DNA免疫吸附治疗狼疮性肾炎的临床观察

目的观察DNA免疫吸附血液灌流器对狼疮性肾炎患者的临床疗效。方法选择重庆第三军医大学新桥医院肾内科16例活动性狼疮性肾炎患者,采用DNA免疫吸附血液灌流器进行32例次血液灌流。观察相关症状及蛋白尿改善情况;ANA、ds-DNA清除效果;血常规、肝、肾功能、电解质、免疫球蛋白等影响程度。结果吸附后症状明显改善,尿蛋白减轻;ANA水平显著下降(P=0.0001),ds-DNA抗体完全清除;血中有形成份、肝、肾功能、电解质等无明显影响。结论DNA免疫吸附血液灌流的净化疗法是治疗狼疮性肾炎特异性相对较强、疗效好、无明显毒副反应的一种新疗法。     

类风湿关节炎免疫吸附剂的临床应用

目的　探讨免疫吸附剂治疗类风湿关节炎 (RA)的临床效果。方法　将 6 7例RA患者随机分为RA免疫吸附剂治疗 35例 (治疗组 )和非吸附治疗 32例 (对照组 )。将治疗组患者动脉血流经RA免疫吸附剂 ,吸附后由肘静脉回输入体内。随访 8～ 30个月 ,比较两组疗效。结果　治疗组经 1～ 2次吸附治疗 ,有效率 97% (34/ 35 ) ,较对照组 6 9% (2 2 / 32 )差异有显著性 (P <0 0 1)。完全缓解率治疗组 83% (2 9/ 35 ) ,较对照组 5 0 % (16 / 32 )差异有显著性 (P <0 0 1)。其中病史 <2年并关节功能状态Ⅱ级者 2 2例 ,完全缓解率 10 0 % (2 2 / 2 2 ) ,较对照组病史 <2年并关节功能状态Ⅱ级者 2 0例 ,完全缓解率 70 % (14 / 2 0 )差异有显著性 (P <0 0 1)。病史≥ 2年治疗组完全缓解率 5 4 %(7/ 13) ,较对照组 17% (2 / 12 )差异有显著性 (P <0 0 1)。关节功能状态Ⅲ级者治疗组完全缓解率 5 8% (7/ 12 ) ,较对照组 18% (2 / 11)差异有显著性 (P <0 0 1)。结论　免疫吸附剂治疗RA ,优于非吸附疗法     

Immusorba TR and Immusorba PH: Basics of Design and Features of Functions

Abstract: Immusorba was reported by Yamazaki et al. to be the world's first practical immunoadsorbent in 1982. Since then, this immunoadsorbent has accumulated an abundance of clinical achievements. Immusorba has such unique functions that it is used in treating various diseases and holds possibilities for application to more diseases. Immusorba was designed as an artificial receptor for rheumatoid factor (RF) based on structural analysis of heat-denaturated globulin. Subsequently, new substances that it can adsorb have been found as seen in reports on the adsorption performance of Immusorba to anti-acetylcholine receptor antibodies (anti-AChR Abs) and antiganglioside antibodies. Along with this, Immusorba has been used in treating a wide range of diseases. The greatest characteristic of Immusorba is that its adsorption capability is selective rather than specific, making it effective against a great number of diseases.     

全自动酶免疫分析系统对AFP定量的精密度影响分析

目的 观察FAME-STAR全自动酶免疫分析联体饥定量检测血清甲胎蛋白（AFP）对其精密度的影响。方法 参考美国国家临床实验室标准化委员会（NCCLS）制订的（EP5-T2）评价方案进行精密度实验，并与AxSYM化学发光法定量AFP进行对比。结果 运用FAME-STAR全自动酶免疫分析联体机ELISA法定量AFP，在低、高值血清中，批内精密度分别为2．38％、5．96％；日内精密度分别为3．97％、6.80％；日问精密度分别为4．68％、7.15％；总精密度分别为5．29％，8．46％。与AxSYM全自动化学发光分析法测定AFP结果比较，两种方法相关性良好（N=42，Ra=0．9877，y^-（ELISA）=08589x（ICA）＋2．6005）。结论 FAME-STAR全自动酶免疫分析联体机定量检测AFP，精密度好。     

Immusorba TR and PH

Immusorba TR (IM-TR) and PH (IM-PH) were developed as adsorbents with non-biological materials as affinity ligands to remove pathogenic autoantibodies. The adsorbents of IM-TR and IM-PH are polyvinyl alcohol gel immobilized with tryptophan and phenylalanine as ligand, respectively. IM-TR is clinically applied for treatment of autoimmune neurological diseases such as myasthenia gravis and Guillain-Barre syndrome. IM-PH is used for not only neurological diseases such as GBS and multiple sclerosis but also collagen diseases such as rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). As many autoantibodies with different specificities have been found to have similar affinities to the ligand of Immusorba, it is expected that Immusorba will be applied to more diseases and contribute to the clarification of the mechanisms of the development of diseases by the identification of adsorbed unknown pathogenic substances with Immusorba.     

DNA免疫吸附柱治疗狼疮性肾炎的临床应用

目的:观察DNA免疫吸附柱对狼疮性肾炎患者的临床疗效。方法:选择16例活动性狼疮性肾炎患者,采用DNA免疫吸附柱进行32例次血液吸附。观察相关症状及蛋白尿改善情况:ANA、ds-DNA清除效果;血常规、肝、肾功能、电解质、免疫球蛋白等影响程度。结果:吸附后症状明显改善,尿蛋白减轻;ANA水平显著下降(P=0.0001),ds-DNA抗体完全清除;血中有形成份、肝、肾功能、电解质等无明显影响。结论:DNA免疫吸附的净化疗法是治疗狼疮性肾炎特异性相对较强、疗效好、无明显毒副反应的一种新疗法。     

DNA免疫吸附剂血液灌流治疗系统性红斑狼疮临床应用研究

目的 :应用DNA免疫吸附剂 ,对系统性红斑狼疮 (SLE)患者进行血液灌流治疗 ,以清除致病抗体及其免疫复合物 ,使血液得到净化以治疗疾病。方法 :将患者动脉血液流经血液灌流仪 ,以保温 (38℃± )和保持流速(2 0 0ml/min)进入DNA免疫吸附罐 ,在罐内经吸附后由静脉回输入体内。吸附 1次需 1.5～ 2h ,使患者体内血液流经 3～ 4遍。结果 :32例SLE患者吸附后 1～ 2天发热、乏力、关节痛消失 ,2周皮损 87.5 %消失 ,1周各项检测异常指标皆达正常参考值内。而血中有形成份红细胞、白细胞、血小板则无影响。所治疗 32例SLE患者已随访 12～ 4 4个月 ,与未用此法治疗的对比组 34例SLE患者相比 ,生活质量明显提高 ,病死率显著下降 (P <0 .0 1)。结论 :用DNA免疫吸附剂进行血液灌流的净化疗法是特异性强、疗效高、无菌、无毒性、无致热源、无溶血反应、便于应用的一种新疗法     

Clinical Trials of Immunoadsorbent in Systemic Lupus Erythematosus Therapy

Abstract: Five patients with systemic lupus erythematosus (SLE) were perfused through an extracorporeal shunt filled with DNA-immunoadsorbent (DNA immobilized on carbonized resin beads). High concentrations of anti-DNA antibodies (36.4–67.0%) (binding percentage with ¹²⁵I-DNA) in the serum of SLE patients were reduced to 13.8–53.0%, respectively. The highest removal percentage was 62.1%. Although the decline levels varied, the symptoms of patients, i.e., long-term severe joint pain, severe edema, hydropericardium, and ascites were all relieved considerably. The immunoadsorbent showed satisfactory blood compatibility.     

用三乙胺作氰基转移剂活化Sepharose 4B制备免疫吸附剂

制备免疫吸附剂的方法有溴化氰(CNBr)活化琼脂糖珠,过碘酸钠氧化葡聚糖凝胶以及三氯三氮六环活化纤维素等,其中最常用的是溴化氰活化琼脂糖珠法,一般在强碱性反应液中进行。但CNBr和有活性的氰酸酯在此条件下很快便发生水解,且CNBr的用量较大,故操作时的危险性亦大。     

Isolation and characterization of a hereditary abnormal antithrombin III 'Antithrombin III Toyama'

A hereditary abnormal antithrombin III (AT-III) 'Antithrombin III Toyama' was purified from the plasma of a patient with recurrent thrombophlebitis by a procedure involving barium chloride and ammonium sulfate fractionations, affinity chromatography on anti-AT-III-Sepharose gel, and DEAE-Sephadex chromatography. Purified abnormal AT-III was shown to be the same as normal one in the molecular size, having the same molecular weight, amino-terminal sequence and carboxy-terminal amino acid. Abnormal AT-III gave the same UV spectrum as normal AT-III and both proteins were immunologically identical. Abnormal AT-III, however, showed the different electrophoretic mobility on agarose gel electrophoresis and immunoelectrophoresis. Abnormal AT-III was more electronegative than normal one, before and after a neuraminidase digestion of both proteins. These results suggest that in antithrombin III Toyama an amino acid residue at the heparin-binding site has been replaced by less basic or more acidic one which has no ability to interact with heparin, resulting in a loss of heparin cofactor activity of this protein.