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1.
邓安彦  文婧  董琼 《生物磁学》2009,(15):2889-2891
目的:观察围手术期成份输血对胃癌患者炎症反应的影响。方法:随机选择胃癌病人分为3组:对照组,压积红细胞组,全血组。分别采用ELISA法和放免法检测患者术前及术后低1、3、7、14天血清中IL-6、IL-10、COX-2及PGE2含量。结果:手术后第一周是感染发生的主要时期,两周后,炎症反应基本消失,输血能升高患者血清中的促炎因子,降低抗炎因子IL-10的表达,但相对于输异体全血,输成份血能降低血清中COX-2、PGE2、IL-6的含量,升高血清IL-10的含量。结论:胃癌患者围手术期输血能促进机体的炎症反应,成份输血致炎效果弱于输异体全血。  相似文献   

2.
左归丸含药血清对成骨细胞IL-1、IL-6和COX-2表达的影响   总被引:4,自引:0,他引:4  
目的通过观察左归丸含药血清对成骨细胞白细胞介素-1(IL-1)、白细胞介素-6(IL-6)和环加氧酶-2(COX-2)表达的影响,探讨其治疗骨质疏松症的作用机制。方法体外分离、培养成骨细胞,实验分为3组:正常血清组、卵巢切除(OVX)血清组和OVX含药血清组。采用免疫组化法,检测成骨细胞IL-1、IL-6和COX-2的表达。结果OVX血清组成骨细胞IL-1、IL-6和COX-2的表达明显强于正常血清组,而OVX含药血清组的表达较OVX血清组明显减弱,与正常血清组比较,则无显著性差异。结论在去势状态下,左归丸可能是通过抑制成骨细胞IL-1、IL-6和前列腺素E2(PGE2)的分泌,进而达到治疗骨质疏松的作用。  相似文献   

3.
目的:探讨高体重指数支气管哮喘患者血清中IL-8、IL-10及INF-γ的变化及临床意义。方法:选择高体重指数支气管哮喘患者(36例)、正常体重指数支气管哮喘患者(32例)以及健康人(32例),采用双抗体夹心ELISA法检测其急性发作期和缓解期血清中IL-8、IL-10和INF-γ的水平。结果:①高体重指数支气管哮喘组与正常体重指数支气管哮喘组急性发作期血清中IL-8水平显著高于缓解期以及对照组的水平(P<0.05)。②在缓解期,高体重指数支气管哮喘组血清中IL-8水平仍高于正常体重指数支气管哮喘组和对照组的水平(P<0.05)。③在急性发作期,高体重指数支气管哮喘组和正常体重指数支气管哮喘组血清中IL-10水平均显著低于其在缓解期及对照组的水平(P<0.05)。④三组间血清INF-γ水平在急性期与缓解期均无明显差异(P>0.05)。结论:血清中IL-8是高体重指数支气管哮喘患者发病过程中的重要炎症因子,并且始终参与其中。IL-10可能是支气管哮喘的抑炎因子,其缺乏可能是导致哮喘患者急性发作的因素之一。  相似文献   

4.
目的:检测胆管癌组织中白细胞介素-6(IL-6)、环氧化酶-2(COX-2)和前列腺素E2(PGE2)的表达,探讨其与胆管癌发生发展的意义。方法:应用免疫组化S-P法检测49例胆管癌组织和20例胆囊结石胆囊管组织中IL-6、COX-2和PGE2的表达情况。结果:IL-6在胆囊管组织和胆管癌中的表达率分别为40.0%和81.6%,差异具有统计学意义(P0.01);COX-2在胆囊管组织和胆管癌中的表达率分别为10%和69.4%,差异具有统计学意义(P0.01);PGE2在胆囊管组织和胆管癌中的表达率分别为35.0%和73.5%,差异具有统计学意义(P0.01)。IL-6和COX-2、COX-2和PGE2、IL-6和PGE2在胆管癌中的阳性表达呈显著正相关(r=0.37,P0.01;r=0.50,P0.01;r=0.31,P0.05)。结论:IL-6、COX-2与PGE2的过度表达共同参与胆管癌的进展。  相似文献   

5.
血必净注射液对AOPP患者血清TNF-a、IL-10的干预研究   总被引:1,自引:0,他引:1  
目的:探讨血必净注射液对AOPP患者血清TNF-a、IL-10的干预作用.方法:将40例AOPP患者随机分为两组:常规治疗组(20例)给于洗胃、胆碱酯酶复能剂、阿托品、长托宁及对症支持治疗,血越净治疗组(20例)在常规治疗的基础上加用血必净注射液,空白对照组为医院健康体检者(20例).观察AOPP两组1、3、5、7天血清TNF-a、IL-10的变化水平.结果:两组患者在入院第一天治疗前机体炎性因子TNF-a、IL-10较空白对照组明显升高,但两组差异无统计学意义(P>0.05),两组与空白对照组比较差异均有统计学意义(P<0.01),治疗3天后血必净治疗组机体炎性因子TNF-a、IL-10较常规治疗组明显降低,两组之间差异有统计学意义(P<0.05).结论:血必净注射液可以明显减低AOPP惠者血清炎性因子的水平,改善其预后,降低死亡率.  相似文献   

6.
目的:探讨肠易激综合征(IBS)患者血清白细胞介素10(IL-10)白细胞介素12(IL-12)和皮质醇(CO)浓度变化及它们在IBS中的可能作用和临床意义.方法:随机抽取来源于门诊和住院IBS患者和健康志愿者血清,采用放射免疫法测量血清IL-10、IL-12和CO浓度.结果:腹泻型IBS病人血清IL-10和CO含量显著高于正常(P<0.05),便秘型IBS病人血清内IL-10和CO水平也高于正常对照(P<0.05).腹泻型和便秘型IBS病人血清内IL-10和CO水平之间差别无统计学意义(P>0.05).腹泻型IBS组血清IL-12含量比正常组低(P<0.05),便秘型IBS组血清内IL-12水平也低于正常对照组(P<0.05).腹泻型和便秘型组之间血清内IL-12水平差别无统计学意义(P>0.05).结论:炎症因子和应激可能参与IBS发病.  相似文献   

7.
摘要 目的:从血流变和抑制炎症因子角度探讨白芷冰片的抗皮肤炎症作用及机制。方法:将60只SD大鼠随机分为 6 组: 正常组、模型组、复方醋酸地塞米松乳膏组、白芷组、冰片组和白芷冰片合用组。除正常组外,其余各实验组均使用角叉菜胶注射足底建立足皮下炎症模型。建模成功1 h后每组按设计分别在致炎处涂抹各组药物,给药4h后使用激光多普勒血流成像系统检测各组大鼠足趾血流变化,并测量足趾肿胀度,建模4 h后取炎症组织,以Elisa法检测肿胀足组织中SOD、HIS、MDA、PGE2、PGD2、COX-2以及IL-6、IL-1β、IL-8、IL-10的水平。结果:与正常组比,炎症模型组的足趾肿胀率、血流变显著增加;各给药组与模型组比较足趾肿胀率明显降低,各给药组对血流变影响差异显著,其中白芷对末梢微循环的作用明显,而冰片对足趾枝干血流变影响更显著,合用后对总体血流变有改善作用;相关细胞因子结果显示,模型组除SOD外,其余HIS、MDA、PGE2、PGD2、COX-2、IL-6、IL-1β、IL-8、IL-10显著性升高,白芷、冰片及合用组与模型组比较,各项指标因子均有不同程度的改善,其中冰片对SOD和HIS作用较弱,白芷与合用组可明显降低PGD2、COX-2、IL-6、IL-1β、IL-8指标( P < 0.05 );白芷、冰片及合用组对IL-10无明显作用。结论:白芷联合冰片对角叉菜胶诱导的急性炎症有明显的抗炎治疗作用,可显著降低水肿反应,抑制微循环扩张引起的血流变增加,其机制可能与PGE2、COX-2以及多种白介素有关。  相似文献   

8.
目的:探讨T辅助细胞(Th)相关细胞因子在狼疮性肾炎发病中的免疫机制作用。方法:64例系统性红斑狼疮患者和28例健康体检者作为对照,采用酶联免疫吸附测定法(ELISA法)检测所有受试者血清IL-17、IFN-γ、IL-4水平,并对其与SLEDAI、SDI、24小时尿蛋白量相关性进行研究。结果:狼疮性肾炎组血清IL-17水平显著高于狼疮无肾炎组和健康对照组(P<0.001),狼疮性肾炎组血清IFN-γ水平显著高于狼疮无肾炎组(P<0.05)和健康对照组(P<0.01),血清IL-4水平在狼疮性肾炎组、狼疮无肾炎组均显著高于健康对照组(P<0.01)。狼疮性肾炎组IFN-γ/IL-4比值显著高于狼疮无肾炎组(P<0.01)和健康对照组(P<0.05);狼疮无肾炎组IFN-γ/IL-4比值显著低于健康对照组(P<0.01)。SLE患者血清IFN-γ表达水平与SLEDAI积分呈正相关(r=0.402,P<0.05),血清IL-17、IL-4表达水平与SLEDAI、SDI、抗ds-DNA抗体、C3、24小时尿蛋白量均无相关性。结论:狼疮性肾炎患者外周血中IL-17、IFN-γ、IL-4等促炎细胞因子均有不同程度升高促起炎症发生及组织损伤,参与了狼疮性肾炎的免疫发病过程。  相似文献   

9.
目的:探讨人工关节置换术中预存式联合自体回收式输血患者免疫功能和炎症因子水平的变化,并分析免疫功能和炎症因子的相关性。方法:选取在我院接受人工关节置换术的患者80例,根据随机数字表法将患者分为对照组和观察组。对照组患者行异体输血治疗,观察组行预存式联合自体回收式输血治疗。比较两组患者围术期失血量和输血量,分析两组患者不同时间点的免疫功能指标和炎症因子水平的变化及其相关性,统计两组患者术后出现的不良反应。结果:两组患者的术中失血量、术后失血量、总失血量和总输血量比较差异无统计学意义(P0.05)。术后24 h两组患者的CD3~+、CD4~+、CD4~+/CD8~+、自然杀伤细胞(NK)明显降低,且观察组高于对照组(P0.05),术后24 h两组患者的白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平明显升高,且观察组低于对照组(P0.05)。经Pearson相关性分析显示,IL-6、IL-8、TNF-α均与CD3~+、CD4~+、CD4~+/CD8~+、NK呈负相关(P0.05)。观察组的不良反应率低于对照组(P0.05)。结论:人工关节置换术中预存式联合自体回收式输血对患者免疫功能、炎症反应的影响较小,输血安全性较好,且患者的免疫因子和炎症因子相互制约。  相似文献   

10.
目的:探讨小儿难治性支原体肺炎(RMPP)血清肿瘤坏死因子-α(TNF-α)、白细胞介素-4(IL-4)、白细胞介素-10(IL-10)水平变化及临床意义。方法:选自我院2013年1月至2016年1月收治的90例RMPP住院患儿设为RMPP组,根据肺炎严重指数(PSI)评分标准分为重症肺炎组(30例)和非重症肺炎组(60例),并选择同期健康体检的健康儿童为50例对照组。并对患儿进行跟踪、随访,收集47例患儿作为RMPP恢复期组,采用酶联免疫吸附法(ELISA)检测各组血清中TNF-α、IL-4、IL-10的水平变化。结果:RMPP组、RMPP恢复期组患者血清中TNF-α、IL-4和IL-10水平明显高于对照组(P0.05);RMPP组患者血清中以上三个指标均明显高于RMPP恢复期组(P0.05);重症肺炎组有纤维化改变和无纤维化的患儿血清中TNF-α、IL-4和IL-10水平均高于非重症肺炎组患儿血清(P0.05);重症肺炎组和非重症肺炎组内出现纤维化改变的患儿血清中TNF-α、IL-4和IL-10水平均高于无纤维化患儿(P0.05);PSI评分与TNF-α、IL-4和IL-10的水平呈正相关(P0.05)。结论:TNF-α、IL-4和IL-10水平参与了RMPP的发病过程,它们高水平表达与病情严重程度密切相关,可以作为早期诊断RMPP及控制病情发展的重要依据。  相似文献   

11.
Insulin-dependent diabetes mellitus (IDDM) is a chronic disease characterized by T-cell-dependent autoimmune destruction of the insulin-producing beta cells in the pancreatic islets of Langerhans, resulting in an absolute lack of insulin. T cells are activated in response to islet-dominant autoantigens, the result being the development of IDDM. Insulin is one of the islet autoantigens responsible for the activation of T-lymphocyte functions, inflammatory cytokine production, and development of IDDM. The aim of this study was to investigate serum concentrations of interleukin (IL)-1beta, IL-2, IL-6, and tumor necrosis factor (TNF)-alpha in children IDDM. The study population consisted of 27 children with IDDM and 25 healthy controls. Children with IDDM were divided into three subgroups: (1) previously diagnosed patients (long standing IDDM) (n : 15), (2) newly diagnosed patients with diabetic ketoacidosis (before treatment) (n : 12), and (3) newly diagnosed patients with diabetic ketoacidosis (after treatment for two weeks) (n : 12). In all stages of diabetes higher levels of IL-1beta and TNF-alpha and lower levels of IL-2 and IL-6 were detected. Our data about elevated serum IL-1beta, TNF-alpha and decreased IL-2, IL-6 levels in newly diagnosed IDDM patients in comparison with longer standing cases supports an activation of systemic inflammatory process during early phases of IDDM which may be indicative of an ongoing beta-cell destruction. Persistence of significant difference between the cases with IDDM monitored for a long time and controls in terms of IL-1beta, IL-2, IL-6, and TNF-alpha supports continuous activation during the late stages of diabetes.  相似文献   

12.
From the sequence of human IL-2 we have recently characterized a peptide (p1-30), which is the first IL-2 mimetic described. P1-30 covers the entire alpha helix A of IL-2 and spontaneously folds into a alpha helical homotetramer mimicking the quaternary structure of a hemopoietin. This neocytokine interacts with a previously undescribed dimeric form of the human IL-2 receptor beta-chain likely to form the p1-30 receptor (p1-30R). P1-30 acts as a specific IL-2Rbeta agonist, selectively inducing activation of CD8 and NK lymphocytes. From human PBMC we have also shown that p1-30 induces the activation of lymphokine-activated killer cells and the production of IFN-gamma. Here we demonstrate the ability of p1-30 to act in synergy with IL-2, -4, -9, and -15. These synergistic effects were analyzed at the functional level by using TS1beta, a murine T cell line endogenously expressing the common cytokine gamma gene and transfected with the human IL-2Rbeta gene. At the receptor level, we show that expression of human IL-2Rbeta is absolutely required to obtain synergistic effects, whereas IL-2Ralpha specifically impedes the synergistic effects obtained with IL-2. The results suggest that overexpression of IL-2Ralpha inhibits p1-30R formation in the presence of IL-2. Finally, concerning the molecular effects, although p1-30 alone induces the antiapoptotic molecule bcl-2, we show that it does not influence mRNA expression of c-myc, c-jun, and c-fos oncogenes. In contrast, p1-30 enhances IL-2-driven expression of these oncogenes. Our data suggest that p1-30R (IL-2Rbeta)(2) and intermediate affinity IL-2R (IL-2Rbetagamma), when simultaneously expressed at the cell surface, may induce complementary signal transduction pathways and act in synergy.  相似文献   

13.
We have investigated the effects of IL-2 and IL-4 on different parameters of T cell activation using three T cell lines. The Th cell line L14 and the cytotoxic T cell line C30.1, both grown in IL-2-containing medium, and a line derived from C30.1 cells (line 1) cultured in IL-4 for a prolonged period were studied. All three cell lines could be activated with IL-2 or IL-4. T cell stimulation by either IL-2- or IL-4-induced identical patterns of cell size enlargement and transferrin receptor expression. However, only IL-2 up-regulated cell-surface expression of the p55 subunit of the IL-2R (p55 IL-2R) as measured by flow cytometry and RIA. This difference was also reflected by the accumulation of soluble p55 IL-2R in the culture medium. No significant increase in expression of membrane or soluble forms of p55 IL-2R was detected after IL-4 stimulation. mAb specific for p55 IL-2R which block IL-2-induced T cell growth did not affect IL-4-mediated T cell proliferation indicating that p55 IL-2R is not involved in IL-4-mediated T cell growth. Analysis of IL-4R expression performed on line 1 using biotinylated IL-4 revealed that IL-4, but not IL-2, is capable of increasing IL-4R expression. Together these results suggest that during IL-2- or IL-4-induced T cell proliferation, each lymphokine specifically up-regulates its own receptor.  相似文献   

14.
Neurochemical Research - Interleukin-2 (IL-2) is a classical pro-inflammatory cytokine known to display neuroprotective roles in the central nervous system including the retina. In the present...  相似文献   

15.
A temporal study assessed the relationship between fibrosarcoma growth and immunologic encumberance due to the inability of BALB/c mouse splenocytes to elaborate the lymphokine Interleukin 2 (IL-2). Nylon-wool fractionation and antiserum treatments suggested the existence of a mildly nylon-wool-adherent, anti-Lyt 2-sensitive tumor-induced suppressor T (Ts,) cell which significantly decreased IL-2 activity. Absorption investigations indicated that ligand-activated tumor-bearing host (TBH) spleen cells were less receptive to IL-2 than their normal counterparts. When splenocytes were antiserum treated before absorption, removal of Lyt 2+ (suppressor T) cells resulted in greater IL-2 absorption by the remaining cells. Purified IL-2 only partially restored suppressed TBH spleen cell mitogen- or alloantigen-induced blastogenesis; whereas, normal host reactivity was significantly augmented. The collective data suggest that TBH spleen cells were capable of producing IL-2 and of responding to the IL-2 amplification signal when tumor-induced Ts cells were depleted.  相似文献   

16.
In the periphery, IL-18 synergistically induces the expression of the Th1 cytokine IFN-gamma in the presence of IL-12 and the Th2 cytokines IL-5 and IL-13 in the presence of IL-2. Although the expression of these cytokines has been described in the thymus, their role in thymic development and function remains uncertain. We report here that freshly isolated thymocytes from C57BL/6 and BALB/c mice stimulated in vitro with IL-2-plus-IL-18 or IL-12-plus-IL-18 produce large amounts of IFN-gamma and IL-13. Analysis of the thymic subsets, CD4(-)CD8(-) (DN), CD4(+)CD8(+), CD4(+)CD8(-), and CD4(-)CD8(+) revealed that IL-18 in combination with IL-2 or IL-12 induces IFN-gamma and IL-13 preferentially from DN cells. Moreover, DN2 and DN3 thymocytes contained more IFN-gamma(+) cells than cells in the later stage of maturation. Additionally, IL-18 in combination with IL-2 induces CCR4 (Th2-associated) and CCR5 (Th1-associated) gene expression. In contrast, IL-18-plus-IL-12 specifically induced CCR5 expression. The IL-2-plus-IL-18 or IL-12-plus-IL-18 effect on IFN-gamma and IL-13 expression is dependent on Stat4 and NF-kappaB but independent of Stat6, T-bet, or NFAT. Furthermore, IL-12-plus-IL-18 induces significant thymocyte apoptosis when expressed in vivo or in vitro, and this effect is exacerbated in the absence of IFN-gamma. IL-12-plus-IL-18-stimulated thymocytes can also induce IA-IE expression on cortical and medullary thymic epithelial cells in an IFN-gamma-dependent manner. Thus, the combination of IL-2, IL-12, and IL-18 can induce phenotypic and functional changes in thymocytes that may alter migration, differentiation, and cell death of immature T cells inside the thymus and potentially affect the Th1/Th2 bias in peripheral immune compartments.  相似文献   

17.
The effect of hyperlipaemic serum on mitogen-induced T lymphocyte proliferation was investigated with cynomolgus monkeys. The mitogen-induced blastogenesis was remarkably inhibited when either hyperlipaemic or normal monkey lymphocytes were incubated with hyperlipaemic sera. Hyperlipaemic serum also inhibited ConA-induced interleukin 2 (IL-2) production as well as IL-2 receptor (IL-2R) expression of normal monkey lymphocytes. On the other hand, it showed slight inhibition of T-cell proliferation induced by adding recombinant human IL-2 to IL-2R-positive normal monkey lymphocytes. These results indicate that hyperlipaemic serum inhibited an early stage of T-cell autocrine activation pathway including IL-2 production and IL-2R expression.  相似文献   

18.
The high-affinity interleukin 2 receptor (IL-2R) consists of at least three distinct subunits: the IL-2R alpha chain (IL-2R alpha), beta chain (IL-2R beta), and gamma chain (IL-2R gamma). It has been shown that the cytoplasmic region of IL-2R beta, but not of IL-2R alpha, is essential for IL-2 signalling to the cell interior. In the present study, we examined the functional role of the IL-2R gamma cytoplasmic region in the IL-3-dependent mouse hematopoietic cell line BAF-B03, which expresses the endogenous IL-2R alpha and IL-2R gamma, or its subline F7, which additionally expresses human IL-2R beta cDNA. We show that overexpression of a mutant IL-2R gamma, lacking all but 7 amino acids of its cytoplasmic region, results in the selective inhibition of IL-2-induced c-fos gene activation and cellular proliferation in F7 cells. When two chimeric receptor molecules in which the cytoplasmic regions of IL-2R beta and IL-2R gamma had been swapped with each other (IL-2R beta/gamma and IL-2R gamma/beta) were coexpressed in BAF-B03, the cells responded to IL-2. These results indicate the critical importance of the IL-2-induced functional cooperation of the two cytoplasmic regions. Finally, we provide evidence that the IL-2R gamma cytoplasmic region is also critical for the IL-4 and IL-7-induced growth signal transduction in BAF-B03.  相似文献   

19.
The in vitro production of IL-2 and IL-2R expression by lymphoid cells of inbred mice of strong (NFS), intermediate (C3H), or weak (B10.BR) in phenotype of Trichinella spiralis (TS) rejection was measured during a primary infection. Maximum production of IL-2 by spleen and mesenteric lymph node (MLN) cells occurred at 5 days postinfection. Cell depletion experiments demonstrated that Lyt-1.2+ T cells were predominantly responsible for in vitro IL-2 production. Cells from strong-responder NFS mice produced more IL-2 than cells from intermediate-responder C3H or weak-responder B10.BR mice. Similarly, after TS infection, NFS mice had significantly more IL-2R expressing MLN cells than B10.BR or C3H MLN cells. All mouse strains displayed a dose-dependent increase in in vitro IL-2 production after infection with 100 to 800 TS. This effect was most pronounced in NFS mice. Limiting dilution analysis of day 5 infected MLN cells demonstrated that the frequency of TS-reactive CD4+ cells was threefold higher in NFS mice than B10.BR and fourfold higher than in C3H mice. Finally, MLN cells taken from infected NFS mice responded to an exogenous source of IL-2, whereas MLN cells from infected C3H or B10.BR mice were unable to do so. We conclude that strong responsiveness in parasite rejection may be related to the amount of IL-2 produced as well as to the capacity of the lymphocytes of each mouse strain to respond to IL-2. Although these differences help explain the strong rejection phenotype of NFS mice, they fail to separate C3H and B10.BR mice where TS-responsive CD4+ precursors, IL-2 production, and dose responsiveness are all lower for the intermediate phenotype (worm rejection) C3H than the weak phenotype B10.BR mice.  相似文献   

20.
The programmed death (PD)-1 molecule and its ligands (PD-L1 and PD-L2), negative regulatory members of the B7 family, play an important role in peripheral tolerance. Previous studies have demonstrated that PD-1 is up-regulated on T cells following TCR-mediated activation; however, little is known regarding PD-1 and Ag-independent, cytokine-induced T cell activation. The common gamma-chain (gamma c) cytokines IL-2, IL-7, IL-15, and IL-21, which play an important role in peripheral T cell expansion and survival, were found to up-regulate PD-1 and, with the exception of IL-21, PD-L1 on purified T cells in vitro. This effect was most prominent on memory T cells. Furthermore, these cytokines induced, indirectly, the expression of PD-L1 and PD-L2 on monocytes/macrophages in PBMC. The in vivo correlate of these observations was confirmed on PBMC isolated from HIV-infected individuals receiving IL-2 immunotherapy. Exposure of gamma c cytokine pretreated T cells to PD-1 ligand-IgG had no effect on STAT5 activation, T cell proliferation, or survival driven by gamma c cytokines. However, PD-1 ligand-IgG dramatically inhibited anti-CD3/CD28-driven proliferation and Lck activation. Furthermore, following restimulation with anti-CD3/CD28, cytokine secretion by both gamma c cytokine and anti-CD3/CD28 pretreated T cells was suppressed. These data suggest that gamma c cytokine-induced PD-1 does not interfere with cytokine-driven peripheral T cell expansion/survival, but may act to suppress certain effector functions of cytokine-stimulated cells upon TCR engagement, thereby minimizing immune-mediated damage to the host.  相似文献   

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