目的 通过观察卵巢早衰 POF 患者外周血CD4+CD25+调节性T细胞 Treg 及干扰素-γ（IFN-γ）、转化生长因子-β(TGF-β)的变化，探讨POF的免疫学发病机制。 方法 收集2011年12月－2012年9月就诊的POF患者17例，卵巢储备功能减退 DOR 患者11例，以及生殖中心健康育龄女性16例，流式细胞仪定量检测外周血Treg数量，Elisa方法检测血清IFN-γ、TGF-β的水平，并以FSH/LH评价卵巢储备功能，进行相关性分析。 结果 与对照组相比，POF组和DOR组IFN-γ水平增高 P＜0.01 、TGF-β水平降低 P＜0.01 ，POF患者及DOR患者Treg比例降低 P＜0.01 ，IFN-γ的增高与卵巢储备功能的下降呈显著正相关 r=0.70，P＜0.01 。 结论 Treg 和IFN-γ、TGF-β水平与卵巢早衰密切相关，IFN-γ对评估卵巢储备功能、预测卵巢早衰具有参考价值。
ObjectiveTo summarize the clinical, radiological and pathological characteristics of acquired immune deficiency syndrome (AIDS) combined with Pneumocystis carinii pneumonia (PCP), so as to improve the clinicians' understanding of the disease. MethodsThe clinical data of 50 AIDS patients combined with PCP admitted between February 2006 and May 2015 were retrospectively analyzed, including medical history, physical signs, laboratory examination, chest high resolution CT (HRCT), pathological characteristics, treatment and prognosis, etc. ResultsThe clinical features of AIDS patients combined with PCP included cough, dyspnea and fever, without obvious positive signs in the lung.The patients were divided as a mild group, a moderate group and a severe group according to the levels of PaO2.There was significant difference among three groups in serum albumin level [(23±3) g/L vs. (30±5) g/L and (28±6) g/L, P < 0.01].There were no significant differences among three groups in CD4+ T lymphocyte and lactate dehydrogenase (LDH) (P > 0.05).The typical chest radiograph feature of HRCT was ground-glass shadows in both lungs, and may be associated with reticular shadows or "gravel sign" and cyst.Of 50 patients, 16 patients were diagnosed via pathology of transbronchial lung biopsy(TBLB) and only 5 patients were diagnosed via silver staining of the bronchoalveolar lavage fluid (BALF).The other patients were clinically diagnosed.100% of the patients were treated with sulfamethoxazole (SMZco), 64%with caspofungin, and 72% with glucocorticoid.All the patients relieved with no death in hospital. ConclusionWhen a patient got cough, dyspnea and fever, especially ground glass on HRCT in both lungs, AIDS combined with PCP should be highly considered, and diagnostic treatment with SMZco and CD4+ T lymphocyte measurement should be conducted as soon as possible, so as to reduce misdiagnosis and mortality.
Objective To observe the turbulence of regional intra-artery implantation chemotherapy and peripheral venous chemotherapy on immunologic function of patients. Methods Two weeks after radical operation of gastric carcinoma, chemotherapy was performed. Eighty-three patients were divided into two groups, one (42 patients) received peripheral venous chemotherapy (PVC) and the other (41 patients) received regional intra-artery implantation pump chemotherapy (RAIPC). The serum T-lymphocyte subsets and immunoglobulin level before and 1-4 days after the chemotherapy were measured. Results After PVC, proportion of CD3 and CD4, CD4/CD8 and IgG, IgA, IgM concentration in PVC group were significantly decreased compared with those before PVC （P＜0.05， P＜0.01）, and it is the same when compared with postRAIPC patients except for CD4 and IgM （P＜0.05）. In RAIPC group, there were no significant changes in proportion of CD3, CD4 and CD8, CD4/CD8 and IgG, IgA concentration between pre- and post-RAIPC patients. Conclusion After radical operation of gastric carcinoma, RAIPC affects the immunologic function more moderate than PVC.
ObjectiveTo evaluate the effects and mechanism of indoleamine 2, 3-dioxygenase (IDO) modified rat bone marrow mesenchymal stem cells (BMSCs) in composite tissue allograft rejection. MethodsBMSCs isolated from Brown Norway (BN) rats (aged, 4-6 weeks) were infected by IDO[green fluorescent protein (GFP)]-lentivirus. The high expression target gene and biological activity cell line (IDO-BMSCs) were screened. IDO mRNA and protein expressions were detected by RT-PCR and Western blot. The biological activity of IDO in supernatant was detected by measuring the amount of kynurenine generation. In mixed lymphocyte reaction system, different numbers of IDO-BMSCs mixed with responding cells (peripheral blood mononuclear cell isolated from 4-6-week-old LEWIS rats, as recipient) and stimulating cells (peripheral blood mononuclear cell isolated from BN rats, as donor), with the cells ratios of 1:5:5, 1:10:10, 1:50:50, and 1:100:100 (as experimental groups 1, 2, 3, and 4, respectively). Each reaction system was blocked by 1 mmol/L 1-methyl-tryptophan (1-MT) (IDO specific inhibitor). IDO-BMSCs mixed with responding cells (1:5) as the negative control group, responding cells mixed with stimulating cells (1:1) as positive control group; and IDO-BMSCs were cultured in RPMI 1640 medium alone as blank control group. MTT assay was used to detect the T lymphocytes proliferation at 5 days. Furthermore, GFP-BMSCs (group A), IDO-BMSCs (group B), and normal saline (group C) were infused via the tail vein of allogeneic limb transplantation rats, and graft survival time and rejection were observed in each group. ResultsThe IDO expression of BMSCs after genetic modification was higher than that before genetic modification. IDO-BMSCs could significantly improved kynurenine concentration in culture medium supernatant when compared with GFP-BMSCs (P<0.05). Before adding 1-MT, with the ratio of IDO-BMSCs to responding cells decreased, T lymphocytes proliferation rate increased in experimental groups 1, 2, and 3, showing significant differences between groups (P<0.05); there was no significant difference between experimental group 4 and the positive control group (P>0.05). After adding 1-MT, T lymphocytes proliferation rate was significantly higher than that before adding 1-MT in the other experimental groups (P<0.05) except experimental group 4 (P>0.05). In vivo, IDO-BMSCs could promote colonization in allograft, inhibit transplantation rejection, and prolong survival time of composite tissue allograft; the survival time of composite tissue allograft was (11.5±0.6) days in group A, (14.5±0.8) days in group B, and (9.0±0.3) days in group C, and it was significantly longer in group B than in groups A and C, and in group A than in group C (P<0.05). ConclusionIDO-BMSCs can promote the survival of allogeneic composite tissue grafts in rats, and its mechanism may involve in inhibition of T lymphocytes proliferation and promotion their own colonization in allograft.
Objective To observe the proportion changes of CD4+CD25+FOXP3+ T cells in peripheral blood of patients with VogtKoyanagiHarada disease (VKH) before and after one month of treatment. Methods he peripheral blood samples from 15 patients with VKH disease before and after one month of treatment by glucocorticoid, and from 15 healthy volunteers were collected，and lymphocytes were separated from them. CD4+CD25+ regulatory T cells were labeled by antibodies of cell surface marker CD4、CD25 and transcription factor FOXP3. The proportion of CD4+CD25+FOXP3+ T cells were detected by flow cytometry. Results Before the treatment, the percentage of CD4+CD25+FOXP3+ T cells in periphery blood was（0.30plusmn;0.19）% of CD4+ cell in VKH patients, and（1.41plusmn;0.52）% in control group, the difference was statistically significant（t=7.665,Plt;0.01）; after one month of treatment, the VKH patients group was（1.28plusmn;0.54）% which close to the control group. However there were two patients whose CD4+CD25+ T cells increased extraordinarily after one month of treatment. Conclusions The proportion of CD4+CD25+ FOCP3+ T cells in periphery blood in VKH patients were lower than control group obviously before treatment, but were close to control group after treatment. Those results indicated that VKH diseases may be associated with the decreased proportion of CD4+CD25+ regulatory T cells.
To verify the role of mAbCD28 in allograft transplantation. The biological action of mAbCD28 had been tested in mixed-lymphocyte-reaction and parathyroid gland allotranplantation in rats. Results: mAbCD28 could significantly suppress the proliferation of T cells in vitro and prolong the survival time of allograft in vivo. The results showed that mAbCD28 could block the costimulatory signals transmitted by CD28 molecules, and played an immunosuppressive role in parathyroid gland transplantation in rats.
目的:分析艾滋病患者抗病毒治疗后的临床疗效,比较不同基线CD4+T淋巴细胞计数增长情况。方法:纳入51例符合治疗标准的初治患者,采用国家标准抗病毒治疗一线方案和卫生部统一提供的免费药物,通过对服药后半月、1月、3月、6月、12月的时段进行临床评估和实验室检查,并比较不同基线CD4+T淋巴细胞计数水平治疗后的增长情况。结果:治疗12月后,各方案组疗效无差异,不同基线CD4+T淋巴细胞计数的增长有显著差异。毒副反应为肝损伤、过敏性皮疹,消化道反应为主。结论:HAART可显著的抑制体内HIV病毒的复制,重建机体的免疫功能,缓解患者病情,有利于存活期的延长。严重的毒副作用发生较少。