细胞免疫功能及辅助型T细胞因子在口腔扁平苔藓中的作用

目的 探讨细胞免疫功能及辅助型T细胞（Th）细胞因子在口腔扁平苔藓（OLP）中的作用。方法 以35例糜烂型（糜烂组）及29例网纹型OLP（网纹组）患者为对象,选取同期20例健康人为对照组,流式细胞术检测外周血中T细胞、B细胞、NK细胞和调节性T细胞亚群表达百分率。ELISA法检测外周血中TNF-α和INF-γ（Th1型细胞因子）,IL-4和IL-10（Th2型细胞因子）,IL-17、IL-23（Th17型细胞因子）含量;分离外周血单个核细胞,qRT-PCR检测上述因子mRNA的表达。结果 与健康组相比,OLP患者CD3+、CD4+ T细胞亚群比例（F=3.211和3.565,P<0.05）及CD4+/CD8+降低（F=3.430,P<0.05）,CD4+Foxp3+调节性T细胞亚群比例（F=3.370,P<0.05）及外周血中TNF-α、INF-γ、IL-4、IL-10、IL-17、IL-23含量增高（F=0.923、0.820、1.043、1.132、0.745和0.802,P<0.05）。与网纹组相比,糜烂组CD8+ T细胞亚群比例较低（t=2.450,P<0.05）;IL-4、IL-10蛋白（t=22.780和25.112,P<0.05）及mRNA较低（t=3.781和6.710,P<0.05）,IL-17、IL-23蛋白（t=15.765和19.307,P<0.05）及mRNA较高（t=4.022和8.569,P<0.05）。结论 口腔扁平苔藓患者存在细胞免疫紊乱及Th细胞因子异常,其中CD8+及Th17型细胞与糜烂型OLP发病有关,Th2型细胞与网纹型OLP发病有关。     

Increased activin levels in cerebrospinal fluid of rabbits with bacterial meningitis are associated with activation of microglia

Activin, a member of the transforming growth factor superfamily, is upregulated in a number of inflammatory episodes such as septicemia and rheumatoid arthritis. In the CNS, activin has been predominantly assessed in terms of a neuroprotective role. In this report we characterized the activin response in the CNS in a rabbit model of meningitis. In normal animals, cerebrospinal fluid (CSF) activin levels were higher than those in serum, indicating an intracranial secretion of this cytokine. Following intracisternal inoculation with Streptococcus pneumoniae, activin in CSF was unchanged for the first 12 h and then rose progressively; levels were increased approximately 15-fold within 24 h. Activin levels were correlated positively with CSF protein content and with the number of apoptotic neurons in the dentate gyrus. No apparent correlation was observed between CSF activin concentrations and bacterial titer, lactate concentrations or leukocyte density. Using immunohistochemistry, activin staining was localized to epithelial cells of the choroid plexus, cortical neurons and the CA3 region of the hippocampus, with similar staining intensities in both normal and meningitic brains. However, in meningitic brains there was also strong staining in activated microglia and infiltrating macrophages. Taken together, these results demonstrate that activin forms part of the CNS response to immune challenge and may be an important mediator to modulate inflammatory processes in the brain.     

颅内感染患者血清和脑脊液降钙素原水平的观察

目的 研究降钙素原(PCT)在脑膜炎患者血清和脑脊液(CSF)中的水平,探讨其在脑膜炎诊断中的临床意义.方法 用免疫透射比浊法测定42例脑膜炎患者(细菌性脑膜炎18例、病毒性脑膜炎24例)急性期内血清和脑脊液PCT,并与CSF的常规生化指标作相关性分析;20例神经系统非感染性疾病为对照组.结果 细菌性脑膜炎患者血清和CSF中的PCT含量均显著高于病毒性脑膜炎和对照组(P＜0.01);但病毒性脑膜炎患者与对照组之间的PCT水平差异无统计学意义(P＞0.05).相关性分析显示,在CSF中PCT与白细胞数(r=0.161,P＞0.05)无明显相关性,但与CSF蛋白含量和血清PCT水平呈弱相关性(r=0.465和0.570,P＜0.05).结论 PCT升高是颅内细菌感染的标志之一;PCT可作为一项CSF的常规生化指标,有助于指导临床对脑膜炎的诊治.     

成人化脓性脑膜炎患者脑脊液变化

分析成人化脓性脑膜炎患者脑脊液细胞、病原菌等的变化及其关系, 为该病的有效诊断、病情监测和针对性治疗提供参考。

对我院32例成人化脓性脑膜炎患者用药前后不同时期的脑脊液分别进行常规、生化与细胞学检测, 对检测结果进行统计分析。

与恢复期比较, 患者急性期时脑压、脑脊液白细胞总数与乳酸脱氢酶水平显著升高(均P < 0.05)。32例患者中, 15例脑脊液细菌培养呈阳性。典型菌与非典型菌感染者急性期脑脊液白细胞总数、小淋巴细胞、单核吞噬细胞和嗜中性粒细胞比例差异均有统计学意义(均P < 0.05)。

成人化脓性脑膜炎患者脑脊液变化显著, 脑脊液细胞学变化与感染类型相关, 可为个性化诊疗提供参考。

     

Number of helper T cells and phytohemagglutinin stimulation correlate in cancer patients

Summary Mononuclear cells from 12 normal controls (co), 10 advanced untreated (c1), and 6 advanced treated cancer patients (c2) have been isolated. The numbers of mononuclear cells bearing Leu1, Leu2, Leu3, Leu2/HLA-DR and LeuM3 were measured with a fluorescence-activated cell sorter. Only the quantity of helper T cells (Leu3) was decreased in cancer patients (co: 0.89, c1: 0.32, c2: 0.44 × 10⁹/1). Expression of all other markers, including activated suppressor T cells (Leu2/HLA-DR), did not differ significantly from the control. The proliferation of the lymphocytes was determined in a phytohemagglutininculture assay. The cancer groups showed a significantly decreased response (co: 95.8 × 10⁹, cl: 28.7 × 10⁹, c2: 25.7 × 10⁹ cpm). These values correlated with the number of helper T cells but not with the suppressor T cells. Monocytes of cancer patients adsorbed significantly more immunoglobulins than the monocytes of controls. The addition of indomethacin or isoprinosine to phytohemagglutinin-culture assay increased the proliferation of lymphocytes from both the cancer patients and normal controls.Supported by the Swiss National Science Foundation     

脑脊液乳酸和血清降钙素原及C反应蛋白对小儿细菌性脑膜炎的诊断价值

目的 探讨脑脊液乳酸、血清降钙素原及C反应蛋白对小儿细菌性脑膜炎的诊断价值。方法 选取我院2016年4月至2017年6月收治的50例细菌性脑膜炎患儿以及50例病毒性脑膜炎患儿进行作为研究对象,比较2类患儿脑脊液乳酸（LA）、血清降钙素原（PCT）及C反应蛋白（CRP）的水平,并分析其诊断价值。结果 细菌性脑膜炎组患儿脑脊液LA、血清PCT及CRP水平显著高于病毒性脑膜炎患儿（均P<0.05）。血清PCT诊断的灵敏度和特异度最高（96.4%、90.9%,P<0.05）。3项指标联合检测的灵敏度（100.0%）和特异度（95.5%）明显高于任一单项指标（均P<0.05）。经过Pearson相关性分析,脑脊液LA、血清PCT及CRP与小儿细菌性脑膜炎均呈显著正相关关系（均P<0.05）。结论 脑脊液乳酸、血清PCT及CRP对小儿细菌性脑膜炎的诊断和治疗效果监测有重要应用价值。     

哮喘患者外周血Treg和Th1/Th2的变化及其与哮喘病情的关系

目的：探讨哮喘患者外周血调节性T细胞（Treg）以及辅助性T细胞（Th1/Th2）的比例的变化,探讨其在哮喘的临床治疗中的作用。方法：80例哮喘患者（哮喘组）按临床表现分为急性发作期组（54例）和缓解期组（26例）,同时选择50例健康体检者。应用流式细胞仪检测上述各组外周血CD4＋CD25＋Foxp3＋Treg、CD4＋IFN-γ＋Th1和CD4＋IL-4＋Th2细胞水平,并进行统计学分析。结果：哮喘组CD4＋CD25＋Foxp3＋Treg水平亦明显低于正常对照组（P〈0.05。其中急性发作期组Treg水平明显低于缓解期组和正常对照组（P〈0.05）。而哮喘组Th1/Th2比值显著低于对照组（P〈0.05）,且在哮喘急性发作组中Th1/Th2比值显著低于缓解期组和正常对照组（P〈0.05）。结论：提示Treg和Th在哮喘的发生和发展中起着重要的作用。     

哮喘患者外周血Treg和Th1/Th2的变化及其与哮喘病情的关系

目的:探讨哮喘患者外周血调节性T细胞(Treg)以及辅助性T细胞(Th1/Th2)的比例的变化,探讨其在哮喘的临床治疗中的作用。方法:80例哮喘患者(哮喘组)按临床表现分为急性发作期组(54例)和缓解期组(26例),同时选择50例健康体检者。应用流式细胞仪检测上述各组外周血CD4+CD25+Foxp3+Treg、CD4+IFN-γ+Th1和CD4+IL-4+Th2细胞水平,并进行统计学分析。结果:哮喘组CD4+CD25+Foxp3+Treg水平亦明显低于正常对照组(P<0.05。其中急性发作期组Treg水平明显低于缓解期组和正常对照组(P<0.05)。而哮喘组Th1/Th2比值显著低于对照组(P<0.05),且在哮喘急性发作组中Th1/Th2比值显著低于缓解期组和正常对照组(P<0.05)。结论:提示Treg和Th在哮喘的发生和发展中起着重要的作用。     

SEREX identification of the autoantibodies that are prevalent in the cerebrospinal fluid of patients with moyamoya disease

We performed SEREX (serological analysis of recombinant cDNA expression library) to identify autoantibodies that are prevalent in the cerebrospinal fluid of patients with moyamoya disease. These autoantibodies include PC326 (of unknown function), SRY (sex determining region Y), and peroxisomal D3,D2-enoyl-CoA isomerase.     

Raman spectroscopy provides a powerful,rapid diagnostic tool for the detection of tuberculous meningitis in ex vivo cerebrospinal fluid samples

In this letter, we propose a novel method for diagnosis of tuberculous meningitis using Raman spectroscopy. The silicate Raman signature obtained from Mycobacterium tuberculosis positive cases enables specific and sensitive detection of tuberculous meningitis from acquired cerebrospinal fluid samples. The association of silicates with the tuberculosis mycobacterium is discussed. We envision that this new method will facilitate rapid diagnosis of tuberculous meningitis without application of exogenous reagents or dyes and can be aptly used as a complementary screening tool to the existing gold standard methods. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Functional adaptation to oxidative stress by memory T cells: an analysis of the role in the cardiovascular disease process

T cells participate in combating infection and critically determine the outcomes in any given disease process. Impaired immune response occurs in a number disease processes such as in cancer and atherosclerosis although the underlying mechanisms are still not fully understood. This article gives an up-to-date review of T cells development and functional adaptation to pathophysiological stimuli and participation in the cardiovascular disease process. In addition, we have discussed the signaling pathways controlled by the microenvironment that determine T cells function and resultant type of immune response. We have also discussed in detail how oxidative stress is a key component of the micro environmental interaction.     

A silkworm larvae plasma test for detecting peptidoglycan in cerebrospinal fluid is useful for the diagnosis of bacterial meningitis

The silkworm larvae plasma (SLP) test has been established based on a cascade reaction triggered by either peptidoglycan or (1, 3)-beta-D-glucan to produce melanin. We applied this test to the diagnosis of bacterial meningitis. Cerebrospinal fluid (CSF) obtained from patients with bacterial meningitis due to gram-positive bacteria, gram-negative bacteria, or fungi, showed positive reactions to the test. In contrast, CSF from patients with viral meningitis or noninfectious illnesses gave negative reactions. Therefore, this test seems to be useful for diagnosis of bacterial and fungal meningitis. When this test was used together with two types of limulus tests, an endotoxin-specific test, and a conventional test, meningitis was further characterized as gram-positive, gram-negative or fungal meningitis. The SLP test requires a computerized instrument for quantitative colorimetric measurement. A qualitative alternative of this test also can be accomplished by visually observing the darkening color. Thus, this method can be applied for simple and rapid diagnosis of meningitis.     

Proteomic studies in the discovery of cerebrospinal fluid biomarkers for amyotrophic lateral sclerosis

Introduction: Amyotrophic lateral sclerosis (ALS) is a progressive degenerative motor neuron disease, which usually leads to death within a few years. The diagnosis is mainly based on clinical symptoms and there is a need for ALS-specific biomarkers to make an early and precise diagnosis, for development of disease-modifying drugs and to gain new insights into pathophysiology.

Areas covered: In the present review, we summarize studies using mass spectrometric (MS) approaches to identify protein alterations in the cerebrospinal fluid (CSF) of ALS patients. In total, we identified 11 studies fulfilling our criteria by searching in the PubMed database using the keywords ‘ALS’ and ‘CSF’ combined with ‘proteome’, ‘proteomic’, ‘mass spectrometry’ or ‘protein biomarker’. Ten proteins were differently regulated in ALS CSF compared to controls in at least 2 studies. We will discuss the relevance of the identified proteins regarding the frequency of identification, extent of alteration and brain-specificity.

Expert commentary: Most of the identified CSF biomarker candidates are irreproducible or mainly blood-derived. We assign the missing success of CSF proteomic studies in biomarker discovery to a lack of sensitivity, unsuitable normalization, low quality assurance and variations originating from sample preparation. These issues must be improved in future proteomic studies in CSF.     

Expression and regulation of IL-22 in the IL-17-producing CD4＋ T lymphocytes

IL-22 is a novel cytokine in the IL-10 family that functions to promote innate immunity of tissues against infection. Although CD4＋ helper T lymphocytes （TH） were found as a source of IL-22, the regulation of this cytokine has been poorly understood. Here, we show that IL-22 is expressed at both mRNA and protein levels by a novel subset of TH cells that also makes IL-17. IL-22 and IL-17 were found to be coordinately regulated by TGFI3 and IL-6 during TH differentiation by real-time PCR as well as ELISA analysis. However, IL-22 does not regulate TH differentiation; exogenous IL-22 or an IL-22 antagonist had no effect on TH differentiation. These data demonstrate a novel cytokine expressed by IL-17-producing T cells, and suggest interaction and synergy of IL-22 and IL-l 7 signaling pathways in tissue inflammation and autoimmune diseases.     

Molecular diagnosis of eosinophilic meningitis due to Angiostrongylus cantonensis (Nematoda: Metastrongyloidea) by polymerase chain reaction-DNA sequencing of cerebrospinal fluids of patients

Cerebrospinal fluid (CSF) samples from clinically diagnosed patients with detectable Angiostrongylus canto-nensis-specific antibodies (n = 10), patients with clinically suspected cases that tested negative for A. cantonensis-an-tibodies (n = 5) and patients with cerebral gnathostomiasis (n = 2) and neurocysticercosis (n = 2) were examined by a single-step polymerase chain reaction (PCR) method using the AC primers for the 66-kDa native protein gene. The PCR method detected A. cantonensis DNA in CSF samples from four of 10 serologically confirmed angiostrongyliasis cases. The PCR results were negative for the remaining CSF samples. The nucleotide sequences of three positive CSF-PCR samples shared 98.8-99.2% similarity with the reference sequence of A. cantonensis. These results indicate the potential application of this PCR assay with clinical CSF samples for additional support in the confirmation of eosinophilic meningitis due to A. cantonensis.     

A comparison of HMGB1 concentrations between cerebrospinal fluid and blood in patients with neurological disease

Aims: To determine whether a correlation exists between paired cerebrospinal fluid (CSF) and serum levels of a novel inflammatory biomarker, high-mobility group box 1 (HMGB1), in different neurological conditions.

Methods: HMGB1 was measured in the serum and CSF of 46 neurological patients (18 idiopathic intracranial hypertension [IIH], 18 neurological infection/inflammation [NII] and 10 Rasmussen’s encephalitis [RE]).

Results: Mean serum (±?SD) HMGB1 levels were 1.43?±?0.54, 25.28?±?27.9 and 1.89?±?1.49?ng/ml for the patients with IIH, NII and RE, respectively. Corresponding mean (±?SD) CSF levels were 0.35?±?0.22, 4.48?±?6.56 and 2.24?±?2.35?ng/ml. Both CSF and serum HMGB1 was elevated in NII. Elevated CSF HMGB1 was demonstrated in RE. There was no direct correlation between CSF and serum levels of HMGB1.

Conclusion: Serum HMGB1 cannot be used as a surrogate measure for CSF levels. CSF HMGB1 was elevated in NII and RE, its role as a prognostic/stratification biomarker needs further study.     

人类免疫缺陷病毒1型同性恋感染者与健康人群Th17/Treg平衡状况的比较研究

通过探讨人类免疫缺陷病毒1型(HIV-1)同性恋感染者外周血中辅助性T细胞17(Th17)与CD4+CD25hiFoxp3+调节性T细胞(Treg)比例及Th17/Treg平衡状态与疾病进展的关系,初步阐明Th17/Treg失衡在HIV发病机制中的作用和意义。选取54例未经抗病毒治疗的HIV感染者,另有32名健康志愿者作为正常对照。分离外周血单核细胞后,利用流式细胞技术检测Th17和Treg水平。结果表明,在HIV感染者外周血中Th17比例明显低于正常对照组(0.68±0.35vs1.42±0.86,P<0.001),Treg比例明显高于正常对照(6.15±2.12vs4.50±0.76,P<0.001),导致HIV感染者中Th17/Treg比例较正常对照显著降低(0.12±0.07vs0.31±0.17,P<0.001)。研究还发现,Th17/CD4比例与CD4+T细胞计数正相关(r=0.371,P<0.05),与病毒载量不相关;Treg/CD4比例与CD4+T细胞计数负相关,与病毒载量正相关(r=-0.402,P<0.05;r=0.447,P<0.001)。此外,Th17/Treg比例与CD4+T细胞计数正相关,与病毒载量负相关(r=0.525,P<0.001;r=-0.318,P<0.05)。结果提示,HIV感染中存在Th17/Treg失衡现象,与疾病进程密切相关,可能在HIV进展中具有重要作用。     

甲醛致炎痛对大鼠远位触液神经元γ-氨基丁酸表达的影响

目的：观察甲醛致炎痛对大鼠远位触液神经元的γ-氨基丁酸（GABA）表达。方法：SD大鼠甲醛致痛后,观察行为学变化,并采用CB-HRP/GABA双重标记技术分别观察大鼠远位触液神经元中GABA表达的变化。结果：甲醛致痛后,6h远位触液神经元内GABA增加,24h最为显著,48h恢复至正常水平。与空白对照组相比有显著差异（P〈0.05）。结论：甲醛致炎痛后大鼠远位触液神经元内在一定时间内GABA表达增加,提示远位触液神经元内GABA这种表达变化可能参与了机体对炎性痛的信息调控。