复方辛夷滴鼻液联合氯雷他定治疗儿童变应性鼻炎的疗效及对患儿免疫功能指标的影响

目的:研究复方辛夷滴鼻液联合氯雷他定治疗儿童变应性鼻炎的疗效及对患儿免疫功能指标的影响。方法:选取2016年10月至2017年10月在我院接受诊治的126例变应性鼻炎患儿作为研究对象,参照随机数表法分成对照组、研究组,每组各63例。对照组患儿仅接受氯雷他定治疗,研究组患儿接受复方辛夷滴鼻液联合氯雷他定治疗,两组均持续治疗2个月。对比两组患儿的治疗效果及治疗前后CD3~+、CD4~+、CD8~+、CD4~+/CD8~+、血清白细胞介素-4(IL-4)、γ-干扰素(IFN-γ)水平的变化。结果:治疗后,研究组治疗总有效率[95.2%(60/63)]显著高于对照组[81.0%(51/63)],差异有统计学意义(P0.05);两组患儿的CD3~+、CD4~+、CD4~+/CD8~+水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P0.05);两组患儿的CD8~+水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P0.05);两组患儿的血清IL-4水平均低于治疗前,且研究组低于对照组,差异有统计学意义(P0.05);两组患儿的血清IFN-γ水平均高于治疗前,且研究组高于对照组,差异有统计学意义(P0.05)。结论:复方辛夷滴鼻液联合氯雷他定治疗儿童变应性鼻炎的临床效果显著优于单用氯雷他定治疗,其能有效减轻机体炎症水平,提高机体免疫功能。     

三氧化二砷对MRL/Ipr狼疮鼠IFN-γ、IL-4表达和Th1/Th2平衡的影响

探讨三氧化二砷(ATO)对MRL/Ipr狼疮鼠IFN-γ、IL-4表达和Th1/Th2平衡的影响.将发病早期和晚期的MRL/Ipr狼疮鼠分别接受ATO、环磷酰胺(CTX)和生理盐水(NS)治疗2个月,然后用ELISA法测血清中IFN-γ、IL-4的浓度和抗ds-DNA抗体水平及四色流式细胞术测脾脏CD3 (T)细胞、CD3 CD4 (Th)细胞、CD3 CD4 IFN-γ IL-4-(Th1)细胞和CD3 CD4 IL-4 IFN-γ(Th2)细胞的百分率,从而研究ATO对MRL/lpr狼疮鼠IFN-γ、IL-4表达和Th1/Th2平衡的影响.发现给药后,3、5月龄ATO组MRL/lpr狼疮鼠血清抗ds-DNA抗体水平明显下降(P<0.05),其血清IFN-γ和IL-4浓度、Th1、Th2和CD3 细胞百分率均低于相应月龄的NS组(P<0.05),且NS组中5月龄组Th1/Th2值较3月龄组显著升高(P=0.003),而在ATO组中差异无统计学意义(P=0.187).因此,研究显示ATO能显著降低发病早期和发病晚期的MRL/lpr狼疮鼠血清抗ds-DNA抗体的水平,可抑制T细胞和Th细胞增生和活化功能,降低IFN-γ和IL-4的血清水平和细胞诱生水平,并在一定程度上逆转发病晚期的MRL/lpr狼疮鼠的Th1偏移.     

Th17及Th1相关细胞因子与支气管哮喘的关系研究

目的:分析外周血Th17、Th1及相关细胞因子表达水平和支气管哮喘(bronchial asthma,BA)发生、发展的相关性研究。方法:回顾选取我院收治的BA病例57份,称作BA组,另选取呼吸系统正常的病例55例为对照组,检测两组入选者的外周血IL-2、TNF-α、Th17、IL-6、Th1指标表达差异,并进行多因素回归分析。结果:BA组Th17(0.62±1.67)%、Th1(1.45±0.48)%及Th1/Th17(2.33±1.28)均显著低于对照组(P均0.05);BA组TNF-α(27.46±8.12)pg/mL、IL-6(11.69±2.14)pg/mL表达量显著高于对照组,IL-2(2.58±3.89)pg/mL、IFN-γ(3.74±6.15)pg/mL含量均显著低于对照组(P均0.05);经Logistic回归分析,TNF-α、IL-6、IFN-γ、Th1/Th17、IL-2均和BA有密切相关性(P均0.05)。结论:IL-2、IFN-γ、Th1/Th17、TNF-α、IL-6表达水平均与BA有密切关联,可能是参与BA发病的主要原因,及早进行Th17、Th1及相关细胞因子检查有助于明确病情。     

妊娠期肝内胆汁淤积症患者外周血中维生素D受体 与Th1/Th2 型细胞因子的变化

目的:研究妊娠期肝内胆汁淤积症患者外周血中维生素D受体的表达与Th1/Th2型细胞因子干扰素-γ/白细胞介素-4(IFN-γ/IL-4)的变化关系,探讨ICP发病机制。方法:选取ICP患者31例(ICP组),孕周相匹配的正常孕妇31例(正常对照组)。采用酶联免疫吸附试验(ELISA法),检测两组孕妇血清中Th1型细胞因子(IFN-γ)和Th2型细胞因子(IL-4)的水平;采用实时荧光定量逆转录-多聚酶链反应(qRT-PCR),检测两组孕妇外周血单个核细胞维生素D受体(VDR)mRNA的表达水平,采用3-磷酸甘油醛脱氢酶(GAPDH)为内参,根据相对定量公式:2-△△CT分析VDR mRNA的表达水平。结果:(1)ICP组外周血清中IFN-γ的浓度[(230.93±36.04)pg/ml]明显高于正常对照组[(138.37±25.08)pg/ml],差异有统计学意义(P<0.01)。ICP组血清中IL-4浓度[(9.99±3.19)pg/ml]和正常对照组[(8.58±2.43)pg/ml]比较,差异无统计学意义(P>0.05)。ICP组IFN-γ/IL-4比值(24.56±6.91)高于正常对照组(17.13±4.84),差异有统计学意义(P<0.05)。(2)ICP组外周血单个核细胞维生素D受体mRNA的表达明显低于正常对照组(P<0.01),正常对照组VDR的表达定义为1.0,ICP组的表达量为0.4。(3)ICP组外周血中VDR的表达水平与IFN-γ浓度呈明显负相关(r=-0.833,P<0.01),与IL-4浓度无明显相关(r=-0.109,P>0.05),与IFN-γ/IL-4比值呈负相关,但相关性不强(r=-0.356,P=0.049<0.05)。结论:ICP患者外周血Th1/Th2型细胞因子平衡由Th2向Th1偏移,可能与ICP孕妇外周血单个核细胞VDR的表达减少有关。     

他克莫司软膏联合氯雷他定片治疗特应性皮炎的临床疗效及机制研究

目的:研究他克莫司软膏联合氯雷他定片治疗特应性皮炎患者的临床疗效及可能机制。方法:选取2014年9月至2016年7月于我院就诊的特应性皮炎患者共计82例纳入研究,所有患者随机分成观察组(n=41)和对照组(n=41)。对照组患者采取氯雷他定片治疗,观察组患者在此基础上应用他克莫司软膏治疗。观察并比较两组患者的临床治疗效果、SCORAD评分情况、复发情况以及血清白细胞介素-4(IL-4)、白细胞介素-3(IL-13)、干扰素(IFN-γ)及白细胞介素-7(IL-17)水平的变化和不良反应的发生情况。结果:观察组患者治疗后的临床总有效率明显高于对照组(P0.05)。两组患者皮损严重程度、皮肤病变范围、瘙痒和睡眠程度的评分以及总积分较治疗前明显下降,且观察组低于对照组,差异有统计学意义(P0.05)。两组患者治疗后血清IL-4、IL-13以及IL-17水平均较治疗前显著下降,且观察组低于对照组,差异具有统计学意义(P0.05);两组患者治疗后血清IFN-γ较治疗前明显升高,且观察组高于对照组,差异具有统计学意义(P0.05)。观察组复发率显著低于对照组,差异具有统计学意义(P0.05)。结论:他克莫司软膏联合氯雷他定片治疗特应性皮炎能够有效提高其临床疗效,可能与其降低血清IL-4、IL-13、IL-17水平及提高IFN-γ水平,进而改善患者的免疫功能有。     

右美托咪定对过敏性鼻炎大鼠模型血流动力学和炎症因子的影响

为了考察右美托咪定对过敏性鼻炎大鼠模型血流动力学和炎症因子的影响,本研究将40只Wistar大鼠随机分为对照组、模型组、枸地氯雷他定组和右美托咪定组,每组10只。建立过敏性鼻炎大鼠模型后,分别用枸地氯雷他定和右美托咪定治疗大鼠14 d。检测用药前后大鼠的血流动力学指标变化,采用酶联免疫吸附测定法检测各组大鼠血清中的Ig E含量。采用q RT-PCR和Western blotting检测大鼠鼻粘膜组织中IL-1β、IL-5和TNF-α的表达,采用苏木素伊红(HE)染色评价大鼠的病理变化。研究显示,经相应药物治疗后,枸地氯雷他定组和右美托咪定组大鼠的行为评分均显著低于建模后,且两组间未见显著差异。在用药5 min后,右美托咪定组大鼠的SBP、DBP、HR和MAP水平均比用药前显著降低。而对照组、模型组和枸地氯雷他定组未见明显变化。HE染色病理评分显示,枸地氯雷他定组和右美托咪定组大鼠的病理评分均显著低于模型组。经相应的药物治疗后,枸地氯雷他定组和右美托咪定组大鼠鼻黏膜组织中的IL-1β、IL-5和TNF-αmRNA和蛋白相对表达量均显著低于模型组。本研究证实,右美托咪定除了具有较好的镇静作用外,在治疗过敏性鼻炎方面同样疗效显著,可有效减少过敏性鼻炎大鼠的症状和疾病进展,其治疗机制与抑制炎症因子Ig E、IL-1β、IL-5和TNF-α的合成和分泌有关。     

地喹氯铵联合紫杉醇注射液对神经胶质瘤患者血清IL-6, Th17 细胞水平 及临床疗效的影响

目的:探讨地喹氯铵联合紫杉醇注射液对神经胶质瘤患者血清IL-6、Th17细胞水平及临床疗效的影响。方法:回顾性研究我院神经胶质瘤患者60例,根据电脑生成的随机数字表将所有患者随机分为实验组与对照组,每组各30例,对照组患者给予地喹氯铵进行治疗,实验组患者在对照组的基础上给予紫杉醇注射液。比较治疗前后两组患者血清IL-6,Th17细胞水平,并对两组患者不良反应发生率及临床总有效率进行统计。结果:与治疗前相比,两组患者治疗后的血清IL-6、Th17细胞水平均显著降低(P0.05);且与对照组相比,实验组患者血清IL-6、Th17细胞水平均较低(P0.05)。与对照组相比,实验组患者的不良反应发生率较低(P0.05);临床总有效率较高(P0.05)。结论:地喹氯铵联合紫杉醇注射液能够显著提高神经胶质瘤患者临床疗效,降低不良反应发生率,其机制可能与降低血清IL-6及Th17细胞水平有关。     

匹多莫德辅助治疗儿童细菌感染性肺炎对血清淀粉样蛋白A及Th1/Th2细胞因子谱影响的研究

该文主要研究匹多莫德辅助治疗儿童细菌感染性肺炎的疗效及对血清淀粉样蛋白A(SAA)及细胞因子谱的影响。首先,将106例细菌感染性肺炎患儿随机分为对照组(n=53)与观察组(n=53),分别给予规范化治疗和规范化治疗联合匹多莫德治疗。然后,对比两组患儿的治疗效果、用药情况、症状缓解时间及并发症发生情况。最后,用药前后测定血清SAA、降钙素原(PCT)、C反应蛋白(CRP)、白细胞计数(WBC)、肿瘤坏死因子(TNF-α)、干扰素(IFN-γ)、白细胞介素(IL-2)、IL-4、IL-6、IL-10水平,流式细胞分析仪检测辅助性T细胞(Th1/Th2)。疗效评估显示,观察组的痊愈率及总有效率分别为52.83%、98.11%,均高于对照组的37.74%、86.79%(P0.05)。观察组的抗菌药物使用时间、退热时间、咳嗽消退时间、喘息消退时间、肺啰音消退时间、WBC复常时间及总住院时间均短于对照组(P0.05)。治疗后,观察组的血清SAA、PCT、CRP细胞因子(TNF-α、IFN-γ、IL-2、IL-4、IL-6、IL-10)、Th2细胞比均低于对照组,IFN-γ/IL-4比值及Th1/Th2比值高于对照组(P0.05)。因此,匹多莫德辅助治疗儿童细菌感染性肺炎可促进病情康复,提高临床疗效,可下调血清SAA水平并调节Th1/Th2细胞及相关细胞因子表达,改善患儿的免疫功能状态。     

过敏性鼻炎患儿淋巴细胞亚群与血清IgE水平变化及意义

目的:研究过敏性鼻炎患儿淋巴细胞亚群与血清免疫球蛋白E(IgE)水平变化及其临床意义,为临床诊疗提供依据。方法:选取2015年6月到2016年6月我院收治的过敏性鼻炎患儿103例为研究组,另选取同期健康体检者103例为对照组,应用流式细胞技术检测CD3~+、CD4~+、CD19~+、CD8~+、CD4~+CD25~+水平,应用酶联免疫吸附法检测白介素-4(IL-4)、白介素-5(IL-5)和干扰素-γ(IFN-γ)水平,应用免疫比浊法检测IgE水平,对比两组淋巴细胞亚群水平、血清中IL-4、IL-5、IFN-γ水平及IgE水平的变化,并分析其相关性。结果:研究组CD3~+、CD4~+、CD8~+、CD4~+CD25~+显著低于对照组,CD19~+显著高于对照组,比较差异具有统计学意义(P0.05);研究组IL-4、IL-5水平显著高于对照组,IFN-γ水平显著低于对照组,比较差异具有统计学意义(P0.05);研究组IgE水平显著高于对照组,比较差异具有统计学意义(P0.05);相关性分析显示:CD19~+与IgE水平呈正相关关系(P0.05)。结论:淋巴细胞亚群失衡、血清IgE均与过敏性鼻炎有关,在过敏性鼻炎发生和发展中发挥重要作用。     

孟鲁司特钠对过敏性鼻炎患者血清IL-5和IL-10水平的影响及安全性分析

目的:分析孟鲁司特钠对过敏性鼻炎患者血清白细胞介素-5(IL-5)及白细胞介素-10(IL-10)水平的影响及安全性。方法:选择我院2015年10月~2016年10月收治的106例过敏性鼻炎患者,按不同治疗方式分作对照组与研究组,每组53例。对照组选用氯雷他定片治疗;研究组在对照组基础上加以孟鲁司特钠治疗。观察并比较两组患者的临床疗效、治疗前后血清IL-5及IL-10水平变化、症状及体征积分及不良反应发生情况。结果:研究组总有效率(94.33%)高于对照组(79.24%)(P0.05)。治疗后,两组血清IL-5,症状及体征积分均显著下降,研究组下降更明显,两组血清IL-10均有显著上升,研究组上升更明显,差异均有统计学意义(P0.05)。两组不良反应发生情况比较,差异无统计学意义(P0.05)。结论:孟鲁司特钠能够调节过敏性鼻炎患者血清炎症因子水平,降低症状积分,且安全性较高。     

Th1/Th2 differentiation and cross-regulation

The T helper (Th) phenotypes, Th1/Th2, are acquired upon interaction of a naive T helper cell and an antigen presenting cell (APC). Naive T helper cells may differentiate into either phenotype, and the actual outcome is determined by the density and avidity of the antigenic determinants presented by the APC, and the APCs inherent costimulatory properties. Until recently it was thought that differentiation is further affected by cytokines. However, Murphy et al. (1996, J. Exp. Med. 183, 901) have demonstrated that the experimental results, formerly interpreted as Th1/Th2 differentiation, in effect comprise an observation of two consecutive processes. (i) An interaction between naive T cells and APC creates a mixture of mature cells irreversibly committed to Th1 or Th2 phenotype. (ii) Subsequent addition of regulatory cytokines, promotes expansion of one phenotype while suppressing the other. The consequent shift in the per culture production of marker cytokines mimics the appearance of a cellular phenotype switch. We present and analyse a mathematical model that extrapolates these experimental facts into systemic behavior during an immune response. Despite the fact that differentiation produces cells of Th1 and Th2 phenotypes with the same receptor specificity, our results indicate that competition for antigenic stimulation, mediated by the APCs, combines with cytokine mediated cross-suppression between phenotypes to yield a response that is eventually dominated by T helper cells that are uniform in both receptor specificity (clonotype) and in cytokine secretion phenotype.     

The Th1/Th2/Th17 cytokine profile of HIV-infected individuals: A multivariate cytokinomics approach

HIV infection causes the dysregulation of cytokine production. A cytokinomics approach employing cytometric bead array (CBA) technology, flow cytometry and multivariate analysis was applied to the investigation of HIV-induced T helper cell type 1 (Th1), Th2 and Th17 cytokine changes in the sera of treatment naive individuals. Stepwise linear discriminant analysis (LDA) and logistic regression identified interleukin (IL)-6 to be discriminatory for HIV infection with 74.6% and 71.2% of the cases correctly classified. Analysis of variance (ANOVA) confirmed IL-6 and IL-10 concentrations to be significantly (p = 0.001 and p = 0.025) different between the groups. A scatter plot of the log IL-6 and IL-10 concentrations for the groups largely overlapped, with improved differentiation where patients were advancing to the acquired immunodeficiency syndrome (AIDS). IL-17A levels were higher than other cytokines but did not significantly distinguish the groups suggesting that the HIV? and HIV+ individuals had similar immune profiles. This possibility was supported by other clinical indicators. Taken together, the measured cytokines (IL-6, 10 and 17) have potential prognostic value.     

M-1/M-2 macrophages and the Th1/Th2 paradigm

Evidence is provided that macrophages can make M-1 or M-2 responses. The concept of M-1/M-2 fomented from observations that macrophages from prototypical Th1 strains (C57BL/6, B10D2) are more easily activated to produce NO with either IFN-gamma or LPS than macrophages from Th2 strains (BALB/c, DBA/2). In marked contrast, LPS stimulates Th2, but not Th1, macrophages to increase arginine metabolism to ornithine. Thus, M-1/M-2 does not simply describe activated or unactivated macrophages, but cells expressing distinct metabolic programs. Because NO inhibits cell division, while ornithine can stimulate cell division (via polyamines), these results also indicate that M-1 and M-2 responses can influence inflammatory reactions in opposite ways. Macrophage TGF-beta1, which inhibits inducible NO synthase and stimulates arginase, appears to play an important role in regulating the balance between M-1 and M-2. M-1/M-2 phenotypes are independent of T or B lymphocytes because C57BL/6 and BALB/c NUDE or SCID macrophages also exhibit M-1/M-2. Indeed, M-1/M-2 proclivities are magnified in NUDE and SCID mice. Finally, C57BL/6 SCID macrophages cause CB6F1 lymphocytes to increase IFN-gamma production, while BALB/c SCID macrophages increase TGF-beta production. Together, the results indicate that M-1- or M-2-dominant macrophage responses can influence whether Th1/Th2 or other types of inflammatory responses occur.     

微卡对支气管哮喘Th1/Th2类细胞因子失衡的调节作用

目的 探讨微卡对哮喘ThⅠ/Th2类细胞因子失衡的调节作用.方法 选取确诊的轻中度哮喘40例,所有患者深部肌肉注射微卡22.5μg,每2周1次,共8周,并在治疗前、治疗后1月、2月分别抽取静脉血3 ml检测IFN-γ和IL-4水平（ELISA法）.结果 微卡治疗后1月即可纠正失衡的IFN-γ/IL-4,其中以治疗后2月作用较明显,且未见明显的药物不良反应.结论 微卡通过调节失衡的Th1/Th2平衡而达到抗气道炎症作用,可作为哮喘的防治药物.     

Age-related differentiations of Th1/Th2 cytokines in newborn infants

OBJECTIVE: To evaluate age-related differentiation of immune response in newborns by measuring serum concentrations of interleukin-2 (IL-2), interleukin-4 (IL-4) and interferon-gamma (IFN-gamma) during the perinatal period. SUBJECTS AND METHODS: Fifty-seven healthy term neonates, their mothers and 25 healthy adults (controls) age-matched to the mothers were included in the study. Cytokine concentrations were measured in the umbilical cord (UC), and in first-day (1N) and fifth-day (5N) neonatal samples, compared with those in maternal serum (MS) and control serum samples. RESULTS: Serum IL-2 concentrations in the UC were markedly elevated compared with those in MS and controls (p < 0.0001), decreasing significantly thereafter up to 5N (p < 0.001). IL-4 serum concentrations did not differ significantly between the UC, 1N and 5N samples; they were, however, markedly elevated compared with those in MS (p < 0.001, p < 0.0007 and p < 0.0001, respectively) and controls (p < 0.05, p < 0.01 and p < 0.006, respectively). IFN-gamma serum concentrations were significantly lower in the UC compared with those in controls (p < 0.04), increasing significantly up to 5N (p < 0.03). Both IFN-gamma/IL-2 and IFN-gamma/IL-4 ratios increased significantly in 5N, compared with those in the UC (p < 0.001 and p < 0.03). CONCLUSION: Our findings indicate a differential cytokine balance at birth with enhanced expression of IL-2 and IL-4 against IFN-gamma. However, a regularization of immune response seems to proceed quickly during the early neonatal life.     

The role of Th1/Th2 polarization in mucosal immunity

Mucosal immunity relies on the delicate balance between antigen responsiveness and tolerance. The polarization of T helper cells plays a key role in maintaining or disrupting this equilibrium.     

RGS16 attenuates pulmonary Th2/Th17 inflammatory responses

The regulators of G protein signaling (RGS) protein superfamily negatively controls G protein-coupled receptor signal transduction pathways. RGS16 is enriched in activated/effector T lymphocytes. In this paper, we show that RGS16 constrains pulmonary inflammation by regulating chemokine-induced T cell trafficking in response to challenge with Schistosoma mansoni. Naive Rgs16(-/-) mice were "primed" for inflammation by accumulation of CCR10(+) T cells in the lung. Upon pathogen exposure, these mice developed more robust granulomatous lung fibrosis than wild-type counterparts. Distinct Th2 or putative Th17 subsets expressing CCR4 or CCR10 accumulated more rapidly in Rgs16(-/-) lungs following challenge and produced proinflammatory cytokines IL-13 and IL-17B. CCR4(+)Rgs16(-/-) Th2 cells migrated excessively to CCL17 and localized aberrantly in challenged lungs. T lymphocytes were partially excluded from lung granulomas in Rgs16(-/-) mice, instead forming peribronchial/perivascular aggregates. Thus, RGS16-mediated confinement of T cells to Schistosome granulomas mitigates widespread cytokine-mediated pulmonary inflammation.     

Skewed Th1/Th2 immune response to Sarcoptes scabiei

Scabies is a contagious skin disease of humans and many other species of mammals. Previous studies suggested that the balance between the Th1 and Th2 immune responses may influence the outcome of a scabies infestation in a sensitized host. Therefore, in this study, we examined the T-helper cell cytokine profiles of splenocytes and lymph node cells in BALB/c mice that were immunized with scabies extract (primary response), infested with scabies mites (primary response), or immunized and then infested (secondary response). Lymphocyte cytokine expression was analyzed by flow cytometry after staining for intracellular cytokines. Immunization with scabies extract induced production of interferon-gamma (IFNgamma) (Th1 response) by both spleen and lymph node cells. Mice that were infested with scabies increased production of interleukin-4 by lymph node cells and of IFNgamma by splenocytes. Mice that were first immunized and then infested with mites increased production of IFNgamma by both spleen and lymph node cells. However, this increased level of IFNgamma was only about half of that induced by immunization alone. These results suggest that live scabies mites produced something that inhibited IFNgamma production in the lymph nodes of scabies-immunized mice. Our data also indicate that lymphocytes in the spleen and lymph nodes can present different cytokine response profiles.