进行期银屑病患者活性氧代谢变化探讨

目的：探讨进行期银屑病患者活性氧代谢变化。方法：采用细胞化学发光分析技术测定患者及健康对照组外周血淋巴细胞化学发光强度（ Ｌｙｃｌ）及多形核白细胞化学发光强度（ Ｐ Ｍ Ｎｃｌ）,同时测定血浆超氧化物歧化酶（ Ｓ Ｏ Ｄ）、全血谷胱甘肽过氧化物酶（ Ｇ Ｓ Ｈ Ｐｘ）以及血浆丙二醛（ Ｍ Ｄ Ａ）含量。结果：银屑病患者 Ｌｙｃｌ及 Ｐ Ｍ Ｎｃｌ较对照组显著增强（ Ｐ＜ ０．０５）,血浆 Ｓ Ｏ Ｄ活力明显增强（ Ｐ＜ ０．０５）, Ｍ Ｄ Ａ 浓度较对照组明显增高（ Ｐ＜ ００５）。全血 Ｇ Ｓ Ｈ Ｐｘ 活力较对照组显著下降（ Ｐ＜ ０．０５）。结论：进行期银屑病患者细胞功能改变,机体活性氧代谢增强,抗氧化功能下降,组织细胞损伤加快。活性氧损伤可能是该病患者皮损炎症的重要原因。     

Mutation analysis of the TNFAIP3 in A20 haploinsufficiency: A case report

Introduction:Haploinsufficiency of A20 (HA20) is a novel genetic disease presented by Zhou et al in 2016. A20 is a protein encoded by TNFAIP3. Loss-of-function mutation in TNFAIP3 will trigger a new autoinflammatory disease: HA20. HA20-affected patients may develop a wide range of clinical manifestations, such as Behcet disease, rheumatoid arthritis, rheumatic fever, juvenile idiopathic arthritis, and systemic lupus erythematosus. HA20 is rarely reported, thus remaining far from thoroughly understood. Sixty-one cases of HA20 have been reported worldwide, among which 29 cases were diagnosed with Behcet disease ultimately. Moreover, 3 cases have been reported in China, which was the first report of HA20 characterized by Behcet disease. A comprehensive understanding of the pathogenic genes of HA20 could help us apply targeted therapy as soon as possible to improve patients’ survival rates.Patient concerns:A 2-year-old 3-month-old child was presented to our hospital with recurrent infectious enteritis and stomatitis.Diagnosis:Genetic mutations were detected immediately, and a novel pathogenic mutation was found in TNFAIP3. A heterozygous mutation (c.436-437deTC) located at TNFAIP3 was confirmed. The present research indicated that the TNFAIP3 mutation of c.436-437deTC (p.L147Qfs^∗7) accounted for familial Behcet-like autoinflammatory syndrome in the child suffering from HA20, while no variation in this locus was found in her parents.Interventions:Symptomatic treatments including oral administration of prednisone (12.5 mg/d) and iron supplement were performed, and repeated infection was no longer observed in the child. Pain and activity limitation was found in the knee joints. The treatment regimen was adjusted to oral prednisone (12.5 mg/dose, 2 doses/d) and subcutaneous injection of rhTNFR:Fc (12.5 mg/week).Outcomes: At the last follow-up, the limbs’ activities were normal, the inflammatory indicators were reduced or within the normal range. The prednisone dose was reduced to 7.5 mg/d, while the dose of rhTNFR:Fc was not changed.Conclusion:We have identified a novel pathogenic HA20 mutation. In this article, 1 case was analyzed in-depth in terms of clinical manifestations of the patient and new sources of such a novel disease, which might improve our understanding of this disease.     

肠道菌群和胃食管反流病发病的相关性

胃食管反流病（GRED）是一种较为常见的消化道疾病，其发病机理复杂，受多种因素的影响。近几年的研究表明，GERD与肠道菌群之间存在某种相关性。GERD可能与肠道菌群的紊乱引起机体炎症介质、5-羟色胺及脑－肠轴变化有关。本文就GERD与肠道微生物的关系进行了综述。     

Pulmonary surfactant-associated proteins and inflammatory factors in obstructive sleep apnea

Purpose

Pulmonary surfactant (PS) plays roles in promoting the removal of the liquid, host defense, and immune regulation in the tracheal, bronchial, and alveoli epithelium. PS protein expression level can be regulated by oxygen levels and related free radicals. Obstructive sleep apnea (OSA) is featured with oxygen free radical production for damaging epithelial tissues and thus may affect PS production. The study was to explore the relationship between PS protein and OSA severity.

Methods

We collected serum and bronchoalveolar lavage fluid (BALF) samples from 35 OSA patients and 22 healthy subjects. PS-associated proteins and inflammatory factors, including surfactant proteins, HIF-1α, NF-κB, and IL-6, were analyzed. Regression analysis was performed to reveal the relationship between biochemical factors and clinical indexes recorded during PSG monitor.

Results

Lower BALF and surfactant protein (except surfactant protein C or SPC) levels occurred in OSA patients (all p < 0.05 compared to control group). A strongly negative correlation was found between surfactant protein with apnea-hypopnea index (AHI) and other sleeping indexes including ODI₃ and ODI₄. Similar patterns were found in serum samples, which were strongly correlated with BALF counterparts. Surfactant proteins were further found to have negative regression with inflammatory factors such as HIF-1α, NF-κB, and IL-6.

Conclusions

This study established the relationship between PS-related protein with severity of OSA, plus their relationship with inflammatory factors. Our results provided possibly novel markers in general circulation for disease evaluation of OSA.