微小RNA调控脓毒症患者外周血免疫因子表达及其机制研究

目的:探讨脓毒血症患者血清外周白细胞中的微小RNA(mi RNA)表达水平的变化及其在脓毒症患者中的表达意义以及免疫调控的关系。方法:采用流式细胞仪检测外周血CD4+CD25+Treg细胞表达,采用实时定量PCR(RT-PCR)方法检测110例脓毒症患者以及100例正常对照外周血白细胞中mi RNA以及Foxp3 m RNA表达量,酶联免疫吸附法测定TNF-α和IL-10浓度,序贯器官衰竭估计(SOFA)评分系统评价脓毒症患者的严重程度。对mi RNA与白细胞总数、TNF-α、IL-10和SOFA评分之间的相关性进行分析。结果:实验组mi RNA表达水平较对照组显著降低(P0.01),WBC、IL-10水平显著升高(P0.01)。实验组mi RNA表达水平以及SOFA评分、血清TNF-α和IL-10之间呈负相关关系(r值分别为-0.512、-0.623、-0.432,P0.05);与WBC无显著相关性(r=0.215,P0.05)。脓毒症患者外周血Treg表达率和Foxp3m RNA均显著高于对照组(P0.01);随病情严重而升高,轻、中、重度实验组间两两比较差异均有统计学意义(P0.01)。死亡均在重度脓毒症患者中,死亡组Treg、Foxp3 m RNA及IL-10均显著高于存活组(P0.01);mi RNA低于存活组(P0.01)。结论:脓毒症患者外周血的mi RNA表达量显著降低,表达水平在一定程度上可以反应机体的炎症反应情况,同时还可以判断疾病的严重度,且mi RNA参与对Treg细胞增殖的调节,在脓毒症免疫失衡机制中发挥一定的作用。     

'Sezary-like' cells in malignant and non-malignant diseases.

Lymphocyte-like distinctive cells with cerebriform and serpentiform nuclei, as described in 'Sézary syndrome' were detected in the peripheral blood of two patients, one with plasma-cell leukemia and one with bacterial sepsis. These observations suggest that 'Sézary cells' are not strictly specific, neither for a neoplastic nor for a nonneoplastic disease, but rather representing a reactive form of lymphocytes to different stimuli.     

Increased T lymphocytes and IgMEA-receptor lymphocytes in Hodgkin's disease spleens.

Splenic lymphocytes from 11 patients with Hodgkin's disease were compared to lymphocytes of six spleens from patients with nonlymphoproliferative diseases. T lymphocytes were increased in patients with histological involvement by Hodgkin's disease. Likewise, lymphocytes from spleens with histological involvement showed increased rosette formation with immunologlobulin M-coated sheep red blood cells (IgMEA). A similar increase in T lymphocytes and in IgMEA rosette formation was not observed with normal peripheral blood lymphocytes, control spleens, or with Hodgkin's disease spleens without evidence of histological involvement.     

Segmentation of stained blood cell images measured at high scanning density with high magnification and high numerical aperture optics

In hematological morphology, it is necessary to resolve and analyze the smallest possible cellular details appearing in the light microscope. A prerequisite for computer-aided analysis of subtle morphological features is measuring the cells at a high scanning density with high magnification and high numerical aperture optics. Contrary to visual observations, the information content in a measured picture can be increased by setting the condensor's numerical aperture (NA) greater than the objective's NA. The complexity and heterogeneity of such cell images necessitate a new segmentation method that conserves the morphological information required in the subsequent image analysis, feature extraction, and cell classification. In our segmentation strategy, characteristic color difference thresholds for each nucleus and cytoplasm are combined with geometric operations, probability functions, and a cell model. All thresholds are repeatedly recalculated during the successive improvements of the image masks. None of the thresholds are fixed. This strategy segments blood cell images containing touching cells and large variations in staining, texture, size, and shape. Biological inconsistencies in the calculated cell masks are eliminated by comparing each mask with the cell model criteria integrated into the entire segmentation process. All 20,000 leukocyte images from 120 smears in our leukemia project were segmented with this method.     

Enzyme markers for the presence of circulating interferon: 2-5A synthetase in blood lymphocytes and protein kinase in platelet-rich plasma

The level of 2-5A synthetase in extracts of peripheral blood lymphocytes and a specific protein kinase activity in platelet-rich plasma were measured in normal individuals and in patients suffering from viral or bacterial infections. The level of these enzymes was tested at different times during the disease. The level of 2-5A synthetase and the protein kinase activity was enhanced by several-fold during viral and bacterial infections and decreased during the course of the disease in parallel with clinical ameliorations and reversal of clinical symptoms. Among the different types of infections studied, higher levels of these enzymes were observed during viral than bacterial infections. Our results emphasize the use of these enzymes as markers to evaluate the state of the disease and recovery. Furthermore, they provide evidence for the production of interferon during different types of infection.     

Plasma glutamine concentration in spinal cord injured patients

Glutamine, a non-essential amino acid, is the most important source of energy for macrophages and lymphocytes. Reduction in its plasma concentration is related with loss of immune function, as leukocyte proliferation and cytokine production. It is well known that glutamine is largely produced by the skeletal muscle which is severely compromised as a consequence of the paralysis due to the damage of the spinal cord. In spinal cord injury (SCI) patients, infections, such as pneumonia and sepsis in general, are a major cause of morbidity and mortality. In comparison with the control group, a 54% decrease in plasma glutamine concentration was observed as well as a decrease in the production of TNF and IL-1 by peripheral blood mononuclear cells cultivated for 48 h in SCI patients. Therefore, we propose that a decrease in plasma glutamine concentration is an important contributor to the immunosuppression seen in SCI patients.     

病毒性肺炎患者外周血干扰素刺激基因15 mRNA表达特征的研究

通过分析病毒性肺炎患者外周血干扰素刺激基因15(interferon stimulated gene 15,ISG15)mRNA在感染状态下的特征性表达,探究ISG15与病毒性肺炎发病机制及疾病活动性之间的可能联系,为探索特异性呼吸道病毒感染的宿主生物标志物提供依据.本研究共收集157例社区获得性肺炎(communit...     

Detection of plaque-forming cells in the peripheral blood of actively immunized humans.

Ten adult human volunteers were immunized with Salmonella typhi and their peripheral blood leukocytes were collected for 14 days after immunization. These peripheral blood leukocyted, rich in lymphocytes, were plaqued in a modified Jerne assay against sheep erythrocytes coated with either Salmonella or Escherichia lipopolysaccharide. A specific direct and indirect PFC response developed in immunized individuals by day 7 and peaked at day 10. This vigorous PFC response rapidly declined to normal levels by day 14. This marked and specific PFC response of human peripheral blood leukocytes may be developed as a useful tool for monitoring the humoral immune response of patients with Gram-negative bacterial infections.     

Ascites Bacterial Burden and Immune Cell Profile Are Associated with Poor Clinical Outcomes in the Absence of Overt Infection

Bacterial infections, most commonly spontaneous bacterial peritonitis in patients with ascites, occur in one third of admitted patients with cirrhosis, and account for a 4-fold increase in mortality. Bacteria are isolated from less than 40% of ascites infections by culture, necessitating empirical antibiotic treatment, but culture-independent studies suggest bacteria are commonly present, even in the absence of overt infection. Widespread detection of low levels of bacteria in ascites, in the absence of peritonitis, suggests immune impairment may contribute to higher susceptibility to infection in cirrhotic patients. However, little is known about the role of ascites leukocyte composition and function in this context. We determined ascites bacterial composition by quantitative PCR and 16S rRNA gene sequencing in 25 patients with culture-negative, non-neutrocytic ascites, and compared microbiological data with ascites and peripheral blood leukocyte composition and phenotype. Bacterial DNA was detected in ascitic fluid from 23 of 25 patients, with significant positive correlations between bacterial DNA levels and poor 6-month clinical outcomes (death, readmission). Ascites leukocyte composition was variable, but dominated by macrophages or T lymphocytes, with lower numbers of B lymphocytes and natural killer cells. Consistent with the hypothesis that impaired innate immunity contributes to susceptibility to infection, high bacterial DNA burden was associated with reduced major histocompatibility complex class II expression on ascites (but not peripheral blood) monocytes/macrophages. These data indicate an association between the presence of ascites bacterial DNA and early death and readmission in patients with decompensated cirrhosis. They further suggest that impairment of innate immunity contributes to increased bacterial translocation, risk of peritonitis, or both.     

Myelin basic protein-stimulated rosette-forming T cells in multiple sclerosis

A subpopulation of T lymphocytes sensitized to human myelin basic protein in peripheral blood of patients with multiple sclerosis, central nervous system (CNS) tumors, and cerebrovascular accidents was demonstrated by the antigen-stimulated, rosette-forming T cell assay. A significant increase in the percent of active rosette-forming T cells was detected after in vitro exposure of peripheral blood lymphocytes to human myelin basic protein but not to histones. In contrast, peripheral blood lymphocytes from healthy controls and from patients with benign and malignant breast diseases were unresponsive to stimulation by either antigen. These results demonstrate a functionally active T-lymphocyte subpopulation sensitized to myelin basic protein in patients with multiple sclerosis and in patients with certain other CNS diseases.     

蕈样肉芽肿患者皮损及外周血淋巴细胞CD28分子表达的研究

目的探讨CD28分子在蕈样肉芽肿发病机制中的作用。方法15例蕈样肉芽肿病人,分别采用免疫组织化学ABC方法检测皮损组织,流式细胞仪检测外周血淋巴细胞上的CD28分子表达水平。结果免疫组化结果显示蕈样肉芽肿组皮损中CD28表达明显增多,与正常人对照组相比差异均有显著性(t=4.53,P<0.01)。流式细胞仪检测显示MF外周血淋巴细胞上CD28 T淋巴细胞低于正常对照组(t=16.12,P<0.001)。MF外周血CD8 -CD28 T淋巴细胞低于正常对照组(t=4.925,P<0.001)。结论CD28分子在蕈样肉芽肿发病过程中起一定的作用。     

An immunologic approach for the detection of tumor cells in the peripheral blood of patients with malignant lymphoma; implications for the diagnosis of minimal disease.

Lymphocytes were isolated from infiltrated lymph nodes and blood of eight patients with malignant lymphocytic lymphoma. All patients had normal numbers of circulating lymphocytes with normal morphology. None of the patients had serum paraproteins. The isolated lymphocytes from patients and controls were stained with affinity purified antibody specific for kappa- or lambda-light chains and analyzed by using a fluorescence activated cell sorter. Cells from infiltrated nodes stained for only one light chain type at high levels of fluorescence intensity. An increase in the number of brightly stained cells bearing the light chain type found in the involved node was readily detected in the peripheral blood of all but one of the patients with lymphoma. Similar changes in the ratio of kappa+- to lambda+-cells were not observed in 41 samples from nomral individuals and patients with other diseases.     

Immunoluminometric detection of human procalcitonin

Procalcitonin is a normal precursor of the active hormone calcitonin; however, its level in blood is normally undetectable. Dramatically increased levels of procalcitonin have been found in severe systemic bacterial infections and, today, this molecule is considered to be one of the earliest inflammatory markers of sepsis. In spite of the large body of data, it is still uncertain how and from which tissues procalcitonin is released into the circulation. In our experiments, we tested the analytical performance of a flash-type chemiluminescent immunoassay. The precision and accuracy of the assay was acceptable for early detection of sepsis and procalcitonin levels showed predictive information on the outcome of the infections. Using isolated leukocyte subpopulations and acridinium-labelled anti-calcitonin monoclonal antibody, we made attempts to detect procalcitonin inside the cells or in surrounding medium by measuring the chemiluminescent signal triggered after the specific binding of the antibodies had occurred. Our preliminary data showed that lymphocytes did not contain detectable amounts of procalcitonin nor neutrophils secreted it after stimulation. However, neutrophils expressed chemiluminescence of intracellular origin. This finding suggests that neutrophil leukocytes might be a potential source of serum procalcitonin under in vivo conditions.     

肺癌患者外周血T淋巴细胞分型与抗核抗体之间的关系研究

摘要 目的：研究肺癌患者外周血T淋巴细胞分型与抗核抗体之间的关系。方法：选择2019年1月到2021年6月在我院接受治疗的肺癌患者81例作为研究组,并选择同期健康志愿者81例作为对照组,检测并比较两组患者外周血CD4⁺、CD8⁺和CD4⁺/CD8⁺淋巴细胞比例,以及抗核抗体血清滴度。比较不同抗核抗体、年龄、性别、TNM分期、肿瘤分化程度以及病理类型肺癌患者外周血CD4⁺、CD8⁺和CD4⁺/CD8⁺淋巴细胞比例。结果：（1）肺癌患者外周血CD4⁺和CD4⁺/CD8⁺淋巴细胞比例显著低于对照组,而CD8⁺淋巴细胞比例显著高于对照组（P<0.05）;（2）III+IV肺癌患者外周血CD4⁺、和CD4⁺/CD8⁺淋巴细胞比例均显著低于I+II肺癌患者,而CD8⁺淋巴细胞比例均显著高于I+II肺癌患者（P<0.05）;（3）小细胞肺癌患者外周血CD4⁺、和CD4⁺/CD8⁺淋巴细胞比例均显著低于非小肺癌患者,而CD8⁺淋巴细胞比例均显著高于非小肺癌患者（P<0.05）;（4）肺癌患者抗核抗体血清滴度显著高于对照组（P<0.05）;（5）抗核抗体阳性患者CD4⁺和CD4⁺/CD8⁺淋巴细胞亚群比例均显著低于抗核抗体阴性患者,而CD8⁺淋巴细胞亚群比例显著高于抗核抗体阴性患者（P<0.05）。结论：肺癌患者外周血T淋巴细胞亚群表达异常,并且其表达水平可能与抗核抗体滴度有关。     

Bacteria, phages and septicemia

The use of phages is an attractive option to battle antibiotic resistant bacteria in certain bacterial infections, but the role of phage ecology in bacterial infections is obscure. Here we surveyed the phage ecology in septicemia, the most severe type of bacterial infection. We observed that the majority of the bacterial isolates from septicemia patients spontaneously secreted phages active against other isolates of the same bacterial strain, but not to the strain causing the disease. Such phages were also detected in the initial blood cultures, indicating that phages are circulating in the blood at the onset of sepsis. The fact that most of the septicemic bacterial isolates carry functional prophages suggests an active role of phages in bacterial infections. Apparently, prophages present in sepsis-causing bacterial clones play a role in clonal selection during bacterial invasion.     

外周血单核细胞HLA-DR/CD14分析的临床意义及其与降钙素原、C-反应蛋白、白细胞计数的相关性

目的:探讨外周血单核细胞HLA-DR/CD14表达在感染性疾病中的临床意义,及其与降钙素原(PCT)、C-反应蛋白(CRP)、白细胞(WBC)计数等指标的相关性。方法:收集2012-01~2013-07住院患者75例,包括脓毒血症患者47例,其中重度感染患者25例设为观察1组、中度感染患者22例设为观察2组;非感染炎症患者10例,设为观察3组;其他疾病患者18例,设为观察4组;以及本院健康体检者21例,设为正常对照组。用流式细胞术分析外周血单核细胞HLA-DR/CD14,同步定量检测各组的PCT、CRP、WBC指标,用SPSS13.0软件对各组间数据进行方差分析及相关性比较。结果:观察1、2组各项指标与正常对照组间均存在显著性差异,1、2组间除WBC外其他各项指标间均存在显著性差异,3、4组与1、2组比较各项指标均存在显著性差异,P值均0.01;观察1、2组内HLA-DR/CD14与PCT、CRP存在显著负相关关系,而与WBC不存在显著性相关关系。结论:HLA-DR/CD14在感染性疾病中具有重要意义,联合检测HLA-DR/CD14和PCT、CRP、WBC,有助于感染性疾病的临床评估、诊断治疗及疗效观察。     

Group C adenovirus DNA sequences in human lymphoid cells.

Human peripheral blood lymphocytes from healthy adults, cord blood lymphocytes, and lymphoblastoid cell lines were screened by hybridization for the presence of group C adenovirus DNA sequences. In 13 of 17 peripheral blood lymphocyte samples from adults, 1 of 10 cord blood samples, and seven of seven lymphoblastoid cell lines tested, results were positive for Group C adenovirus DNA (adenovirus 1 [Ad1], Ad2, Ad5, or Ad6). About 1 to 2% of the lymphocytes carried 50 to 100 viral genome copies per positive cell, as estimated by in situ hybridization. Infectious virus representing all members of group C were recovered, but cultivation in the presence of adenovirus antibody did not cure the cells of free viral genomes. Viral DNA was found in B, T, and N cells but only in 1 of 10 cord blood samples. The results suggest that group C adenovirus infections in childhood result in the persistence of the viral genome in circulating lymphocytes.     

Cytogenetic analysis of peripheral blood lymphocytes in workers exposed to vinyl chloride

In the present study, the method of cytogenetic analysis of peripheral blood lymphocytes was used to examine 43 workers exposed to vinyl chloride monomer (average exposure 11.2 years) and 22 subjects selected from the same locality (control group). A total number of 8650 metaphases were analysed. All cytogenetic parameters examined were increased in the exposed group as compared to the control group and 3 parameters, chromatid breaks, percentage of aberrant cells and breaks per cell, were significantly increased (P less than 0.001).     

Use of Comet assay to assess DNA damage in patients infected by Helicobacter pylori: comparisons between visual and image analyses

Studies of DNA damage in gastric epithelial cells of Helicobacter pylori (H. pylori)-infected patients are conflicting, possibly due to different methods used for scoring DNA damage by Comet assay. Therefore, we compared the sensitivity of visual microscopic analysis (arbitrary units-scores and comets%) and image analysis system (tail moment), in the gastric epithelial cells from the antrum and corpus of 122 H. pylori-infected and 32 non-infected patients. The feasibility of cryopreserved peripheral blood lymphocytes and whole-blood cells for DNA damage biomonitoring was also investigated. In the antrum, the levels of DNA damage were significantly higher in H. pylori-infected patients with gastritis than in non-infected patients with normal mucosa, when evaluated by image analysis system, arbitrary units and comets%. In the corpus, the comets% was not sufficiently sensitive to detect the difference between H. pylori-infected patients with gastritis and non-infected patients with normal mucosa. The image analysis system was sensitive enough to detect differences between non-infected patients and H. pylori-infected patients with mild gastritis and between infected patients with moderate and severe gastritis, in both antrum and corpus, while arbitrary units and comets% were unable to detect these differences. In cryopreserved peripheral blood lymphocytes, the levels of DNA damage (tail moment) were significantly higher in H. pylori-infected patients with moderate and severe gastritis than in non-infected patients. Overall, our results indicate that the image analysis system is more sensitive and adequate to measure the levels of DNA damage in gastric epithelial cells than the other methods assayed.