高压氧对正常及SIRS大鼠脾T淋巴细胞的影响

本实验以SIRS为基础,以免疫功能和炎症反应中具有代表性的脾T淋巴细胞为研究对象,观察高压氧对正常机体以及SIRS状态机体的影响并探讨其可能的机制。健康雄性SD大鼠40只,体重约140~180 g,随机分为5组,每组8只。A组：腹腔注射生理盐水（5 mL/kg）;B组：腹腔注射等量生理盐水,做3次高压氧;C组：腹腔注射酵母多糖-石蜡悬液（500 mg/kg）;D组：腹腔注射酵母多糖-石蜡悬液（500 mg/kg）,做1次高压氧治疗;E组：腹腔注射酵母多糖-石蜡悬液（500 mg/kg）,做3次高压氧治疗。采用流式细胞仪计算大鼠脾脏淋巴细胞数量及比例。高压氧治疗（B组）降低正常大鼠外周血CD4＋T细胞百分比（P〈0.01）,对CD8＋T细胞无影响,因此CD4＋/CD8＋T细胞比值下降（P〈0.05）。酵母多糖腹腔注射（C组）使大鼠外周血CD4＋、CD8＋T细胞均减少（P〈0.01）,但CD4＋/CD8＋T细胞比值不变。1次和3次HBO治疗（D和E组）可使酵母多糖所致CD4＋T细胞减少（C组）明显恢复（P〈0.01,P〈0.05）,故CD3＋CD4＋/CD3＋CD8＋比值升高（P〈0.01,P〈0.05）,HBO几乎不影响CD8＋T细胞比例（P〉0.05）。酵母多糖导致大鼠脾脏CD4＋和CD8＋T细胞比例减少;高压氧可减少正常大鼠脾脏CD4＋T细胞比例,而增加SIRS脾脏的CD4＋T细胞比例,而对CD8＋T细胞无影响。     

胰十二指肠切除术后肠黏膜屏障损伤与肠道细菌移位的临床研究

目的:探讨胰十二指肠切除手术后肠道细菌移位(BT)与术后全身炎症反应综合征(SIRS)关系。方法:40例择期行胰十二指肠切除手术患者,于术前和术后1、3、5天采集外周血,进行血浆D-乳酸,全血细菌DNA检测.全血DNA提取后进行PCR扩增,采用靶基因为大肠杆菌特异性β半乳糖苷酶基因和16SrRNA基因。观察患者术后10天以监测SIRS情况。结果:术前PCR检测全血细菌DNA均为阴性,术后共有13例阳性。术后出现全身炎症反应综合征(SIRS)的患者PCR阳性率为85.7%(12/14),无SIRS组为3.8%(1/26()P<0.01)。PCR阳性组SIRS发生率为93.2%(12/13),阴性组为7.4%(2/27)(P<0.01).PCR阳性的患者外周血血浆D-乳酸浓度较PCR阴性者明显升高(P<0.01),有SIRS的患者外周血血浆D-乳酸浓度较无SIRS患者明显升高(P<0.01)。结论:胰十二指肠切除术后肠黏膜屏障损伤与BT关系密切,术后SIRS和与BT密切相关。PCR技术对术后SIRS有较好的早期预警价值。     

Prediction of flu epidemic activity with dynamical model based on weather forecast

The seasonality of respiratory diseases (common cold, influenza, etc.) is a well-known phenomenon studied from ancient times. The development of predictive models is still not only an actual unsolved problem of mathematical epidemiology but also is very important for safety of public health. Here we show that SIRS (Susceptible-Infected-Recovered-Susceptible) model accurately enough reproduces real curves of flu activity. It contains variable reaction rate, which is a function of mean daily temperature.The proposed alternation of variables represents SIRS equations as the second-order ODE with an outer excitation. It reveals an origin of such predictive efficiency and explains analytically the 1:1 dynamical resonance, which is known as a crucial property of epidemic behavior. Our work opens the perspectives for the development of instant short-time prediction of a normal level of flu activity based on the weather forecast, and allows to estimate a current epidemic level more precisely. The latter fact is based on the explicit difference between the expected weather-based activity and instant anomalies.     

一类具饱和传染力和常数输入的SIRS脉冲接种模型研究

利用Floquet乘子理论,研究了一类具饱和传染力和常数输入的SIRS脉冲接种模型,得到了无病周期解全局渐近稳定和系统持久的充分条件.     

Autophagy and ATP-induced anti-apoptosis in antigen presenting cells (APC) follows the cytokine storm in patients after major trauma

Severe trauma and the systemic inflammatory response syndrome (SIRS) occur as a result of a cytokine storm which is in part due to ATP released from damaged tissue. This pathology also leads to increased numbers of immature antigen presenting cells (APC) sharing properties of dendritic cells (DC) or macrophages (MΦ). The occurrence of immature APC appears to coincide with the reactivation of herpes virus infections such as Epstein Barr virus (EBV). The aim of this study was the comparative analysis of the ultrastructural and functional characteristics of such immature APC. In addition, we investigated EBV infection/ reactivation and whether immature APC might be targets for natural killers (NK). Significant macroautophagy, mitochondrial degradation and multivesicular body formation together with the identification of herpes virus particles were morphological findings associated with immature APC. Exogenous stressors such as ATP further increased morphological signs of autophagy, including LC3 expression. Functional tests using fluorescent bacteria proved impaired phagolysosome fusion. However, immature APC were susceptible to NK-92-mediated cytolysis. We found evidence for EBV latency state II infection by detecting EBV-specific LMP1 and EBNA2 in immature APC and in whole blood of these patients. In summary, trauma-induced cytokine storms may induce maturation arrest of APC, promote ATP-induced autophagy, support EBV persistence and impair the degradation of phagocytozed bacteria through inefficient phagolysosome fusion. The susceptibility to NK-mediated cytolysis supports the hypothesis that NK function is likely to contribute to immune reconstitution after major trauma by regulating immature APC, and ATP-induced autophagy and survival.     

Up-regulation of cell surface Toll-like receptors on circulating γδ T-cells following burn injury

Burn injury is associated with profound inflammation and activation of the innate immune system involving γδ T-cells. Similarly, Toll-like receptors (TLR) are associated with activation of the innate immune response; however, it is unclear whether TLR expression is altered in γδ T-cells after major burn injury. To study this, male C57BL/6 mice were subjected to burn injury (25% TBSA) and 1 or 7 days thereafter, blood and spleen cells were isolated and subjected to FACs analysis for TLRs and other phenotypic markers (γδ TCR, αβ TCR, CD69, CD120b). A marked increase in the number of circulating γδ T-cells was observed at 24 h post-burn (14% vs. 4%) and a higher percentage of these cells expressed TLR-2. TLR-4 expression was also increased post-burn, but to a lesser degree. These changes in TLR expression were not associated with altered CD69 or CD120b expression in γδ T-cells. The mobilization of, and increased TLR expression in, γδ T-cells was transient, as phenotypic changes were not evident at 7 days post-burn or in γδ T-cells from the circulation or spleen. The increases in TLR expression were not observed in αβ T-cells after burn injury. In conclusion, 24 h after burn injury mobilization of γδ T-cells with increased TLR expression was observed. This finding suggests that this unique T-cell population is critical in the innate immune response to injury, possibly through the recognition of danger signals by TLRs.     

Cholemic nephropathy – Historical notes and novel perspectives

Acute kidney injury is common in patients with liver disease and associated with significant morbidity and mortality. Besides bacterial infections, fluid loss, and use of nephrotoxic drugs AKI in liver disease may be triggered by tubular toxicity of cholephiles. Cholemic nephropathy, also known as bile cast nephropathy, supposedly represents a widely underestimated but important cause of renal dysfunction in cholestasic or advanced liver diseases with jaundice. Cholemic nephropathy describes impaired renal function along with characteristic histomorphological changes consisting of intratubular cast formation and tubular epithelial cell injury directed towards distal nephron segments. The underlying pathophysiologic mechanisms are not entirely understood and clear defined diagnostic criteria are still missing.This review aims to summarize (i) the present knowledge on clinical and morphological characteristics of cholemic nephropathy, (ii) available preclinical models, (iii) potential pathomechanisms especially the potential role of bile acids, and (iv) future diagnostic and therapeutic strategies for cholemic nephropathy. This article is part of a Special Issue entitled: Cholangiocytes in Health and Disease edited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen.     

Epidemiology in evolutionary time: the case of Wolbachia horizontal transmission between arthropod host species

Wolbachia are bacterial endosymbionts that manipulate the reproduction of their arthropod hosts. Although theory suggests that infections are frequently lost within host species due to the evolution of resistance, Wolbachia infect a huge number of species worldwide. This apparent paradox suggests that horizontal transmission between host species has been a key factor in shaping the global Wolbachia pandemic. Because Wolbachia infections are thus acquired and lost like any other infection, we use a standard epidemiological model to analyse Wolbachia horizontal transmission dynamics over evolutionary time. Conceptually modifying the model, we apply it not to transmission between individuals but between species. Because, on evolutionary timescales, infections spread frequently between closely related species and occasionally over large phylogenetic distances, we represent the set of host species as a small‐world network that satisfies both requirements. Our model reproduces the effect of basic epidemiological parameters, which demonstrates the validity of our approach. We find that the ratio between transmission rate and recovery rate is crucial for determining the proportion of infected species (incidence) and that, in a given host network, the incidence may still be increasing over evolutionary time. Our results also point to the importance of occasional transmission over long phylogenetic distances for the observed high incidence levels of Wolbachia. In conclusion, we are able to explain why Wolbachia are so abundant among arthropods, although selection for resistance within hosts often leads to infection loss. Furthermore, our unorthodox approach of using epidemiology in evolutionary time can be applied to all symbionts that use horizontal transmission to infect new hosts.     

一类非自治SIRS传染病模型的持久性与灭绝性研究

本文研究了一类非自治SIRS传染病模型．在比较弱的条件下,我们不仅得到了疾病强一致持续的充分必要条件,还证明了疾病强一致持续与强持续的等价性．本文给出了新的闽值．另外也给出了疾病灭绝的条件．文献[7]中的结论被改进．     

Higher frequency of septic shock in septic patients with the 47C allele (rs4880) of the SOD2 gene

Aim

To analyze the effect of the two different versions of the manganese superoxide dismutase gene (SOD2) on sepsis. The SOD2 gene presents the 47C > T single nucleotide polymorphism (SNP; ID: rs4880) which produces MnSOD with different activities. The − 9Val MnSOD (47T allele) is less efficient than the − 9Ala version (47C allele). During sepsis there are abundance of ROS, high SOD2 expression and excess of H₂O₂ synthesis. High concentrations of H₂O₂ could affect the sepsis scenario and/or the sepsis outcome.

Methods

We determined the 47C > T single nucleotide polymorphism (SNP) frequencies in 529 critically ill patients with or without sepsis, facing outcome. To collect information on population frequencies, we obtained a pilot 47C > T genotypic and allelic frequencies in a random group of 139 healthy subjects.

Results

We compared the 47C allele carriers (47CC + 47CT genotypes) with 47TT homozygotes and noticed a significant association between 47C allele carriers and septic shock in septic patients (P = 0.025). With an adjusted binary multivariate logistic regression, incorporating 47C > T SNP and the main clinical predictors, we showed high SOFA scores [P < 0.001, OR = 9.107 (95% CI = 5.319–15.592)] and 47C allele [P = 0.011, OR = 2.125 (95% CI = 1.190–3.794)] were significantly associated with septic shock outcome. With this information we presented a hypothesis suggesting that this negative outcome from sepsis is possibly explained by effects on cellular stress caused by 47C allele.

Conclusion

In our population there was a significant higher frequency of septic shock in septic patients with the 47C allele of the SOD2 gene. This higher 47C allele frequency in septic patients with negative outcome could be explained by effects of higher activity MnSOD on cellular stress during the sepsis.