YKL-40、CD4+/CD8+比值与腺病毒肺炎患儿炎性因子和并发喘息的关系研究

摘要 目的：探讨血清壳多糖酶3样蛋白1（YKL-40）、外周血CD4⁺/CD8⁺比值与腺病毒肺炎（AP）患儿炎性因子和并发喘息的关系。方法：选取2019年10月～2022年10月湖北省妇幼保健院收治的97例AP患儿为AP组,根据是否并发喘息分别为喘息组和无喘息组,另选取同期50例体检健康儿童为对照组。收集AP患儿的临床资料,采用酶联免疫吸附法检测血清YKL-40和炎性因子[白细胞介素（IL）-6、IL-8、肿瘤坏死因子-α（TNFα）]水平,流式细胞术检测外周血CD4⁺、CD8⁺比例并计算CD4⁺/CD8⁺比值。采用Spearman相关性分析AP患儿血清YKL-40、CD4⁺/CD8⁺比值与炎性因子水平的相关性,多因素Logistic回归分析AP患儿并发喘息的影响因素。结果：与对照组比较,AP组血清YKL-40、外周血CD8⁺比例升高,CD4⁺比例、CD4⁺/CD8⁺比值降低（P＜0.05）。AP组血清IL-6、IL-8、TNF-α水平高于对照组（P＜0.05）。Spearman相关性分析显示,AP患儿血清YKL-40与IL-6、IL-8、TNF-α水平呈正相关,外周血CD4⁺/CD8⁺比值与IL-6、IL-8、TNF-α水平呈负相关（P＜0.05）。97例AP患儿住院期间喘息发生率为50.52%（49/97）。多因素Logistic回归分析显示,呼吸衰竭、小气道病变、特应性体质和血清IL-6、IL-8、TNF-α、YKL-40升高为AP患儿并发喘息的独立危险因素,外周血CD4⁺/CD8⁺比值升高为独立保护因素（P＜0.05）。结论：AP患儿血清YKL-40水平升高和外周血CD4⁺/CD8⁺比值降低,与炎性因子水平升高和并发喘息密切相关。     

视频脑电图联合PEWS评分、NSE、CD4+/CD8+比值对病毒性脑炎患儿病情评估及预后预测的临床价值

摘要 目的：探讨视频脑电图（VEEG）联合儿童早期预警评分（PEWS）、神经元特异性烯醇化酶（NSE）、CD4⁺/CD8⁺比值对病毒性脑炎患儿病情评估及预后预测的价值。方法：选择2020年3月至2022年3月南京医科大学附属儿童医院收治的152例病毒性脑炎患儿，根据病情严重程度将患儿分为重症组（67例）和轻症组（85例），另选择72例无神经系统损伤住院患儿为对照组。治疗2周后，根据儿童格拉斯哥预后量表（CGOS）将其分为预后良好组（4~5级，89例）与预后不良组（1~3级，63例）。所有研究对象均接受PEWS测评和VEEG检查，检测血清NSE水平，计算CD4⁺/CD8⁺比值。采用单因素和多因素Logistic回归分析影响病毒性脑炎患儿预后的因素。采用受试者工作特征（ROC）曲线分析PEWS、VEEG 及血清NSE、CD4⁺/CD8⁺比值预测病毒性脑炎患儿预后的价值。结果：重症组PEWS、VEEG重度异常比例及血清NSE水平高于轻症组和对照组，CD4⁺/CD8⁺比值低于轻症组和对照组（P＜0.05）；轻症组PEWS、VEEG重度异常比例及血清NSE水平高于对照组，CD4⁺/CD8⁺比值低于对照组（P＜0.05）。预后不良组PEWS、VEEG重度异常比例、血清NSE水平高于预后良好组，CD4⁺/CD8⁺比值低于预后良好组（P＜0.05）。多因素Logistic回归分析结果显示，持续惊厥、高PEWS、VEEG重度异常、血清NSE水平升高是病毒性脑炎患儿预后不良的危险因素，CD4⁺/CD8⁺比值升高是保护因素（P＜0.05）。联合PEWS、VEEG 及血清NSE、CD4⁺/CD8⁺比值预测病毒性脑炎患儿预后曲线下面积为0.859，高于各指标单独预测。结论：病毒性脑炎患儿高PEWS、VEEG重度异常、血清NSE水平升高、CD4⁺/CD8⁺比值降低，与病情加重和预后不良有关，联合以上四项指标辅助预测病毒性脑炎患儿预后的价值较高。     

传染性单核细胞增多症患儿NLR、CD4+/CD8+比值、ADA与EBV-DNA载量的相关性分析及对肝损害的影响

摘要 目的：探讨传染性单核细胞增多症（IM）患儿外周血中性粒细胞/淋巴细胞比值（NLR）、CD4⁺/CD8⁺比值、腺苷脱氨酶（ADA）与EB病毒（EBV）-脱氧核糖核酸（DNA）载量的相关性,分析其对IM患儿肝损害的影响。方法：选择2019年1月至2022年4月我院儿科收治的102例IM患儿（IM组）,另选择同期我科收治的95例EB病毒检测阴性的发热患儿（非IM组）和体检健康的73例健康儿童（对照组）。根据是否发生肝损害将IM患儿分为肝损害组（61例）和非肝损害组（41例）。比较外周血NLR、CD4⁺/CD8⁺比值、ADA与EBV-DNA载量,Pearson法分析NLR、CD4⁺/CD8⁺比值、ADA与EBV-DNA载量的相关性。多因素Logistic回归分析IM患儿发生肝损害的影响因素。结果：IM组ADA高于非IM组和对照组（P＜0.05）,且非IM组高于对照组（P＜0.05）,NLR、CD4⁺/CD8⁺比值低于非IM组和对照组（P＜0.05）,且非IM组低于对照组（P＜0.05）,IM组EBV-DNA载量高于非IM组（P＜0.05）。IM患儿ADA与EBV-DNA载量呈正相关（r=0.493,P＜0.05）,NLR、CD4⁺/CD8⁺比值与EBV-DNA载量呈负相关（r=-0.419、-472,P＜0.05）。肝损害组ADA、EBV-DNA载量高于非肝损害组（P＜0.05）,NLR、CD4⁺/CD8+⁺比值低于非肝损害组（P＜0.05）。肝脏肿大、高EBV-DNA载量、高ADA是IM患儿肝损害的危险因素（P＜0.05）,高NLR、高CD4⁺/ CD8⁺比值是保护因素（P＜0.05）。结论：IM患儿ADA增高,NLR、CD4⁺/CD8⁺比值降低,与EBV-DNA载量增加以及肝损害有关。     

狼疮性肾炎患者血清NETs、TWEAK、外周血CD4+T/CD8+T比例与疾病活动度及肾脏预后的关系

摘要 目的：探讨狼疮性肾炎（LN）患者血清中性粒细胞胞外诱捕网（NETs）、肿瘤坏死因子样凋亡微弱诱导剂（TWEAK）、外周血分化簇（CD）4⁺T/CD8⁺T比例与疾病活动度及肾脏预后的关系。方法：选取2021年8月～2022年8月川北医学院附属医院肾内科收治的LN患者137例（LN组）,根据系统性红斑狼疮疾病活动指数（SLEDAI）-2000评分分为轻度活动组（52例）、中度活动组（45例）、重度活动组（40例）。随访1年,根据肾脏相关终点事件发生情况分为预后不良组（43例）和预后良好组（94例）,另选取同期76名体检健康志愿者（对照组）。采用酶联免疫吸附法检测血清NETs、TWEAK水平,流式细胞术检测外周血CD4⁺T/CD8⁺T比例。Spearman相关性分析LN患者血清NETs、TWEAK和外周血CD4⁺T/CD8⁺T与SLEDAI-2000评分的相关性,多因素Logistic回归分析LN患者预后不良的因素,受试者工作特征曲线分析血清NETs、TWEAK和外周血CD4⁺T/CD8⁺T对LN患者预后不良的预测价值。结果：与对照组比较,LN组血清NETs、TWEAK水平升高,外周血CD4⁺T/CD8⁺T降低（P＜0.05）。轻度活动组、中度活动组、重度活动组血清NETs、TWEAK依次升高,外周血CD4⁺T/CD8⁺T依次降低（P＜0.05）。LN患者SLEDAI-2000评分与血清NETs、TWEAK呈正相关,与外周血CD4⁺T/CD8⁺T呈负相关（P＜0.05）。慢性肾脏病分期4期、SLEDAI-2000评分升高、NETs升高、TWEAK升高为LN患者预后不良的独立危险因素,估算肾小球滤过率升高、CD4⁺T/CD8⁺T升高为独立保护因素（P＜0.05）。血清NETs、TWEAK和外周血CD4⁺T/CD8⁺T联合预测LN患者预后不良的曲线下面积为0.943,大于血清NETs、TWEAK和外周血CD4⁺T/CD8⁺T单独预测的0.790、0.788、0.799（P＜0.05）。结论：LN患者血清NETs、TWEAK水平升高,外周血CD4⁺T/CD8⁺T降低,与疾病活动度及肾脏预后不良密切相关,血清NETs、TWEAK联合外周血CD4⁺T/CD8⁺T预测LN患者肾脏预后的价值较高。     

组蛋白去乙酰化酶3对外周CD4+ T细胞分化的影响

目的 探讨组蛋白去乙酰化酶3（HDAC3）对外周CD4⁺ T细胞分化及功能的调控作用。方法 采用CD4cre酶介导Hdac3杂合基因缺失小鼠（Hdac3^fl/flCD4^cre+/-）及其野生型正常对照小鼠（Hdac3^fl/fl，WT），流式细胞术检测HDAC3缺失对外周CD4⁺和CD8⁺ T细胞比例和数量的影响；在体外佛波酯（PMA）和离子霉素（Ionomycin）刺激条件下，流式细胞术检测HDAC3缺失对CD4⁺ T细胞中IFN-γ、IL-4和IL-17A的表达以及Tfh细胞产生的影响；采用ELISA检测HDAC3缺失对小鼠血清IFN-γ、IL-4和IL-17表达的影响；分选Hdac3^fl/flCD4^cre+/-和WT小鼠外周初始CD4⁺ T细胞，分别在Th1和Th2分化条件下培养，细胞内染色检测HDAC3缺失对Th1、Th2以及Th17相关细胞因子及其特异转录因子表达的影响；采用Microarray检测HDAC3缺失对CD4⁺ T细胞分化亚群相关基因表达的影响；采用链脲佐菌素（STZ）处理小鼠构建I型糖尿病（TIDM）疾病模型，检测HDAC3缺失对T1DM发病的影响。结果 与WT小鼠相比，Hdac3^fl/flCD4^cre+/-小鼠外周CD4⁺和CD8⁺ T细胞的比例和数量显著降低。Hdac3^fl/flCD4^cre+/-小鼠CD4⁺ T细胞及血清中IFN-γ的表达显著降低，而IL-4和IL-17A的表达显著增加，Tfh细胞比例也显著增加；HDAC3缺失抑制体外培养CD4⁺ T细胞向Th1分化但促进其向Th2分化；Microarray检测发现HDAC3缺失导致Th1型细胞谱系基因表达降低，而Th2、Th17以及Tfh细胞谱系基因表达增加；在STZ诱导条件下，HDAC3缺失抑制小鼠T1DM的发生和CD4⁺ T细胞向Th1分化。结论 HDAC3促进外周CD4⁺ T细胞向Th1细胞分化并加重T1DM的发生。     

消疬膏对脾胃虚弱证颈部淋巴结核患者CD4+CD25highFoxP3+调节性T淋巴细胞和胃肠激素的影响

摘要 目的：研究消疬膏对脾胃虚弱证颈部淋巴结核患者CD4⁺CD25^highFoxP3⁺调节性T淋巴细胞和胃肠激素的影响。方法：选择南京市中西医结合医院于2020年3月~2022年1月期间收治的颈部淋巴结核患者120例。按照随机数字表法分为对照组（60例）和研究组（60例）。对照组接受常规抗结核方案，研究组接受消疬膏联合常规抗结核方案，两组疗程均为6个月。观察两组治疗前和治疗6个月后的中医证候积分、CD4⁺CD25^highFoxP3⁺调节性T淋巴细胞相关指标和胃肠激素的变化，记录两组治疗期间用药安全性。结果：两组治疗6个月后肿疡大小、肿疡皮色、面色、纳呆、倦怠乏力、便溏、舌质、脉象评分均下降，且研究组低于对照组（P<0.05）。研究组治疗6个月后CD4⁺CD25^highFoxP3⁺调节性T淋巴细胞、白介素-10（IL-10）水平低于对照组，γ-干扰素（IFN-γ）水平高于对照组（P<0.05）。研究组治疗6个月后胆囊收缩素（CCK）、胃泌素（GAS）水平低于对照组，胃动素（MTL）水平高于对照组（P<0.05）。研究组的不良反应总发生率低于对照组（P<0.05）。结论：消疬膏治疗脾胃虚弱证颈部淋巴结核患者，可有效改善患者临床症状，可能与调节CD4⁺CD25^highFoxP3⁺调节性T淋巴细胞和胃肠激素水平有关。     

五灵胶囊联合富马酸丙酚替诺福韦片对慢性乙型肝炎患者氧化应激、CD4+CD25+调节性T细胞和血清MMP-1、MMP-2、TIMP-1的影响

摘要 目的：探讨五灵胶囊联合富马酸丙酚替诺福韦片对慢性乙型肝炎（CHB）患者氧化应激、CD4⁺CD25⁺调节性T细胞和血清基质金属蛋白酶-1（MMP-1）、基质金属蛋白酶-2（MMP-2）、基质金属蛋白酶组织抑制因子-1（TIMP-1）的影响。方法：纳入苏州大学附属传染病医院2021年6月~2022年12月期间收治的CHB患者122例,采用随机数字表法分为对照组（n=61,富马酸丙酚替诺福韦片）和研究组（n=61,五灵胶囊联合富马酸丙酚替诺福韦片）。对比两组疗效、氧化应激指标、CD4⁺CD25⁺调节性T细胞、肝功能指标[总胆红素（TBIL）、谷丙转氨酶（ALT）、谷氨酰转肽酶（GGT）]、血清MMP-1、MMP-2、TIMP-1水平和不良反应发生情况。结果：研究组的临床总有效率高于对照组（P<0.05）。两组治疗后丙二醛（MDA）下降,且研究组低于对照组同时间点;超氧化物歧化酶（SOD）升高,且研究组高于对照组同时间点（P<0.05）。两组治疗后CD4⁺CD25⁺调节性T细胞下降,且研究组低于对照组同时间点（P<0.05）。两组治疗后MMP-1、MMP-2、TIMP-1下降,且研究组低于对照组同时间点（P<0.05）。两组治疗后TBIL、ALT、GGT下降,且研究组低于对照组同时间点（P<0.05）。两组不良反应总发生率组间对比未见差异（P>0.05）。结论：五灵胶囊联合富马酸丙酚替诺福韦片治疗CHB患者,可有效减轻机体氧化应激,调节CD4⁺CD25⁺调节性T细胞和血清MMP-1、MMP-2、TIMP-1水平。     

CD39的临床意义及其与肝癌浸润T细胞耗竭的相关性分析

摘要 目的：探索CD39分子（编码基因ENTPD1）在原发性肝细胞肝癌（Hepatocellular carcinoma, HCC）中的表达、临床意义及其与HCC中免疫浸润和T细胞耗竭的相关性。方法：TIMER、GEPIA、Kaplan-Meier Plotter、TCGA等数据库分析CD39在肝癌中的差异性表达、与免疫浸润的关系、相关基因的表达及其与肝癌患者预后的关系。免疫荧光染色、细胞测序和流式检测验证临床HCC患者的癌及癌旁组织中CD39的差异性表达及其和CD8⁺T细胞耗竭特性的相关性。结果：（1）生物信息学分析结果显示：CD39在多种肿瘤组织中表达上调（包括HCC）（P＜0.05）；且其表达水平与HCC的临床预后等显著相关（P＜0.05）；与CD39低表达组相比，HCC中CD39高表达组患者无复发生存期（relapse-free survival, RFS）（P=0.025）和无进展生存期（progression-free survival, PFS）（P=0.026）较短；CD39与HCC肿瘤微环境中CD8⁺T、CD4⁺T、巨噬细胞等免疫细胞浸润水平均有明显正相关。（2）临床HCC样本验证：免疫荧光和流式结果显示CD39在癌组织中的表达水平高于癌旁正常组织，与耗竭相关分子LAYN、TIM3、CTLA4等共表达，且在耗竭CD8⁺T细胞中表达比例显著高于非耗竭细胞。结论：CD39在HCC肿瘤组织及浸润的CD8⁺T细胞中高表达，与HCC的RFS、PFS、免疫细胞浸润等紧密相关，且参与CD8⁺T细胞耗竭。     

抗VacA+CagA+幽门螺杆菌IgY的抗感染作用研究*

为研究抗VacA⁺CagA⁺幽门螺杆菌(Hp)IgY的抗感染作用,以VacA⁺CagA+Hp为抗原免疫蛋鸡,聚乙二醇法和水稀释法从鸡卵黄中提取抗-VacA⁺CagA⁺Hp-IgY,酶联免疫吸附实验(ELISA)测定IgY抗体效价。建立胃腔感染VacA⁺CagAHp的昆明系小鼠模型,观察抗-VacA⁺CagA⁺     

体外培养脐血单个核细胞与CD34+富集细胞

对比MNC和CD34⁺富集细胞在SCF+IL-3+IL-6+FL+Tpo细胞因子组合下的体外扩增特性,发现：CD34⁺富集细胞具有很高的扩增潜力,在本实验条件下其总细胞持续扩增了8周,扩增倍数达31270.9±8640.5倍;而MNC在培养至第4周扩增就已呈现下降趋势,最大仅扩增了53.3±6.2倍。对比集落和CD34⁺细胞的扩增发现,MNC的集落密度和CD34⁺细胞含量由第0天至第7天有一个上升的过程,而CD34⁺富集细胞在培养过程中,集落密度和CD34⁺细胞含量却始终呈下降趋势。在体外培养过程中,CD34⁺富集细胞的CFU-GM和CD34⁺细胞最大分别扩增了185.7±14.1和191.7±188.8倍,明显高于MNC的12.4±3.2和50.6±33.2倍;而CD34⁺富集细胞和MNC的BFU-E则只实现了少量扩增,分别为7.2±5.2和10.1±3.4倍。结果显示,从CD34⁺富集细胞出发扩增造血干/祖细胞,可以得到更多的CD34⁺细胞和CFU-GM集落形成细胞。      

Characterization of a murine thymic CD4+ T cell subset-TCRαβ+ 3G11-6C10- CD4+ CD8-thymocytes

The presence of a relatively mature CD4⁺ CD8⁻ (SP) T cell subset in mouse thymus has been demonstrated. Composing of 10% of total CD4SP thymocytes, this subset is defined by the absence of 3G11 and 6C10 expression with a phenotype of CD69^+/−, HSA^med/lo and heterogeneous for Qa-2 expression. The proliferation capability of TCRαβ⁺ 3Gl l⁻ 6C10⁻ CD4⁺ CD8⁻ thymocytes was high while using Con A stimulus. And Con A stimulation could result in secretion of IL4, IL-10, IL-6 and a little amount of IFNγ. IL-2 was barely detectable. This is distinct from typical Th0 type cytokines. The cells of this subset were NK1.1 negative, but strongly expressed GATA-3 mRNA. The results suggest that the CD4⁺ subset of 3G11⁻ 6C10⁻ NK1.1⁻ phenotype possesses immunocompetent cells with functions characteristic of Th2-like cytokines, which may indicate the cells at transitional status from Th0 to Th2, with a propensity to Th2. Project supported by the National Natural Science Foundation of China (Grant No. 39730410).     

Functional maturation of mouse CD4+CD8- thymocytes induced by medullary-type thymus epithelial cells

Murine CD4⁺CD8^- (CD4SP) thymocyte subset is a heterogeneous population, in which the Qa-2^- cells are less functional, whereas the Qa-2⁺ cells are fully functional. Evidence is provided here that the transition from Qa-2^- to Qa-2⁺ CD4SP thymocytes is an intrathymic process of differentiation induced by thymic medullary-type epithelial cells. The separated Qa-2^-CD4SP could be induced to express Qa-2 molecules up to 84%- 89% of the total viable celb after cocultured for 3d with MTEC1 cells, a murine thymic medullary type epithelial cell line established in our laboratory. Kinetic study showed that both the percentage of Qa-2⁺ cells and the density of the expressed Qa-2 molecules on CD4SP thymocytes induced by MTEC1 were progressively increasing in 72-h cultures. The MTECl-induced Qa-2⁺CD4SP thymocytes were fully functional, which exhibited capabilities of proliferation and cytokine secretion in response to Con A stimulation as high as those of freshly isolated Qa-2⁺CD4SP thymocytes. The profile of cytokines secreted by MTECl-induced Qa-2⁺CD4SP thymocytes was Thy 0 type specified by the production of IL-2, IL-4 and IL-6. The results suggest that Qa-2^-CD4SP thymocytes may give rise to the Qa-2⁺CD4SP thymocytes, and acquire fully functional competence in thymic medulla under the foster of local epithelial cells.     

2型糖尿病合并肺部感染患者维生素D的表达及其临床意义

目的:研究2型糖尿病合并肺部感染患者维生素D的表达及其临床意义。方法:以2017年6月～2018年12月我院收治的2型糖尿病患者160例为研究对象。将所有患者按照是否发生肺部感染分为观察组(发生肺部感染)61例与对照组(未发生肺部感染)99例。分别比较两组患者基本资料、维生素D水平、血糖相关指标水平以及T淋巴细胞亚群相关指标,并分析2型糖尿病合并肺部感染患者维生素D与血糖指标、T淋巴细胞亚群相关指标的相关性。结果:两组患者年龄、性别以及糖尿病病程等基本资料对比差异均无统计学意义(均P0.05)。观察组患者空腹血糖、糖化血红蛋白水平高于对照组,而25(OH)D水平低于对照组,差异均有统计学意义(均P0.05)。观察组患者CD3~+、CD4~+以及CD4~+/CD8~+低于对照组,差异有统计学意义(均P0.05)。经Spearman相关性分析可得:25(OH)D与空腹血糖、糖化血红蛋白水平均呈负相关关系,而与CD3~+、CD4~+以及CD4~+/CD8~+均呈正相关关系(均P0.05)。结论:2型糖尿病合并肺部感染患者维生素D水平下降,通过检测维生素D水平,有助于评估患者的血糖水平与免疫功能状况。     

Substantial increase in the frequency of circulating CD4+NKG2D+ T cells in patients with cervical intraepithelial neoplasia grade 1

Background

The NKG2D receptor confers important activating signals to NK cells via ligands expressed during cellular stress and viral infection. This receptor has generated great interest because not only is it expressed on NK cells, but it is also seen in virtually all CD8⁺ cytotoxic T cells and is classically considered absent in CD4⁺ T cells. However, recent studies have identified a distinctive population of CD4⁺ T cells that do express NKG2D, which could represent a particular cytotoxic effector population involved in viral infections and chronic diseases. On the other hand, increased incidence of human papillomavirus-associated lesions in CD4⁺ T cell-immunocompromised individuals suggests that CD4⁺ T cells play a key role in controlling the viral infection. Therefore, this study was focused on identifying the frequency of NKG2D-expressing CD4⁺ T cells in patients with cervical intraepithelial neoplasia (CIN) 1. Additionally, factors influencing CD4⁺NKG2D⁺ T cell expansion were also measured.

Results

Close to 50% of patients with CIN 1 contained at least one of the 37 HPV types detected by our genotyping system. A tendency for increased CD4⁺ T cells and CD8⁺ T cells and decreased NK cells was found in CIN 1 patients. The percentage of circulating CD4⁺ T cells co-expressing the NKG2D receptor significantly increased in women with CIN 1 versus control group. Interestingly, the increase of CD4⁺NKG2D⁺ T cells was seen in patients with CIN 1, despite the overall levels of CD4⁺ T cells did not significantly increase. We also found a significant increase of soluble MICB in CIN 1 patients; however, no correlation with the presence of CD4⁺NKG2D⁺ T cells was seen. While TGF-beta was significantly decreased in the group of CIN 1 patients, both TNF-alpha and IL-15 showed a tendency to increase in this group.

Conclusions

Taken together, our results suggest that the significant increase within the CD4⁺NKG2D⁺ T cell population in CIN 1 patients might be the result of a chronic exposure to viral and/or pro-inflammatory factors, and concomitantly might also influence the clearance of CIN 1-type lesion.     

血清IL-6、IL-8、IgM抗体及T细胞亚群水平对新生儿先天性梅毒的诊断价值

目的:探讨血清白介素-6(IL-6)、白介素-8(IL-8)、IgM抗体及T细胞亚群对先天性梅毒新生儿的诊断价值。方法:选择2015年5月至2017年5月在我院进行临床治疗的先天性梅毒新生儿81例为观察组,另选同期来我院进行健康体检81例新生儿为对照组。比较两组患者血清IL-6、IL-8、T细胞亚群中CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)细胞及IgM抗体的阳性率。结果:治疗后,观察组血清IL-6、IL-8水平均明显高于对照组(P0.05),T细胞亚群中CD~(3+)、CD~(4+)、CD~(4+)/CD~(8+)明显低于对照组,而CD~(8+)T细胞比例高于对照组(P0.05)。19S-IgM-TP ELISA法检测出IgM的阳性率92.59%,明显高于TRUST法(74.07%)及TP-ELSA法(70.37%)(P0.05)。ROC曲线中,血清IL-8特异度为88.34%明显高于血清IL-6特异度81.48%、IgM抗体特异度60.13%、T细胞亚群特异度65.34%;IgM抗体的曲线面积88.91 cm~2明显大于IL-6的曲线面积45.09 cm~2、IL-8的曲线面积76.19 cm~2、T细胞亚群的曲线面积77.35 cm~2;T细胞亚群准备性67.89%明显高于IL-6准确性60.39%、IL-8准确性51.09%、IgM抗体准确性50.12;IgM抗体的灵敏度60.13%高于IL-6灵敏度59.19%、IL-8灵敏度42.35%、T细胞亚群灵敏度59.37%。具有比较意义(P0.05)。结论:血清IL-6、IL-8水平、T细胞亚群中CD~(3+)、CD~(4+)、CD~(8+)、CD~(4+)/CD~(8+)及IgM抗体阳性率是诊断先天性梅毒新生儿的重要指标。     

Effects of CD4+ and CD8+ T cells in tumor-bearing mice on antibody production

The function of T cell subsets in tumor-bearing mice was examined using an in vitro culture system of anti-(sheep red blood cell) antibody production, which is known to be dependent on T cells. The helper function of T cells of fibrosarcoma-MethA-bearing mice in antibody production decreased with the tumor stage of the mice. T cells were separated into CD4⁺ and CD8⁺ cells for further analysis of T cell subsets by the panning method using monoclonal antibodies. The helper function of CD4⁺ T cells in antibody production began to decrease significantly in tumor-bearing mice 1 week after the tumor transplantation. On the other hand, the suppressive function of CD8⁺ T cells was retained and had not decreased in the mice even 3 weeks after the transplantation. The same changes in function of CD4⁺ and CD8⁺ T cells were also observed in Methl-bearing mice. These results suggested that this tumor-associated immunosuppression in antibody production is attributable to the decrease in helper activity of CD4⁺ T cells and the maintenance of the suppressive activity of CD8⁺ T cells.     

脾氨肽联合普米克令舒对小儿支气管哮喘的临床疗效及对CD4+, CD8+, IgE水平的影响

目的:分析脾氨肽联合普米克治疗小儿支气管哮喘的临床疗效及对患儿CD4~+、CD8~+、血清Ig E水平的影响。方法:选取我院2015年6月~2016年10月收治的支气管哮喘急性发作患儿88例,采用随机数字法将其分为对照组和观察组,每组各44例。所有患儿进行止咳化痰治疗,对照组患儿在此基础上采用雾化吸入普米克令舒混悬液,观察组患儿在对照组用药基础上加用脾氨肽口服冻干粉。比较两组患儿的临床疗效、症状消失时间、肺功能变化情况、住院时间及治疗前后CD4~+、CD8~+、CD 4~+/CD8~+及血清Ig E水平的变化。结果:观察组的治疗总有效率显著高于对照组(P0.01)。治疗后,观察组的咳嗽、胸部哮鸣音、喘憋消失时间及住院时间均明显短于对照组(P0.01),FVC、FEV1及FEV/FVC、CD4~+、CD4~+/CD8~+水平均显著高于对照组(P0.01),而血清Ig E浓度明显低于对照组(P0.01)。两组不良反应发生率及CD8~+水平比较差异无统计学意义(P0.05)。结论:脾氨肽联合普米克令舒可显著提高小儿支气管哮喘的临床疗效,迅速改善患儿的临床症状及免疫功能,且安全性高。     

Age-Related CD4+CD25+Foxp3+ Regulatory T-Cell Responses During Plasmodium berghei ANKA Infection in Mice Susceptible or Resistant to Cerebral Malaria

Different functions have been attributed to CD4⁺CD25⁺Foxp3⁺ regulatory T-cells (Tregs) during malaria infection. Herein, we describe the disparity in Treg response and pro- and anti-inflammatory cytokines during infection with Plasmodium berghei ANKA between young (3-week-old) and middle-aged (8-month-old) C57BL/6 mice. Young mice were susceptible to cerebral malaria (CM), while the middle-aged mice were resistant to CM and succumbed to hyperparasitemia and severe anemia. The levels of pro-inflammatory cytokines, such as TNF-α, in young CM-susceptible mice were markedly higher than in middle-aged CM-resistant mice. An increased absolute number of Tregs 3-5 days post-inoculation, co-occurring with elevated IL-10 levels, was observed in middle-aged CM-resistant mice but not in young CM-susceptible mice. Our findings suggest that Treg proliferation might be associated with the suppression of excessive pro-inflammatory Th1 response during early malaria infection, leading to resistance to CM in the middle-aged mice, possibly in an IL-10-dependent manner.