中性粒细胞弹性蛋白酶——神经保护的作用新靶点

许多种组织、器官损伤(尤其缺血/再灌注损伤)后,中性粒细胞浸润,释放大量的弹性蛋白酶加重这些组织的损伤。脑缺血、脑出血、脑外伤等导致的脑损伤都伴有中性粒细胞向脑组织的浸润。因此,中性粒细胞所释放的弹性蛋白酶在脑损伤中可能也具有重要作用。该文对中性粒细胞弹性蛋白酶在脑损伤中的作用及作用机制进行了综述。     

血浆中性粒细胞明胶酶相关脂质运载蛋白与冠心病严重程度的相关性#br#

摘要：目的　探讨血浆中性粒细胞明胶酶相关脂质运载蛋白（NGAL）水平与不同类型冠心病（CHD）患者冠状动脉狭窄严重程度的关系。方法　回顾性分析2017年12月—2019年12月在我院治疗的180例冠心病患者,按照临床表现及实验室检查分为ST段抬高型心肌梗死（STEMI）组61例、稳定型心绞痛（SAP）组58例和对照组61例。所有患者均接受标准冠状动脉血管造影（CAG）检查,采用SYNTAX评分评估冠状动脉病变严重程度。CAG检查前采集外周静脉血5 mL,分离血浆后采用酶联免疫吸附测定（ELISA）法检测NGAL、基质金属蛋白酶-9（MMP-9）、同型半胱氨酸（Hcy）、高敏C反应蛋白（hs-CRP）水平。采用受试者工作特征（ROC）曲线评估血浆NGAL、MMP-9、Hcy和hs-CRP对高SYNTAX评分（＞33分）的预测价值。结果　STEMI组患者总胆固醇、低密度脂蛋白胆固醇、白细胞计数、MMP-9、hs-CRP和NGAL显著高于SAP组和对照组,SYNTAX评分高于SAP组,而LVEF显著低于SAP组和对照组（均P＜0.05）。NGAL预测高SYNTAX评分的曲线下面积为0.890（95%CI：0.815~0.964）,优于MMP-9（0.851,95%CI：0.775~0.927）、Hcy（0.554,95%CI：0.380~0.727）和hs-CRP（0.680,95%CI：0.523~0.838）。相关性分析示SYNTAX评分与NGAL、MMP-9、hs-CRP存在正相关（rs分别为0.426、0.434、0.184,P＜0.05）,与Hcy无显著相关性（rs=0.096,P=0.647）。结论　NGAL对冠心病患者冠状动脉狭窄严重程度的预测价值优于MMP-9、Hcy、hs-CRP,将有助于冠心病患者的危险分层。     

不同类型的肺部磨玻璃结节患者术前免疫炎症指标和癌胚抗原的比较

目的：比较不同病理类型的肺部磨玻璃结节（GGO）患者术前中性粒细胞与淋巴细胞比率（NLR）、血小板与淋巴细胞比率（PLR）、淋巴细胞与单核细胞比率（LMR）和血清癌胚抗原（CEA）的差异及其临床意义。方法：收集接受手术治疗的494例患者的NLR、PLR、LMR,其中浸润性腺癌176例,微浸润性腺癌150例,腺体前驱病变117例,良性病变51例。仅收集到150例浸润性腺癌、127例微浸润性腺癌、95例腺体前驱病变和45例良性病变的血清CEA数值。分别比较各组之间的NLR、PLR、LMR、CEA。结果：腺体前驱病变组的NLR(2.32±1.59)较良性病变组（1.82±0.64）高（P<0.05）。肺腺癌组的PLR(141.19±53.14)、腺体前驱病变组的PLR(145.94±51.92)较良性病变组（124.90±37.04）高（均P<0.05）。肺腺癌组的CEA [1.83(1.18,2.73)ng/mL]较腺体前驱病变+良性病变组[1.49(1.03,2.08)ng/mL]高（P<0.01）。浸润性腺癌组的CEA [2.14(1.29,2.92)ng/mL]分别...     

The overall benefits of empagliflozin treatment in adult siblings with glycogen storage disease type Ib: one year experience

IntroductionRecently published case reports suggest the benefit of empagliflozin use in subjects with glycogen storage disease Ib (GSD Ib).MethodsWe present the clinical and laboratory data of 2 adult brothers with GSD Ib treated with empagliflozin for 12 months.ResultsThere was no severe infection during administration of empagliflozin. The improvement of clinical symptoms of inflammatory bowel disease and arthritis along with reduction in serum CRP levels and urinary albumin excretion was noted. Neutrophil count increased, allowing for reduction or temporary withdrawal of G-CSF treatment.ConclusionsEmpagliflozin may be a new safe treatment in GSD Ib patients with an advanced stage of the disease.     

Assessment of neutrophil to lymphocyte ratio,C-reactive protein,mean platelet volume in obese,and nonobese patients with polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is associated with low-grade chronic inflammation.This was a retrospective case–control study.In the present study, the risk coefficients of neutrophil to lymphocyte ratio (NLR), high-sensitive C-reactive protein (hs-CRP), and mean platelet volume (MPV) in obese patients with PCOS were determined. This study was designed to investigate NLR, hs-CRP, and MPV levels in 68 obese patients with PCOS and 44 nonobese patients with PCOS, and our study group was matched with 47 obese and 43 nonobese controls, respectively.PCOS group had higher MPV, NLR, insulin, glucose, and HOMA-IR rates than those of the controls. Subgroup analyses revealed that the obese PCOS group had higher NLR, hs-CRP, and MPV levels compared to those of controls. The obese PCOS group had higher NLR, hs-CRP, and MPV levels compared to those of the nonobese PCOS group. The odds ratios and 95% confidence intervals of those variables (NLR, hs-CRP, MPV) were found significant (P < .05). NLR, hs-CRP, and MPV variables were found statistically significant in the analysis of receiver operating characteristics.Our study demonstrated that NLR, hs-CRP, and MPV levels are increased in patients with obese PCOS.     

PD-1/PD-L1与脓毒症的免疫紊乱

脓毒症(sepsis)在1991年初次被定义为感染所致的机体全身炎症反应综合征(SIRS).2016年脓毒症国际共识更新至Sepsis 3.0,即由感染所致宿主免疫反应失调引起的威胁生命的器官功能障碍.在脓毒症免疫抑制阶段,程序性死亡受体1(programmed cell death protein-1,PD-1)与程...     

Neutrophilic superficial eccrine ductitis: Proposal of a new disease concept

A 3‐year‐old Japanese boy presented with a 3‐month history of itchy erythematous papules on his trunk and forearms, the histologic findings of which were characterized by predominantly neutrophilic inflammation within and around the eccrine sweat ducts and obliteration and disruption of the superficial eccrine sweat ducts. Although the skin disorder had some clinical and histopathologic similarity to miliaria and neutrophilic eccrine hidradenitis, it was ultimately conformed to be neither disorder. Based on this and a case report in the Japanese literature of a 1‐year‐old boy with erythematous eruptions whose clinical and histopathologic findings were similar to those in our case, we propose the skin disorder in our case, referred to as “neutrophilic superficial eccrine ductitis,” as a unique entity.     

The pro-inflammatory role of platelets in cancer

Thrombosis is a frequent issue in cancer patients. Tumor-induced platelet activation and coagulation does not only constitute a significant risk for thrombosis, but also contribute to tumor progression by promoting critical processes such as angiogenesis and metastasis. In addition to their role in hemostasis, platelets are increasingly recognized as regulators of inflammation. By modulating the immune system, platelets regulate several aspects of cancer-associated pathology. Platelets influence the inflammatory response in cancer by affecting the activation status of the endothelium and by recruiting leukocytes to primary and metastatic tumor sites, as well as to distant organs unaffected by tumor growth. Furthermore, platelets participate in the formation of neutrophil extracellular traps, which can promote metastasis, thrombosis, and contribute to organ failure. In this review, we discuss the role of platelets as coordinators of the immune system during malignant disease and the potential of targeting platelets to prevent cancer-associated pathology.