MMP-9基因多态性与缺血性脑卒中发病及预后的相关性研究

目的:研究基质金属蛋白酶9(MMP-9)基因多态性与缺血性脑卒中(IS)发病及预后的相关性,为IS的防治提供新的理论依据。方法:选取治疗的IS患者100例,根据TOAST分型标准分为大动脉粥样硬化型(LAA)组41例,小动脉阻塞型(SAO)组59例,并选取健康体检者40例作为对照组,采用PCR-RFLP法检测各组MMP-9基因C1562T、R279Q多态性,并对IS患者进行3个月的随访,采用Logistic回归分析C1562T、R279Q多态性与IS患者预后的相关性。结果:LAA组、SAO组MMP-9基因C1562T位点T等位基因、C/T+T/T基因型频数均高于对照组,差异有统计学意义(P0.05),LAA组、SAO组C1562T位点C等位基因、C/C基因型频数及R279Q位点等位基因和基因型频数与对照组比较差异无统计学意义(P0.05);Logistic回归分析显示,MMP-9各型别基因与预后无明显相关性(P0.05)。结论:MMP-9基因C1562T的T等位基因是IS发病的穿易感基因之一,但MMP-9基因多态性与IS患者的预后并无明显相关性。     

全反式维甲酸对乙酰胆碱受体特异性淋巴细胞的免疫调控作用

目的:观察全反式维甲酸(ATRA)对乙酰胆碱受体(AChR)特异性淋巴细胞的体外调控作用,探讨其治疗重症肌无力(MG)的可能机制。方法:建立完全弗氏佐剂(CFA)对照组及实验性自身免疫性重症肌无力(EAMG)组大鼠,并获取淋巴结单个细胞悬液,以ACh R97-116多肽片段以及不同浓度的ATRA体外培养72 h,采用流式细胞仪法、CCK-8法、ELISA法分别检测活细胞比例、细胞凋亡和周期的改变以及Th亚群的格局和B细胞抗体分泌能力的变化。结果:ATRA显著降低活细胞比例(P0.001);不同浓度的ATRA均促进了特异性细胞群的凋亡(P0.001),且呈剂量依赖性,而ATRA未改变AChR特异性淋巴细胞的生长周期;ATRA处理后,CFA和EAMG组的淋巴细胞增殖均受到明显抑制,且ATRA对ACh R特异性的淋巴细胞的抑制明显(EAMG组,P0.01)于CFA组(P0.05);ATRA干预后,ACh R特异性CD4+T淋巴细胞的比例下降(P0.01),且ATRA促进了Th2、Treg细胞亚群百分比(P_(IL-4)0.001,P_(Foxp3)0.001),而抑制了促炎性的Th17、Th1细胞亚群百分比(P_(IL-17)0.05,P_(IFN-γ)0.001);ATRA能够降低ACh R特异性B细胞的抗体分泌能力(P0.01)。结论:ATRA不仅能抑制ACh R特异性T细胞功能,同时也能抑制ACh R特异性B细胞功能,其在MG的临床治疗中可能起治疗作用。     

不同麻醉方法对食管癌手术患者免疫及认知功能的影响

目的:探讨全麻或全麻复合硬膜外麻醉对食管癌手术患者的T细胞水平及术后认知功能的影响。方法:选择2014年1月至2015年12月于我院择期行开胸手术的食管癌患者100例为研究对象,根据手术时间顺序分为观察组(全麻复合硬膜外麻醉)和对照组(全麻),每组50例,观察记录两组患者诱导前、插管时、术中1 h、拔管后的平均动脉压(MAP)、血氧饱和度(Sp O2)和心率(HR);两组患者术前30 min、术后2 h、术后2 d和术后7 d的T细胞亚群水平,包括CD3~+、CD4~+、CD8~+、CD4~+/CD8~+;两组患者术前1 d,术后6 h,术后1 d,术后3 d的认知功能;术后认知功能障碍(POCD)发生率。结果:诱导前观察组和对照组患者的MAP、Sp O2和HR比较,差异均不显著(P0.05),插管时、术中1h和拔管后观察组患者的MAP和HR水平均明显低于对照组(P0.05),而Sp O2明显高于对照组(P0.05)。术后2 h,观察组和对照组的CD3~+、CD4~+、CD8~+、CD4~+/CD8~+值均较术前30 min明显降低(P0.05),但两组间各指标值无显著性差异(P0.05);术后2 d,观察组的CD3~+、CD4~+、CD8~+、CD4~+/CD8~+值均明显高于对照组(P0.05)。术后7 d,两组的T细胞亚群水平均较术前30 min无显著性差异(P0.05)。术后6 h和术后1 d,两组的MMSE评分均较术前1 d明显下降(P0.05),观察组术后1 d、3 d和7 d的MMSE评分均明显高于对照组(P0.05)。术后6 h,观察组的POCD发生率明显低于对照组(P0.05),术后1 d和3 d观察组的POCD发生率低于对照组,但无统计学差异(P0.05)。结论:与单凭全麻比较,全麻复合硬膜外麻醉对食管癌手术患者的T细胞水平及术后认知功能的影响较小,术后恢复快。     

靶向于TNF-α和RANKL的人源化抗体对DBA/1小鼠单关节炎的保护作用

目的制备同时拮抗肿瘤坏死因子α(tumor necrosis factorα,TNF-α)和核因子κB受体活化因子配体(re-ceptor activator of NF-κB ligand,RANKL)的人源化单克隆抗体(h8G12),通过单关节炎小鼠模型,评估h8G12在抑制TNF-α引起的炎症反应和拮抗RANKL引起的骨破坏中的保护作用。方法培养稳定表达h8G12的CHO细胞株,观察细胞生长状态,用间接ELISA检测细胞培养上清中h8G12的表达水平。纯化的h8G12经SDS-PAGE、West-ern blot分析及鉴定,用间接ELISA观察其亲和力。通过向DBA/1小鼠膝关节腔注射人TNF-α重组蛋白和人RANKL重组蛋白,建立单关节炎小鼠模型。用组织学评估观察不同给药方案[阴性对照组、阳性对照组、阿达木单抗(adalimumab,ADA)组和h8G12组]对小鼠单关节炎引起的炎症浸润、软骨侵蚀、膝关节腔内破骨细胞分化的保护作用。结果 CHO细胞株培养96 h时细胞生长状态良好,可稳定分泌h8G12;纯化的h8G12纯度可达90%,Western blot可见特异性条带,且可与rh TNF-α和rh RANKL结合。在单关节炎小鼠模型中,苏木精-伊红染色显示,h8G12组关节腔、周围软组织及骨髓腔内炎性细胞浸润明显少于阳性对照组,炎症评分降低了50%,治疗效果与ADA相似。甲苯胺蓝染色显示,h8G12组病理评分出现显著下降,h8G12治疗后小鼠关节结构相对完好,关节软骨厚度接近正常水平。抗酒石酸酸性磷酸酶染色显示,h8G12组关节腔内破骨细胞明显减少。结论 h8G12可有效抑制TNF-α引起的炎症反应和拮抗RANKL引起的骨破坏,为类风湿关节炎的治疗提供了新方法。     

猴T淋巴细胞趋向性病毒1型双抗原夹心ELISA检测试剂盒的研制

目的研制灵敏度和特异性高的检测实验猴血清中T淋巴细胞趋向性病毒-1型（STLV-1型）／E体的双抗原夹心ELISA（dsELISA）检测试剂盒。方法采用经原核表达系统表达并纯化的人T淋巴细胞白血病病毒-1型（HTLV-1型）的Env蛋白作为包被用抗原，建立了检测STLV-1的dsELISA诊断方法。通过优化反应条件和筛选试剂，确定了dsELISA诊断试剂盒的相关条件，并经敏感性、特异性和重复性试验考查该试剂盒质量。结果试剂盒特异性好，批内重复试验变异系数（CV）〈7％，批间重复试验CV〈10％。对200份猴血清进行随机检测，与国际公认的诊断试剂盒（美国BioReliance公司）的符合率为97％。结论本试剂盒可初步应用于临床上实验猴STLV-1型抗体的检测。     

树突状细胞对海藻酸钙纳米胶囊的吞噬作用与功能诱导

本研究采用量子点标记方法，证实了人外周血来源树突状细胞对海藻酸钙纳米胶囊的吞噬作用，并对其体外成熟诱导和接受偶联有牛血清白蛋白的纳米胶囊刺激之后的自体T淋巴细胞免疫作用进行了探讨。实验结果表明，树突状细胞在吞噬海藻酸钙纳米胶囊后被诱导成熟，而且偶联有牛血清白蛋白的纳米胶囊可诱导自体T淋巴细胞增殖，显示该海藻酸钙纳米胶囊可能成为具有载体功能的癌症细胞免疫治疗佐剂。     

人脐血CD34+细胞在NOD/SCID小鼠免疫重建及其抗HBV作用的初步探讨

目的：探讨NOD／SCID（nonobese diabetic／severe combined immunodeficient）小鼠移植人脐带血（human umbilical cord blood，HUCB）CD34＋细胞后免疫重建的特性。建立hu—NOD／SCID人鼠嵌合模型并观察其人源化免疫细胞在小鼠体内的生长分化特性、存活时间及其对HBV感染的清除作用。方法：1．NOD／SCID小鼠于C0603．5Gy照射后24h内尾静脉输注HUCBCD34＋细胞；2．以流式细胞技术鉴定小鼠外周血中CD45＋，CD3＋，CD19＋，CD56＋等人源化细胞的比例；3．NOD／SCID小鼠于移植后第4wk注射HBV感染者血清并以未移植的NOD／SCID小鼠作为对照，注射同等量的患者血清；4．于感染后1、7、10、15天采血，免疫荧光定量PCR方法分别检测其HBV—DNA含量。结果：1．HUCBCD34＋细胞移植后第2wk，在小鼠外周血中检测出的CD3＋CD8＋T细胞、CD3＋CD4＋T细胞、CD19＋B细胞、CD56＋NK细胞的比例分别为18．6％、16．1％、13．1％和27．8％。各细胞比例随小鼠周龄而变化。所有移植小鼠存活时间均达9wk；2．移植后小鼠感染HBV血清后，病毒仅在感染后第一天检出，随后消失；未移植CD34＋细胞的小鼠外周血HBV—DNA一直维持在103水平：结论：1．NOD／SCID小鼠经射线照射后移植HUCBCD34＋细胞，在不加任何刺激因子的情况下小鼠可以长时间存活并重建免疫；2．hu—NOD／SCID人鼠嵌合模型小鼠免疫成功重建后，对HBV感染有快速的清除作用。     

Human umbilical cord mesenchymal stem cells as treatment of adjuvant rheumatoid arthritis in a rat model

AIM:To investigate the effect of human umbilical cord stem cells,both mesenchymal and hematopoietic(CD34+),in the treatment of arthritis.METHODS:Mesenchymal stem cells(MSCs) and hematopoietic(CD34+) stem cells(HSC) were isolated from human umbilical cord blood obtained from the umbilical cord of healthy pregnant donors undergoing fullterm normal vaginal delivery.MSC,HSC,methotrexate(MTX) and sterile saline were injected intra-articularly into the rat hindpaw with complete freunds adjuvant(CFA) induced arthritis after the onset of disease(day 34),when arthritis had become well established(arthritis score ≥ 2).Arthritic indices were evaluated and the levels of interleukin(IL)-1,tumor necrosis factor(TNF)-α and interferon(IFN)-γ and anti-inflammatory cytokine IL-10 in serum were determined using enzyme-linked immunosorbent assay.Animals of all groups were sacrificed 34 d after beginning treatment,except positive control(PC) which was sacrificed at 10,21 and 34 d for microscopic observation of disease progression.We used hematoxylin,eosin and Masson's trichrome stains for histopathological examination of cartilage and synovium.RESULTS:The mean arthritis scores were similar in all groups at 12 and 34 d post immunization,with no statistical significant difference.Upon the injection of stem cells(hematopoietic and mesenchymal),the overall arthritis signs were significantly improved around 21 d after receiving the injection and totally disappeared at day 34 post treatment in MSC group.Mean hindpaw diameter(mm) in the MSC rats was about half that of the PC and MTX groups(P = 0.007 and P = 0.021,respectively) and 0.6 mm less than the HSC group(P = 0.047),as indicated by paw swelling.Associated with these findings,serum levels of TNF-α,IFN-γ and IL-1 decreased significantly in HSC and MSC groups compared to PC and MTX groups(P 0.05),while the expression of IL-10 was increased.Histopathological examination with H and E stain revealed that the MTX treated group showed significant reduction of leucocytic infiltrate and hypertrophy of the synovial tissue with moderate obliteration of the joint cavity.Stem cells treated groups(both hematopoietic CD34+ and mesenchymal),showed significant reduction in leucocytic infiltrate and hypertrophy of the synovial tissue with mild obliteration of the joint cavity.With Masson's trichrome,stain sections from the PC group showed evidence of vascular edema of almost all vessels within the synovium in nearly all arthritic rats.Vacuoles were also visible in the outer vessel wall.The vessel became hemorrhagic and finally necrotic.In addition,there was extensive fibrosis completely obliterating the joint cavity.The mean color area percentage of collagen in this group was 0.324 ± 0.096,which was significantly increased when compared to the negative control group.The mean color area percentage of collagen in hematopoietic CD34+ and mesenchymal groups was 0.176 ± 0.0137 and 0.174 ± 0.0197 respectively,which showed a marked decrement compared to the PC group,denoting a mild increase in synovial tissue collagen fibers.CONCLUSION:MSC enhance the efficacy of CFAinduced arthritis treatment,most likely through the modulation of the expression of cytokines and amelioration of pathological changes in joints.