS) has been shown to play a critical role in T-cell activation and differentiation, and the regulation of alloimmune responses in vivo. Using an MHC class II mismatched model of CD4(+) T-cell-mediated rejection, we found that treatment of mice with DST and ICOS-B7h blockade induced long-term skin allograft survival and donor-specific transplantation tolerance. ICOS blockade, either during antigen priming or during the effector phase, previously shown to alter the outcome of the immune response, had a similar effect on graft survival. DST and anti-B7h mAb reduced the frequency of IFN-gamma-producing allospecific cells but did not produce deviation to a T(H)2 phenotype. In an adoptive transfer model using ABM TCR transgenic mice directly reactive to I-A(bm12), DST and anti-B7h mAb reduced the number of allospecific CD4(+) T cells and increased CD4(+) T-cell apoptosis. These data demonstrate that DST and anti-B7h mAb induces transplantation tolerance to MHC class II mismatched skin grafts by a reduction of the alloreactive clone size that is, at least in part, dependent on apoptosis of host alloantigen-specific CD4(+) T cells.     

流式细胞仪检测尖锐湿疣患者的T细胞亚群及NK细胞

目的 研究尖锐湿疣患者的细胞免疫功能。方法 用流式细胞仪检测了３０例尖锐湿疣患者外周血Ｔ细胞亚群及ＮＫ细胞百分率。结果 尖锐湿疣患者ＣＤ４细胞百分率下降,ＣＤ８细胞百分率增高,ＮＫ细胞数降低,与对照组相比差异均有显著性。结论 尖锐湿疣患者存在细胞免疫功能缺陷。     

Cyr61基因在非特指外周T细胞淋巴瘤中的表达及意义

目的探讨富含半胱氨酸61(Cyr61)在非特指外周T细胞淋巴瘤中的表达及意义。方法应用实时荧光定量PCR和免疫组织化学技术分别检测非特指外周T细胞淋巴瘤中Cyr61mRNA及其蛋白水平的表达情况,用细胞核增殖相关抗原(Ki-67)单克隆抗体标记肿瘤细胞并计算细胞增殖指数,用SPSS10.0软件分析Cyr61表达与该肿瘤细胞增殖指数、临床特征及预后的关系。结果①20例非特指外周T细胞淋巴瘤中有17例(85.0%)Cyr61mRNA表达上调,15例(75.0%)肿瘤细胞CYR61蛋白表达阳性;②Cyr61表达与该肿瘤细胞增殖指数呈正相关(r=0.8,P=0.008);③Cyr61表达与该肿瘤的临床分期、B症状及血清乳酸脱氢酶(LDH)有关(P=0.026,P=0.006,P=0.010);④Cox多因素相关分析显示,年龄>60岁和Cyr61表达上调为预后不良因素(P=0.020和P=0.021)。结论Cyr61在非特指外周T细胞淋巴瘤中广泛表达,可能与该肿瘤的临床特征和预后有关。     

炎琥宁注射液治疗寻常型银屑病前后外周血T细胞亚群的变化

目的：探讨寻常型银屑病患者炎琥宁注射液治疗前后外周血CD3^＋，CD4^＋，CD8^＋ T细胞变化情况。方法：40例患者中予炎琥宁注射液240mg加入0．9％生理盐水250mL～500mL中静滴，1次／d；内服中药银花虎杖饮（加减），1剂／d，分2次服；苦豆子油外用，2次／d，治疗4周。治疗前及治疗后检测患者外周血CD3^＋，CD4^＋，CD8^＋ T细胞。选择门诊健康体检者40例作为对照组。结果：治疗组有效率为85％，CD3^＋，CD4^＋，CD8^＋ T细胞以及CD3^＋/CD4^＋比值与治疗前比较差异有统计学意义（P〈0．01）。结论：炎琥宁注射液对寻常型银屑病疗效肯定，其在改善症状的同时亦能纠正患者外周血T细胞及其亚群的失衡状态。     

肺结核患者全血细胞减少的发病机理探讨

目的探讨肺结核合并全血细胞减少的可能发病机理。方法采用间接免疫荧光法检测23例初诊肺结核合并全血细胞减少患者治疗前后T细胞亚群(CD3、CD4、CD8、CD4/CD8),双抗体夹心ELISA法检测患者治疗前后血清IL-2、IFN-γ、IL-4和IL-10,全自动生化仪免疫透射比浊法定量检测患者治疗前后血清免疫球蛋白(IgG、IgA和IgM)。同时,同期检测20例健康者的上述指标作为对照。结果患者治疗前CD4/CD8倒置,Th1类细胞因子(IL-2、IFN-γ)呈低水平,Th2类细胞因子(IL-4和IL-10)明显增高(与正常对照比较P<0.01);血清免疫球蛋白明显增高(与正常对照比较均P<0.01),且以IgG增高为主。结论肺结核合并全血细胞减少患者其免疫异常导致自身抗体大量产生是主要原因之一。     

抗-HBs、抗-HBe和抗-HBc阳性人群的胸腺近期输出功能初步探讨

目的观察抗-HBs、抗-HBe和抗-HBc阳性人群外周血单个核细胞(PBMCs)中T细胞受体重排删除环(TRECs)的含量,从而推测其胸腺近期输出功能。方法利用实时荧光定量PCR方法检测30例抗-HBs、抗-HBe和抗-HBc阳性人群及22例正常人PBMCs中TRECs含量。结果抗-HBs、抗-HBe和抗-HBc阳性人群中TRECs含量为(5.67±1.55)cop ies/103PBMCs,与正常人TRECs水平(6.11±2.11)cop ies/103PB-MCs无差异(P>0.05)。结论抗-HBs、抗-HBe和抗-HBc阳性人群TRECs水平情况显示其胸腺近期输出功能与正常人比较无差异。     

VEGF基因在非特指外周T细胞淋巴瘤中的表达及意义

目的探讨血管内皮细胞生长因子(VEGF)在非特指外周T细胞淋巴瘤中的表达及意义。方法应用实时荧光定量PCR和免疫组织化学技术分别检测非特指外周T细胞淋巴瘤中VEGFmRNA及其蛋白水平的表达情况,用CD34单克隆抗体标记肿瘤血管计算其微血管密度(MVD),用SPSS10.0软件分析VEGF表达与该肿瘤微血管密度、临床特征及预后的关系。结果(1)20例非特指外周T细胞淋巴瘤中有14例(70.0%)VEGFmRNA表达上调,13例(65.0%)肿瘤细胞VEGF蛋白表达阳性;(2)VEGF表达与该肿瘤微血管密度呈正相关(r=0.8,p=0.0270);(3)VEGF表达与该肿瘤的临床分期、B症状及血清乳酸脱氢酶(LDH)有关(p=0.034,p=0.013和p=0.007);(4)Cox多因素相关分析显示,年龄>60岁和VEGF表达上调为预后不良因素(p=0.040和p=0.027)。结论VEGF在非特指外周T细胞淋巴瘤中广泛表达,可能与该肿瘤的临床特征和预后关系密切。     

四君子汤联合肠内营养对胃癌手术患者T细胞亚群及营养状况影响的随机对照研究

目的：观察胃癌患者围手术期使用中药四君子汤联合肠内营养对T细胞亚群及营养状况的影响。方法：采用前瞻性、随机、单盲、对照研究，将59例胃癌手术患者随机分为对照组（n=20）、研究A组（n=21）和研究B组（n=18）。研究B组术后2～9d经鼻饲管给予中药四君子汤100ml，研究A、B组患者手术后第2天开始给予等热量、等氮肠内营养支持8d，对照组术后给予等热量、等氮肠外营养支持9d。术前1d，术后第1天和第10天分别检测T细胞亚群及血清白蛋白、前白蛋白、转铁蛋白等营养指标。结果：3组患者血清白蛋白、前白蛋白、转铁蛋白和CD3^＋、CD4^＋、CD4^-／CD8^-水平术后均较术前显著降低。术后第10天，应用肠内营养的A、B两研究组T细胞亚群及营养指标水平较使用肠外营养支持的对照组有不同程度的提高，且四君子汤辅助肠内营养的研究B组血清白蛋白、转铁蛋白和T细胞亚群水平均较单纯肠内营养的研究A组显著提高（P〈0.05）。结论：健脾益气中药四君子汤辅助的肠内营养能进一步改善和优化胃癌术后机体的细胞免疫功能及营养状况。