Sjögren syndrome: comparative studies in local ocular and serum immunoglobulin concentrations with special reference to secretory IgA

The objective of the present study was to examine Secretory IgA in tears and serum of Sjögren patients (34 patients and 23 controls). The test was performed in a parallel study using a polyclonal and a monoclonal method (Inter-Assay variation 9.1/Intra-Assay variation 5.5). No differences in the levels of tear secretory IgA were found between patients and controls. In serum however, secretory IgA, total IgA, IgM and IgG showed a significant increase in the Sjögren patients. The fact that secretory IgA levels remain normal in the ocular mucosa of these patients may explain that, despite the autoimmune destruction of the lacrimal gland, humoral defense factors are normally present on the surface of the eye to combat infections.     

保元活血颗粒对老年气虚肾虚证患者免疫功能的影响

目的：观察老年气虚肾虚证患者的免疫功能状况及保元活血颗粒对其的调节作用。方法：60例老年气虚肾虚患者被随机分为两组，治疗组和对照组各30例，治疗组服用保元活血颗粒治疗，疗程30d，检测T淋巴细胞亚群、自然杀伤细胞（NK细胞）、B淋巴细胞、免疫球蛋白、补体、淋巴细胞非组蛋白图像分析（Ag-Nors）等免疫指标于用药前后的表达情况，与对照组进行比较。结果：老年气虚肾虚证患者的免疫紊乱主要表现为细胞免疫显著下降，固有免疫减低，其中CD3、CD4、CD4/CD8、Ag-Nors、NK细胞水平均有所减低，体液免疫变化不明显。通过保元活血颗粒治疗，能提高老年气虚肾虚证患者的CD3、CD4、CD4/CD8值，提高NK细胞、Ag-Nors水平，对免疫球蛋白、补体、B细胞无明显影响。结论：保元活血颗粒对与老年气虚肾虚证相关的免疫紊乱有调节作用，尤其是细胞免疫，对体液免疫无明显影响。     

Massive hemolysis following inhalation of volatile nitrites

Volatile nitrites are drugs which have become widely used for their mood-altering and aphrodisiac effects. Their use has been associated with methemoglobinemia and mild hemolysis; more significant hemolysis has been noted in a patient with G6PD deficiency. We report here a case of massive hemolysis following inhalation of volatile nitrites in the absence of an apparent intrinsic red cell defect. It is important that health care workers are aware of side effects from these commonly abused substances.     

汞作业工人免疫状况的研究

本实验采用酸性α-醋酸萘酯酸法对汞作业工人外周血T淋巴细胞进行了测定,并采用单克隆抗体检测了T淋巴细胞亚群的变化;同时测定了血清免疫球蛋白IgG、IgA和IgM的含量。结果表明ANAE阳性细胞、OKT3、OKT4阳性细胞及OKT4~+/OKT8~+比值均明显低于对照组;血清IgM含量低于对照组,而IgG含量则高于对照组。说明汞接触者细胞免疫和体液免疫功能均会发生改变。结合作业环境条件、汞接触者工种、工龄及中毒情况进行综合分析,提示免疫功能的检查可考虑作为汞毒性损伤的敏感指标之一,有必要进行进一步研究和探讨。     

Subcorneal pustulosis with combined lack of IgG/IgM and monoclonal gammopathy type IgA/Kappa

Subcorneal pustulosis (Sneddon‐Wilkinson disease) is a rare inflammatory neutrophilic dermatosis. While subcorneal pustulosis is often associated with an IgA gammopathy, the combined lack of IgG/IgM seen in our case is rare. An 83‐year‐old man with combined lack of IgG/IgM and monoclonal gammopathy type IgA/Kappa presented with subcorneal pustules. Intravenous immunoglobulin therapy led to complete regression and might be another therapeutic option.     

免疫球蛋白改善新生儿缺氧缺血性脑病患者意识、肌张力障碍

目的探讨静脉注射免疫球蛋白(IVIG)改善新生儿缺氧缺血性脑病(HIE)患者意识、肌张力障碍的临床疗效及其作用机制。方法将40例HIE患儿随机分为IVIG治疗组及常规治疗组,比较两组患儿临床症状、体征消失及住院时间;并采用ELISA法检测患儿治疗前后外周血单个核细胞(PBMC)产生肿瘤坏死因子-α(TNF-α)、白细胞介素-1β(IL-1β)和白细胞介素-6(IL-6)的水平。结果与常规治疗组相比,IVIG治疗组患儿意识、肌张力障碍等症状消退时间及住院时间较常规治疗组均显著缩短犤(36±11)hvs(55±20)h,(34±18)hvs(50±19)h,(252±37)hvs(280±50)h,t=2.04～3.63,P<0.05犦。IVIG治疗后患儿PBMC产生前炎症细胞因子水平明显低于治疗前犤TNF-α:(1.0±1.6)μg/Lvs(4.2±3.8)μg/L,IL-1β:(1.1±1.5)μg/Lvs(3.4±3.8)μg/L,IL-6:(0.8±1.4)μg/Lvs(3.0±3.2)μg/L,P<0.01犦,而常规治疗前后无明显差异。结论IVIG早期应用对改善HIE患儿意识、肌张力障碍具有较好疗效,可能是通过抑制PBMC产生TNF-α,IL-1β和IL-6等损伤性细胞因子发挥作用。     

Precursor Frequency and Affinity Determine B Cell Competitive Fitness in Germinal Centers,Tested with Germline-Targeting HIV Vaccine Immunogens

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31例轻链型多发性骨髓瘤实验室指标分析

目的探讨实验室检测指标在轻链型多发性骨髓瘤(MM)诊治中的应用价值。方法收集轻链型MM患者31例及对照组60例,对照组为健康者20例(健康组),以及该院诊断的IgGκ型和IgAκ型MM患者各20例。检测免疫球蛋白、血清蛋白电泳、免疫固定电泳、尿素氮(UREA)、肌酐(Cr)、β_2微球蛋白,并进行流式细胞免疫表型检测及骨髓细胞学检查。结果血清蛋白电泳检测到M蛋白的阳性率为29.03%,Durie-Salmon临床分期Ⅱ期与Ⅲ期M蛋白水平差异有统计学意义(P0.05);免疫固定电泳结果均需用琼脂糖凝胶电泳法加做IgD及IgE抗体复查;轻链型MM患者与健康者的IgG、IgA、IgM、UREA、Cr、β_2微球蛋白比较,差异有统计学意义(P0.05);MM细胞形态特征改变显著,细胞抗原表达以CD38、CD138、CD56为主。结论免疫球蛋白定量及免疫固定电泳可作为M蛋白的筛查方法,血清蛋白电泳可用于患者的临床分期和疗效观察;骨髓细胞学检查对轻链型MM起到重要的诊断作用,轻链型MM比其他类型MM有更加严重的肾功能损伤。     

Verapamil and furosemide prevent cholecystokinin-induced translocation of immunoglobulins in rat intestine

Our previous studies have shown that cholecystokinin and pilocarpine are known to be extracellular messengers promoting the release of immunoglobulins A and G antibody activity in the lumen of the rat intestine. In the present study, which was also performed in rats, we show that CCK also promotes the translocation of albumin, electrolytes, and water into the lumen of the intestine. The effect of CCK on the translocation of immunoglobulins, albumin, and electrolytes is reduced by the prior injection of the calcium-channel blocker verapamil and the chloride-channel blocker furosemide. Taken together, the above observations suggest that the translocation of immunoglobulins, albumin, and electrolytes in the intestine appears to be stimulated by identical mechanisms and to proceed simultaneously.This work was supported in part by GIF grant 1-79-063.2/88 in part by the Miriam Coven-Fish Fund and in part by the joint Research Fund of the Hebrew University and Hadassah.