大鼠骨髓间充质干细胞和免疫调节作用

目的 研究一氧化氮(nitric oxide,NO)在骨髓间充质干细胞(mesenchymal stem cells,MSCs)的免疫调节作用.方法 贴壁筛选法分离培养Lewis大鼠骨髓间充质干细胞.以刀豆蛋白A(concanavalin A,ConA)作为刺激因素,SD大鼠外周血分离的T淋巴细胞作为反应细胞,采用CCK-8法检测T淋巴细胞与MSCs共培养后其增殖能力的变化.然后采用RT-PCR、Western blot检测MSCs诱导型一氧化氮合酶(inducible nitric oxide synthase,iNOS)mRNA与蛋白的表达;Griess法检测上清液亚硝酸盐含量;ELISA检测上清液Th1细胞因子IFN-γ和Th2细胞因子IL-4的水平.结果 MSCs明显抑制ConA诱导的T淋巴细胞增殖,抑制作用因细胞比例的不同而有所区别.当实验组MSC:T为1:10时最明显,增殖率为(33.83±2.10)%,而1:80组[(78.62±3.80)%]与不含MSCs的阳性对照组[(79.03±1.70)%]差异无统计学意义(P＞0.05).实验组MSCs的iNOS mRNA与蛋白的表达以及上清液中亚硝酸盐含量均较阳性对照组明显上调,1:10～1:40的范围内呈明显递增趋势,但1:80组与1:40组差异无统计学意义(P＞0.05).在加入iNOS特异性抑制剂2-甲基-2-巯基硫酸脲(S-methylisothiourea sulfate,SMT)后,各组T淋巴细胞增殖率基本恢复.实验组IFN-γ含量随MSCs所占比例的降低而增加,各组IL-4含最差异无统计学意义(P＞0.05).结论 MSCs对同种异体外周血T淋巴细胞的增殖有免疫调节作用,机制可能与其分泌的可溶性因子NO影响了 Th1/Th2平衡有关.

Abstract：

Objective To observe the role of nitric oxide(NO) in the immune regulatory effect of bone marrow mesenchymal stem cells(MSCs). Methods Bone marrow MSCs were isolated from Lewis rats by adherence screening. Concanavalin A (ConA) was adopted as the stimulator and T-lymphocyte isolated from peripheral blood of SD rats as the reactive cells. The changes of the ability of T-lymphocyte proliferation, when co-cultured with MSCs, were measured by CCK-8 assay. The inducible nitric oxide synthase (iNOS) mRNA and protein expression on MSCs and were detected by RT-PCR, Western blot. The contents of nitrites and the levels of Th1 type cytokine IFN-γand Th2 type cytokine IL-4 were measured by Griess test and ELISA respectively, in the co-cultured supernatant. Results T-lymphocyte proliferation was inhibited by co-cultured MSCs, which was concentration-dependent. In this study, the inhibition was most obviously group[ (79.03 ± 1.70)% ] (P ＞ 0.05 ). The I NOS mRNA expression, protein and nitrite levels were signifigroups, the proliferation rate of T-lymphocyte recovered. The content of IFN-γwas increased with the ratio decline of MSCs in the experimental group and IL-4 in each group has no significant difference( P ＞ 0.05 ).Conclusion MSCs inhibited T-lymphocyte proliferation by influencing Th1/Th2 balance, and the secretion of soluble factor NO, which secreted by MSCs, may plays an important role in the immune regulation.     

少见十二指肠球部间质瘤1例报道

十二指肠球部间质瘤位置较特殊,临床少见,诊断和治疗较困难。本文对1例十二指肠球部间质瘤的诊治进行报道,探讨手术切除范围和术前留置鼻胆管的作用。     

同系大鼠骨髓间充质干细胞对同种异体胰岛刺激的T淋巴细胞的免疫调节作用

目的:研究同系大鼠骨髓间充质干细胞(Mesenchymal stem cell,MSC)对同种异体胰岛刺激的T淋巴细胞的免疫调节作用,以及对共培养胰岛胰岛素分泌的影响。方法:以Wistar大鼠胰岛作为刺激原,Lewis大鼠MSC及外周血T淋巴细胞作为共培养细胞,分为三组:实验组(A)20IEQ胰岛细胞、1×108 L-1 T淋巴细胞和1×107 L-1 MSCs共培养;药物对照组(B)20IEQ胰岛细胞与1×108 L-1 T淋巴细胞共培养并加入0.25μg/ml CsA;阳性对照组(C)20IEQ胰岛细胞与1×108 L-1 T淋巴细胞共培养。CCK-8检测共培养3天时T淋巴细胞对同种异体胰岛刺激的反应性,ELISA检测共培养3天时上清液IFN-γ、IL-2、IL-4和IL-10的含量,以及共培养胰岛的胰岛素分泌功能。结果:MSC与CsA均可抑制同种异体胰岛刺激的T淋巴细胞增殖,A组T淋巴细胞增殖率(17.10±2.7)%与B组(14.65±1.8)%间差异无统计学意义(P>0.05);C组IFN-γ、IL-2含量显著高于A组及B组,IL-10含量显著低于A及B组,差异有统计学意义(P<0.05);IL-4含量在A、B、C三组间差异均无统计学意义(P>0.05)。A组胰岛的胰岛素分泌水平显著高于B组和C组,差异有统计学意义(P<0.05);胰岛素刺激指数(2.37±0.52)显著高于B组(1.80±0.36),差异有统计学意义(P<0.05)。结论:MSC与CsA均可通过减少Th1类细胞因子的表达使受者Th1/Th2平衡向Th2方向偏移,抑制同种异体胰岛刺激的T淋巴细胞增殖。相对于CsA,MSC可以保持胰岛素高分泌水平和良好的糖刺激反应性,避免了CsA可能带来的毒性和副作用,具有一定的临床应用优势及前景。     

骨髓间充质干细胞移植途径对胰岛移植物免疫排斥反应的影响

目的:探讨骨髓间充质干细胞(MSC)与胰岛共移植对诱导胰岛移植物免疫耐受的作用,并比较MSC不同途径移植的效果。方法:SD大鼠和Lewis大鼠分别作为供、受体。取SD大鼠股骨,贴壁培养法分离和扩增MSC,胶原酶V分离胰岛。应用链脲佐菌素制备Lewis大鼠糖尿病模型后,将其随机均分为A组(将BrdU标记的MSC与胰岛经门静脉混合输入),B组(将胰岛经门静脉输入,BrdU标记的MSC经尾静脉输入),C组(胰岛经门静脉输入,联合应用环孢素A)和D组(单纯胰岛门静脉移植)。观察各组术后血糖变化,比较各组胰岛移植物存活时间。术后第7天切取各组部分存活大鼠肝脏、胸腺、脾脏行免疫组化染色观察MSC归巢位置。结果:A,B两组大鼠术后正常血糖维持时间最长,C组次之,D组最短;各组胰岛存活时间A组为(12.1±2.3)d,B组为(8.6±1.4)d,C组为(13.2±1.9)d,D组为(2.2±0.6)d;MSC归巢部位观察显示,A组BrdU阳性的MSC主要分布于肝脏,并在植入胰岛周围形成"类微囊化效应",B组BrdU阳性的MSC主要分布于胸腺、脾脏。结论:MSC与胰岛共移植能诱导胰岛移植物免疫耐受,且MSC和胰岛混合经门静脉移植效果优于胰岛门静脉移植联合MSC外周静脉移植。     

原发性骨髓纤维化脾切除术一例

患者男,38岁.因"发现腹部包块4年,伴胀痛呼吸困难1个月"入院.患者于4年前无意间发现左上腹部包块,鸡蛋大小,质硬,无压痛,当地医院检查诊断为"骨髓纤维化,脾大".经多家医院非手术治疗,效果无明显好转,脾脏进行性增大;近1个月病情加重,出现腹部胀痛,呼吸困难,进食和平卧受限等症状.查体:消瘦,腹部明显膨隆,并可触及一巨大肿物,下缘达脐下5指,右缘超正中线10 cm,质硬,活动度欠佳,压痛、叩击痛阳性.     

14岁以下儿童肝细胞癌的治疗现状

肝细胞癌(HCC)是儿童第二常见的原发性肝脏肿瘤,具有复杂的临床特点,恶性较高,预后较差。儿童HCC的治疗方式有多种,包括手术切除、肝移植、化疗、经动脉化疗栓塞治疗、靶向治疗等多种治疗方式。笔者就14岁以下儿童HCC的各种治疗方式的现状进行综述。     

基于真实病例的PBL教学在国际学生外科课间实习中的应用

在2006级国际学生的外科课问实习中开展基于真实病例的PBL教学。通过事先设计病例,并在实习前根据真实病例做出修改以适应真实情况,将国际学生分组床头实习后小组讨论,收到良好的实习效果。基于真实病例的PBL教学是适用于国际学生的教学方法,有利于提高国际学生的学习热情,提高学习效果。     

Immune regulation of different genotypes of bone marrow mesenchymal stem cells on allogenic islet transplantation

<正>Objective To compare the immune regulation of syngenic and allogenic mesenchymal stem cells ( MSCs) in the transplantation combined with islets. Methods After induction of diabetes in 30 Lewis rats with streptozotocin ( STZ) ,the recipient Lewis rats received islets     

与大鼠胰岛细胞联合移植的骨髓间充质干细胞的免疫调节作用

目的 研究同种异体或自体的大鼠骨髓间充质干细胞(MSC)与胰岛肝内联合移植对胰岛移植物的免疫调节作用及其机制.方法 以链佐星制备Lewis大鼠的糖尿病模型,作为胰岛移植受者,分为3组:单纯移植组大鼠经门静脉单独移植SD大鼠胰岛6000 IEQ/kg;同系MSC组大鼠经门静脉共同移植1×109/L的Lewis大鼠MSC 1 ml与SD大鼠胰岛6000 IEQ/kg;同种MSC组大鼠经门静脉共同移植1×109/L的SD大鼠MSC 1 ml与SD大鼠胰岛6000 IEQ/kg.检测受鼠的血糖变化,术后1、3 d大鼠外周血γ干扰素(IFN-γ)、白细胞介素(IL)-2、IL-4和IL-10的含量.结果 3组大鼠术后第1天血糖均下降到13.9 mmol/L以下.同系MSC组移植物存活时间为(11.38±4.03)d,同种MSC组为(5.50±2.07)d,单纯移植组为(2.88±1.25)d(P＜0.01).术后1、3 d,单纯移植组IFN-γ和IL-2的含量显著高于同系MSC组和同种MSC组(P＜0.01),同种MSC组IFN-γ和IL-2的含量高于同系MSC组(P＜0.05);单纯移植组IL-10的含量低于同系MSC组和同种MSC组(P＜0.01),同系MSC组IL-10的含量与司种MSC组相比较,差异无统计学意义(P＞0.05);各组IL-4含量的差异无统计学意义(P＞0.05).结论 MSC与同种胰岛共移植可以延长胰岛移植物存活时间,应用同系MSC的效果优于同种异体MSC.共移植的MSC主要通过减少TH1类细胞因子(IFN-y和IL-2)的表达使受者TH1/TH2平衡向TH2方向偏移.

Abstract：

Objective To compare the immune regulation of syngenic and allogenic mesenchymal stem cells (MSCs) in the transplantation combined with islets. Methods After induction of diabetes in 30 Lewis rats with streptozotocin (STZ), the recipient Lewis rats received islets from SD rats combined with syngenic (group B) or allogenic (group C) MSCs injection via the portal vein. The group of islets transplanted alone served as control (group A). The survival time of grafts in all groups was assessed by the level of blood glucose. ELISA was used to detect the levels of interferon-γ (IFN-γ), interleukin 2 (IL-2), IL-4 and IL-10 in the peripheral blood on the 1st and 3rd day after transplantation. Results The blood glucose levels in all three groups were decreased in a normal range (13. 9 mmol/L) and the survival time of grafts in group B (11.38 ± 4. 03 days) was significantly longer than in group C (5. 50± 2. 07 days) as well as group A (2. 88 ± 1.25 days). On the 1 st and 3rd day after transplantation, the levels of TH 1 cytokines IFN-γ and IL-2 in group A were significantly higher than in groups C and B (P＜0.05). Meanwhile the levels of TH 2 cytokine IL-10were increased in group B, but there was no significant difference between groups A and C (P＞0.05). The levels of IL-4 had no significant difference among these three groups (P ＞ 0.05).Conclusion Islet transplantation combined with MSCs could prolong the survival time of grafts.Syngenic MSCs, superior to allogenic ones, were more effective in changing the balance of TH1/TH2to TH2. Decreased expression of TH1 cytokine (IFN-γ, IL-2), which was closely related to the induction of immune tolerance, was beneficial to the long-term survival of grafts.     

miR-34a通过调控TGF-β/Smad4信号通路激活自噬而降低结肠癌细胞对奥沙利铂的耐药性

目的探讨miR-34a调节结肠癌细胞对奥沙利铂(OXA)的耐药作用及其机制。方法采用实时荧光定量PCR(qRT-PCR)方法检测结肠癌组织和细胞系中miR-34a的表达水平;采用基因软件预测、分析及检测结肠癌细胞中miR-34a的下游靶基因;采用细胞计数试剂盒(CCK-8试剂盒)检测细胞的生存率;采用流式细胞仪以及Western blot方法检测结肠癌细胞的凋亡和自噬情况。结果接受OXA化疗的结肠癌患者的血清中miR-34a的表达水平明显降低,转化生长因子-β(TGF-β)mRNA和Smad4 mRNA的表达水平均明显增高。OXA引起miR-34a的表达下调,亲代结肠癌细胞和对OXA耐药的结肠癌细胞中TGF-β和Smad4的表达均上调。自噬的激活增强了结肠癌细胞对OXA的耐药性。在结肠癌组织中,Smad4 mRNA和miR-34a的表达水平间具有负相关性,过表达miR-34a通过靶向抑制Smad4的表达来抑制自噬的激活并降低耐药性。结论 miR-34a抑制TGF-β/Smad4信号通路的激活,抑制自噬降低结肠癌细胞对OXA的耐药性。