中性粒细胞在抗结核免疫中的作用

结核病是世界范围内的重要传染性疾病之一,严重威胁人类健康。免疫细胞在抗结核免疫过程中起重要作用,各细胞亚群通过不同作用机制影响结核病的病程及转归。中性粒细胞为机体应对结核分枝杆菌感染的第一道防线,在宿主免疫应答过程中是一把双刃剑。一方面,机体感染结核分枝杆菌后,中性粒细胞于第一时间向感染部位聚集,通过多种方式对抗感染：中性粒细胞吞噬结核分枝杆菌后,通过自身凋亡而杀菌;参与形成肉芽肿,形成胞外陷阱来限制结核分枝杆菌的生长和传播;产生功能性细胞因子,调控宿主的抗结核免疫反应。另一方面,中性粒细胞还参与机体的病理损伤过程,甚至促进体内结核分枝杆菌的生长。本文综述了中性粒细胞在抗结核免疫中作用的最新研究进展。     

结核菌L型的致病性及其与肺癌的关系

结核菌Ｌ型的致病性及其与肺癌的关系蚌埠医学院微生物教研室蚌埠２３３００３戴云海，黄谷良细菌Ｌ型是细菌的细胞壁缺陷型。早在１８８８年就有人报道在结核患者的分离培养物中发现丝状体、球状体等多种形态，以致难于识别，并在一般结核分枝杆菌（Ｍｙｃｏｂａｃｔｅｒ...     

结核分枝杆菌滤过型的初步研究

目的研究结核分枝杆菌滤过型的生物学特性与检测方法。方法菌阴肺结核患者的结核分枝杆菌及其L型的液体培养物经0.45μm滤膜过滤后,涂片观察细菌形态,滤液分别进行分枝杆菌及其L型培养,并采用荧光基因定量法进行结核菌DNA检测。培养物用免疫组化染色鉴定,并采用透射电镜观察。结果30例痰、血滤前、滤后FQ-PCR检测同时阳性为53%,同时阴性为13%,滤前、滤后FQ-PCR结果符合率为67%。滤过后液体培养9例涂片见少许抗酸颗粒或椭圆性球菌。透射电镜见细胞壁缺失的"致密体"样细菌和细胞壁缺如菌。结论菌阴肺结核痰及血培养物中存在结核菌滤过型,滤过型携带遗传信息并可自我复制,采用生物学方法可以对其进行检测。     

复治肺结核患者结核分枝杆菌L型培养结果分析

目的:了解复治肺结核患者的结核分枝杆菌L型培养情况,探讨结核分枝杆菌L型阳性与耐多药的关系。方法:选择180例肺结核患者的痰标本进行结核分枝杆菌培养和结核分枝杆菌L型培养,同时对110例复治组中培养阳性的标本行耐药监测。结果:复治组的L型阳性率为43.6%,初治组的L型阳性率为15.7%,复治组显著高于初治组(P<0.01);菌阳复治组的L型阳性率50%,菌阴复治组的L型阳性率39.4%,菌阳组明显高于菌阴组(P<0.05);L型菌阳性患者的耐药率显著高于L型菌阴性组(P<0.05)。结论:结核分枝杆菌L型阳性是引起结核病复发、耐药的重要原因;MDR-TB与结核分枝杆菌L型感染有关。     

结核分枝杆菌eis基因突变与氨基糖苷耐药的研究

目的：探讨结核分枝杆菌eis基因突变与氨基糖苷耐药之间的相互关系。方法：以本室保存的35株已确定耐一线药物（异烟肼、利福平、乙胺丁醇、链霉素）的结核分支杆菌为研究对象,应用BECTEC960测定其二线药物（阿米卡星、卡那霉素）的耐药情况,同时应用基因测序的方法测定结核分枝杆菌eis基因突变情况,分析eis基因突变与氨基糖苷耐药之间的相互关系。结果：氨基糖苷耐药的部分结核分杆杆菌中,eis基因487位碱基出现突变,相应的163位氨基酸密码子由CGT突变为CAT,即由缬氨酸变为异亮氨酸。结论：eis基因V163I突变（缬氨酸变为异亮氨酸）可能与结核分枝杆菌耐氨基糖苷类药物有关。     

结核分枝杆菌eis 基因突变与氨基糖苷耐药的研究

目的:探讨结核分枝杆菌eis基因突变与氨基糖苷耐药之间的相互关系。方法:以本室保存的35株已确定耐一线药物(异烟肼、利福平、乙胺丁醇、链霉素)的结核分支杆菌为研究对象,应用BECTEC960测定其二线药物(阿米卡星、卡那霉素)的耐药情况,同时应用基因测序的方法测定结核分枝杆菌eis基因突变情况,分析eis基因突变与氨基糖苷耐药之间的相互关系。结果:氨基糖苷耐药的部分结核分杆杆菌中,eis基因487位碱基出现突变,相应的163位氨基酸密码子由CGT突变为CAT,即由缬氨酸变为异亮氨酸。结论:eis基因V163I突变(缬氨酸变为异亮氨酸)可能与结核分枝杆菌耐氨基糖苷类药物有关。     

复治肺结核患者结核分枝杆菌L型培养结果分析

目的：了解复治肺结核患者的结核分枝杆菌L型培养情况,探讨结核分枝杆菌L型阳性与耐多药的关系。方法：选择180例肺结核患者的痰标本进行结核分枝杆菌培养和结核分枝杆菌L型培养,同时对110例复治组中培养阳性的标本行耐药监测。结果：复治组的L型阳性率为43．6％,初治组的L型阳性率为15．7％,复治组显著高于初治组（P〈0．01）;菌阳复治组的L型阳性率50％,菌阴复治组的L型阳性率39．4％,菌阳组明显高于菌阴组（P〈0．05）;L型菌阳性患者的耐药率显著高于L型菌阴性组（P〈0．05）。结论：结核分枝杆菌L型阳性是引起结核病复发、耐药的重要原因;MDR-TB与结核分枝杆菌L型感染有关。     

自噬在结核分枝杆菌感染中作用的研究进展

结核病是一种由结核分枝杆菌感染引发的全球致死性传染病。结核分枝杆菌感染巨噬细胞后其在胞内的命运与细胞自噬的发生息息相关。但是,由于结核分枝杆菌与细胞自噬之间的博弈过程十分复杂且机制尚未完全阐明。因此,该文以结核分枝杆菌感染巨噬细胞后经典自噬和LAP对结核病发生发展的作用为切入点,从自噬抗结核分枝杆菌感染与结核分枝杆菌破坏自噬发生两个方面阐述了自噬与结核分枝杆菌之间的相互作用,从而为结核病发病机制的研究提供新的思路和视角。     

肺泡Ⅱ型上皮细胞自噬体与结核分枝杆菌相互作用的研究

目的:检测LC3在肺泡Ⅱ型上皮细胞A549上的表达情况,及结核分枝杆菌刺激后对其表达的影响,探讨自噬在结核分枝杆菌感染上皮细胞中所起的作用。方法:体外培养肺泡Ⅱ型上皮细胞A549,在结核分枝杆菌感染A549细胞0h,24h分别提取RNA,采用RT-PCR的方法检测LC3mRNA的表达情况。采用凋亡坏死染色试剂盒在结核分枝杆菌感染24h后检测对照组,3-MA组,MTB组和3-MA+MTB组的细胞坏死情况。在结核分枝杆菌感染A549细胞4h,8h,16,24h采用Non-Radioactive Cytocity Assay的方法检测对照组,3-MA组,MTB组和3-MA+MTB组上清液LDH的OD值。结果:LC3在肺泡Ⅱ型上皮细胞显著表达,结核分枝杆菌感染后LC3表达降低。细胞凋亡和坏死染色结果显示空白组和3-MA组没有明显差异(P>0.05),MTB组和3-MA+MTB组有明显差异(P<0.05)。LDH检测显示MTB组和3-MA+MTB组上清液LDH的OD值数据两两之间有明显差异(P<0.05)并且有时间依赖性。结论:肺泡II型上皮细胞自噬体在抵抗结核分枝杆菌的感染过程中起一定的作用。     

分枝杆菌所致家兔皮肤液化病理模型研究

目的 建立卡介苗( BCG) 、H37Ra 和耻垢分枝杆菌感染的新西兰兔皮肤模型, 为肺结核干酪样坏死和继而发生的液化提供研究模型。方法 新西兰兔皮内分别注射BCG、H37Ra 和耻垢分枝杆菌的5 ×10⁶CFU、5 ×10⁴CFU、5 ×10²CFU/ml 菌液, 6 周后在病灶周围再次以相同剂量皮内注射,14 d 后病变明显时取材, 制作切片, 行HE 染色, 显微镜下观察。结果新西兰兔分别经皮内接种BCG、H37Ra 或耻垢分枝杆菌后, 高剂量组观察到明显的炎症反应和脓肿液化、破溃等改变。再次免疫可观察到郭霍现象。引起病变的严重程度依次为BCG 强于H37Ra, 后者又强于耻垢分枝杆菌。显微改变可具典型的结核结节样病灶。皮肤模型处取材, 行细菌抗酸染色, 结果阳性。BCG 中、低剂量组再次免疫可诱导小结节样病变, 但不发生液化溃疡, 其余中剂量组及低剂量组没有观察到明显改变。结论 BCG、H37Ra 和耻垢分枝杆菌均可引起皮肤干酪样坏死和液化,病理损伤与感染细菌剂量密切相关, 5 ×10⁶CFU/ml 浓度的分枝杆菌可有效诱导液化和坏死, 其中BCG 引起的病理改变最明显。     

The process of the persistence of Salmonella typhi L forms in the body of experimental animals studied by immunoradiometric analysis

The use of the immunoradiometric assay made it possible to reveal a prolonged persistence of the antigen of viable cultures of S. typhi stable L-forms, as well as to study the dynamics of its spread in the body of experimental animals. After both subconjunctival and intraperitoneal infection of guinea pigs the antigen of S. typhi L-forms spread slowly in the body of experimental animals with its localization first in the lymphoid formations in the pharynx and the intestine and subsequent undulatory accumulation in the marrow, spleen and bile. The persistence of the antigen of live S. typhi L-forms lasted as long as 6 months (the term of observation); killed L-forms could be detected for not more than 17 days. Regular inoculations of samples from different organs into media for the cultivation of S. typhi bacterial and L-forms yielded no positive results, which showed the difficulty of obtaining stable L-forms and evidenced the absence of their reversion in the body of experimental animals.     

Comparative evaluation of methods of inducing Brucella L forms and a study of their adaptibility in the body of animals]

The action of bicillin-3 on Brucella directly in the body of animals enhances their potential ability to convert into L-forms. One of the factors contributing to the generalization of the infection caused by the L-forms of Brucella and to their prolonged persistance in the body is the presence of an L-transforming agent (in this case, bicillin-3), which indicate that the appearing L-forms of Brucella are obviously antibiotic-dependent.     

Identification with the aid of various serological reactions of L forms of streptococci isolated from the live organism]

Growth inhibition, agglutination, precipitation, and passive hemagglutination tests were used for the identification of the L-forms of streptococci isolated from the organism of experimental rabbits both after the infection with the L-forms of streptococci and with the streptococci of group A. The tests were positive not only with the antiserum of homologous, but also of heterologous strains of the L-form of streptococcus, group A. The L-form cultures isolated from the experimental animals failed to differ from the laboratory strain of the L-forms of streptococcus, group A, by serological properties.     

细菌L型与喉癌关系的研究

用组织切片革兰氏染色、免疫组织化学染色等方法,对８５例喉癌重新切片,进行细菌Ｌ型检查,结果发现有６５例革兰氏染色Ｌ型菌阳性,其阳性率为７６．５％。５３例（６４．７％）Ｌ型抗体免疫组化染色和革兰氏染色Ｌ型菌均阳性,两者总符合率为８３．５％。细菌Ｌ型呈多形性,分布于癌巢、癌间质,常聚集成堆,也可呈散在性分布。５８例（６８．２％）癌细胞胞浆内也见到Ｌ型菌。提示细菌Ｌ型感染与喉癌关系密切。     

慢性肾盂肾炎L型细菌感染及耐药分析

目的了解L型细菌在慢性肾盂肾炎的感染及耐药状况。方法对71例患者清洁中段尿做普通细菌培养(B型)、L型细菌培养(L型)及耐药分析。结果细菌阳性率为77.5%,其中单独L型阳性率为49.3%、B型与L型混合感染为15.5%,而B型阳性率仅为12.7%。主要是大肠埃希菌,其次是葡萄球菌;青霉素及头孢噻肟均有较高的耐药率(88.9%及73.6%)。结论L型细菌在慢性肾盂肾炎感染中占主导,β-内酰胺类药物有较高的耐药性,临床治疗应据药敏结果合理选择及时调整抗生素。     

Unique biological properties of Mycobacterium tuberculosis L-form variants: impact for survival under stress

Bacteria can, under certain conditions, enter into a cell-less state known as L-form conversion. This phenomenon is universal, but also recognized with difficultly by microbiologists. The current study addresses several aspects concerning the ability of tubercle bacilli to use L-form conversion as a unique adaptive strategy to survive and reproduce under unfavorable conditions. Nutrient starvation of M. tuberculosis in vitro followed by passages in Middlebrook 7H9 semisolid medium was used for stress induction and the selective isolation of mycobacterial L-form variants. Light and electron microscopy images evidence the peculiar characteristics of mycobacterial L-forms. For example, mycobacterial L-forms were observed to lose their acid-fastness and change their morphology. In addition, wide morphological variability, the presence of large and elementary bodies, coccoids and small granular forms, as well as the appearance of unusual modes of irregular cell division were observed. Unlike classical tubercle bacilli, L-form variants grew and developed typical "fried-egg" colonies faster. L-forms were verified as M. tuberculosis by spoligotyping. The results provide insights into the nature of L-form phenomena in M. tuberculosis and link them to the mechanisms allowing mycobacterial survival under stress.     

咽部活组织中细菌L型的检出及意义

应用病原微生物培养、电镜、组织切片细菌学检查及Ｌ型抗体免疫组化染色等方法,检测６４例慢性咽炎组织的细菌Ｌ型。结果有４２例培养出细菌Ｌ型,其阳性率为６５．６％;它与切片革兰氏染色Ｌ型检出阳性率（６７．２％）无显著性差异,Ｐ＞０．０５。透射电镜在慢性咽炎组织的间质及上皮细胞、巨噬细胞等细胞内见皮细菌Ｌ型;且Ｌ型抗体免疫组化染色亦证实组织中有细菌Ｌ型抗原。提示,细菌Ｌ型感染与慢性咽炎关系密切,Ｌ型侵入组织并在宿主细胞内生长的特征,可能是慢性咽炎反复发作,迁延不愈的重要原因。     

In vivo experimental modelling of the infectious process caused by stable L forms of the causative agent of typhoid

To simulate the infectious process and to study the persistence of L-forms, rabbits and guinea pigs were infected with S. typhi stable L-forms. The materials presented in this work indicate that both subconjunctival and intraperitoneal infection led to the development of the clinically indistinct, but morphologically pronounced pathological process with characteristic localization and typical changes in the gastrointestinal tract. The typical features of the process were the generalized immunomorphological reaction of the lymphoid apparatus with the appearance of light-colored reticulomacrophagal elements, the signs of the activation of humoral and cell-mediated immunity and the formation of small epitheloidocellular granulomas. The results of the investigation indicate that the stable cultures of S. typhi L-forms are highly pathogenic and capable of inducing the infectious process in experimental animals.     

鼻咽癌与细菌L型的关系

大量研究表明,鼻咽癌与ＥＢ病毒有关。通过对９８例鼻咽癌组织的切片革兰氏染色Ｌ型检查、电镜和Ｌ型抗体免疫组化染色等研究,发现鼻咽癌组织中细菌Ｌ型亦甚常见,切片革兰氏染色有７８例查见细菌Ｌ型,其阳性率为７９．６％;免疫细化染色Ｌ型抗原检出阳性率为６２．２％,电镜不仅在细胞间质见到细菌Ｌ型,而且在癌细胞、巨噬胞细等细胞胞质内也见到细菌Ｌ型。提示,细菌Ｌ型与鼻咽癌关系十分密切,很可能是鼻咽癌致癌因子之一。     

人体病理组织中细菌L型的电镜观察

对9例细菌L型感染的人体病理组织进行透射电镜观察。结果显示:(1)L型可分布于组织间质或进入吞噬细胞、上皮细胞和癌细胞等细胞胞质;(2)L型具有多形态、大小不等、胞壁缺陷、电子密度低等特点,细胞胞质内的细菌L型尚有A、B两种形态区别;(3)L型在组织中形成了不完全箍缩分裂;(4)宿主细胞超微结构仅出现轻微改变。本结果与文献报道基本一致,提出了透射电镜下病理组织中细菌L型的形态特征及分布;并对L型感染与慢性炎症的关系等问题进行了讨论。