生殖器疱疹初发患者外周血淋巴细胞检测结果分析

目的检测生殖器疱疹初发患者（GH）外周血T淋巴细胞亚群、NK细胞和B细胞的表达水平,探讨其发病机制与细胞免疫功能之间的关系。方法应用流式细胞仪检测20例初发生殖器疱疹患者外周血T淋巴细胞亚群、NK细胞和B细胞的表达水平,并与60例复发性生殖器疱疹患者（RGH）、35例健康对照者外周血检测结果相比较。结果（1）初发组和对照组相比,除NK细胞降低差异有显著性外,其他差异无显著性;（2）初发组与复发组相比,初发组T细胞、CD4^＋细胞、CD4^＋／CD8^＋均高于复发组,CD8^＋细胞百分比低于后者,差异有显著性;B细胞、NK细胞比例差异无显著性;（3）复发组与对照组相比,外周血中T细胞、CD4^＋细胞、NK细胞所占比例,CD4^＋／CD8^＋均降低,差异有显著性;CD8^＋细胞百分比升高,差异有显著性;B细胞比例差异无显著性。结论生殖器疱疹初发患者存在细胞免疫功能异常。     

外周血CD4^＋、CD8^＋及CD56^＋细胞在肺癌靶向治疗患者中的表达意义

目的：探讨埃罗替尼靶向治疗前后非小细胞肺癌患者外周血CD4^＋,CD8^＋和CD56^＋的表达及其临床意义。方法：流式技术检测30例EGFR突变的非小细胞肺癌患者埃罗替尼一线靶向治疗前后,外周血T细胞亚群的表达情况及疗效。结果：靶向治疗1个月后,与治疗前相比较非小细胞肺癌患者外周血T细胞亚群CD4^＋CD8^＋以及CD56^＋表达数量有统计学差异（P〈0．05）。其中,CD4^＋表达上升,CD8^＋和CD56^＋表达下降。结论：埃罗替尼靶向治疗可以改善非小细胞肺癌患者细胞免疫功能,观察外周血T细胞亚群表达情况有助于评价埃罗替尼靶向治疗的疗效和预后。     

LGT蛋白质组阳性肿瘤患者免疫功能的观察报告——LGT系列论文之八

目的：了解LGT（lost goodwill target）蛋白质组阳性表达患者CD3^＋、CD4^＋、CD8^＋、CD4^＋/CD8^＋、T细胞和NK细胞的变化规律.方法：对30例LGT蛋白质组阳性表达的肿瘤患者分别采用美国BD公司生产的流式细胞检测仪及提供的相应单克隆抗体检测患者空腹血清CD3^＋、CD4^＋、CD8^＋、CD4^＋/CD8^＋、T细胞和NK细胞并用美国赛费吉（Ciphergen）公司制造的蛋白质指纹仪及该公司提供的弱阳离子交换芯片（WCX2）按其操作方法（SELDI检测技术）配对检测肿瘤患者空腹血清中的蛋白质指纹,对有病情加重的患者均检查两次以上.以指纹图上质荷比（M/Z）为11100＋H～11900＋H之间出现一峰簇样（cluster）的指纹标志为LGT阳性诊断标准,并按蛋白质指纹LGT检测阳性次数分成二组.对二组内CD3^＋、CD4^＋、CD8^＋、CD4^＋/CD8^＋、T细胞和NK细胞与正常参考值之间进行统计学显著性检验.结果：CD3^＋T细胞值在LGT蛋白质组持续阳性表达组是增高的,在另一组是无变化,二者之间有显著性差异,而CD8^＋T细胞在二组内同时增高,CD4^＋T细胞和NK细胞二组同时低下,无显著性差别.结论：本研究提示肿瘤晚期可能存在有酪氨酸蛋白激酶修饰的细胞内信号传导,使之病情加重,而肿瘤早期则不明显.这是一种新的看法,应加强这个方面的研究.     

曲马多、吗啡术后自控镇痛对食管癌患者细胞免疫功能的影响

目的：比较曲马多、吗啡对食管癌术后患者的镇痛疗效以及对机体免疫功能的影响。方法：将本院50 例行食管癌手术患者随 机分成对A 组和B 组,A 组接受硬膜外吗啡镇痛,B 组接受硬膜外曲马多镇痛,常规监测心电图（ECG）、无创血压（BP）、心率 （HR）、血氧饱和度（SPO2）、呼气末二氧化碳分压(PETCO2）。记录两组患者不同时间点视觉模拟疼痛（VAS）评分、不良反应发生 率、外周血T 淋巴细胞亚群(CD3+、CD4+、CD8+)、NK 细胞的变化。结果：两组患者均得到满意的术后镇痛效果,术后1d,A、B两组 患者外周血T淋巴细胞亚群、NK 细胞的水平较术前降低（P<0.05）,且A 组降低幅度明显大于B 组（P<0.05）;术后2d,A 组外周 血T 淋巴细胞亚群、NK 细胞的水平虽有所升高,但仍较术前降低（P<0.05）,B 组CD3+、CD4+、CD8+及NK细胞水平恢复至术前水 平;术后3d,A 组上述指标恢复至麻醉前水平。结论：曲马多在镇痛的同时对机体外周血T 淋巴细胞亚群和NK细胞水平影响较 小,减轻了麻醉对细胞免疫功能的抑制效应。     

siRNA沉默t-bet基因对CD4、CD8T淋巴细胞亚群IFN-γ产生的影响

利用化学合成针对人t-bet基因的小干扰RNA（siRNA）,转染体外培养的人外周血单个核细胞,利用流式细胞仪分选纯化CD4^＋、CD8^＋T淋巴细胞,半定量RT-PCR检测CD4^＋、CD8^＋T淋巴细胞中t-betmRNA的表达变化,流式细胞术检测转染前后IFN-γ产生的变化情况。探讨转录因子t-bet对人CD4^＋、CD8^＋T淋巴细胞亚群IFN-γ产生的调控作用。与对照组相比,转染后的人CD4^＋、CD8^＋T淋巴细胞t-betmRNA表达水平明显下降;转染siRNA后,CD4＋T淋巴细胞中IFN-γ＋细胞比例为（18.46±6.86）%,与对照组（50.20±5.91）%比较有显著性差异（P〈0.01）;CD8＋T淋巴细胞IFN-γ＋细胞比例为（74.18±9.33）%,和对照组（76.51±6.49）%比较差异不明显（P〉0.05）。体外转录合成的siRNA可有效降低人CD4^＋、CD8^＋T淋巴细胞t-bet的基因表达;转录因子t-bet对人不同淋巴细胞亚群IFN-γ的产生所起作用不同。     

总状蕨藻盾叶变种多糖及其硒化产物对小鼠T细胞和NK细胞的调节

一种分离自总状蕨藻盾叶变种的多糖CrvpPS与纳米硒反应之后形成稳定的多糖纳米硒（CrvpPS-nano—Se）系统．实验检测了CrvpPS和CrvpPS—nano-Se对小鼠T淋巴细胞亚群及NK细胞的调节功能．用氢化可的松制造免疫功能低下的小鼠动物模型,给模型小鼠分别连续10天灌胃CrvpPS、蔗糖-纳米硒、CrvpPS—nano-Se溶液和阳性对照药物左旋咪唑,检测脾脏和胸腺指数的变化,并用流式细胞仪检测血中T细胞亚群（CD3^＋,CD4^＋,CD8^＋）和脾脏NK细胞百分比．结果表明,CrvpPS和CrvpPS-nano-Se对胸腺有较大的刺激作用,能使模型小鼠的CD3^＋,CD3^＋CD4^＋,NK细胞百分比以及CD4^＋／CD8^＋明显升高（P〈0．05）,CrvpPS-nano—Se提升CD3^＋,CD3^＋CD4^＋细胞百分比的作用明显优于CrvpPS、蔗糖-纳米硒及左旋咪唑（P〈0．05）．表明CrvpPS对免疫功能低下小鼠的胸腺指数、T细胞亚群和NK细胞百分比具有正向调节作用;其硒化产物CrvpPS-nano-Se对CD3^＋,CD3^＋CD4^＋细胞的调节作用优于单纯多糖和单纯纳米硒．     

同种异基因骨髓移植GVHD动物模型的建立及其病理生理学机制初探

目的：建立稳定的异基因骨髓移植GVHD（移植物抗宿主病）动物模型,并初步了解其病理生理学机制。方法：以BALB／c（H-2^d）雌性小鼠为受者,接受8Gy致死剂量的。Co全身照射后,输注雄性C57BL／6（H-2^b）供鼠的脾细胞和骨髓细胞,观察受鼠的体征、造血功能恢复及生存时间的变化,并进行病理学、嵌合体和T细胞亚群及相关细胞因子的检查。结果：模型组小鼠在移植后出现了典型的GVHD症状;肠、肝、脾、皮肤的病理学分析均属于Ⅳ度GVHD;嵌合体植入成功;以7、14和21d为检测时间点,发现模型组鼠体内T细胞亚群移植后较移植前CD3^＋CD4^＋T细胞数量减少,CD3＋CD8＋T细胞显著升高,CD4^＋和CD8^＋T细胞比例严重倒置,随着时间变化比值会逐渐升高,但仍然处于较显著的倒置水平;血清中IFN-γ、TNF-α在移植后＋7d表达显著增高,尤其是IFN-γ的表达在＋7d达峰值;IL-4和IL-10的水平在移植前后几乎没有变化。结论：建立了稳定的GVHD动物模型;此模型发病过程中,CD8^＋T细胞介导的CTL细胞毒性作用可能要大于CD4＋Th介导的细胞因子效应;IFN-γ、TNF-α炎症因子在GVHD的早期发挥重要作用;IL-4、IL-10的低水平分泌与急性GVHD的高发病率有关。     

建立适用于旋毛虫抗肿瘤相关基因筛选的动物模型

目的为利用抑制消减杂交（SSH）法筛选旋毛虫抗肿瘤相关基因,建立理想的动物模型获取可靠的实验样本。方法Balb／c小鼠随机分为检测组（Tester）和驱动组（Driver）,Tester为经口服感染旋毛虫250条、400条和550条组,Driver为不接种组,在感染后11d,两组同时在皮下分别接种SP^2/0细胞2×10^6个,只,检测组和驱动组小鼠荷瘤后,于20d后处死,采集两组肿瘤组织和脾脏组织,用天平称量肿瘤块的重量,游标卡尺测量肿瘤块3个互相垂直直径进行体积比较;为了检测两组小鼠免疫情况,又采用流式细胞术检测体内T淋巴细胞的动态变化,以便评估所需样本的可靠性。结果将肿瘤组织与正常组织分离后,经统计分析比较两组肿瘤块重量和体积大小的差异均极为显著（P〈0．01）通过检测T淋巴细胞亚类,FACS共检测1×10^5个细胞,分别得到脾细胞中CD3^＋、CD4^＋和CD8^＋T淋巴细胞的数量,感染组小鼠机体的CD3^＋、CD4^＋、CD8^＋和CD4^＋／CD8^＋显著增高,在接种不同剂量的旋毛虫后荷瘤,小鼠脾脏特异的T淋巴细胞亚类：CD3^＋差异显著（P〈0．05）;CD4^＋差异显著（P〈0．05）;CD8^＋差异显著（P〈0．05）;CD4^＋／CD8^＋差异显著（P〈0．05）。通过以上指标的测定,我们认为所建立的动物模符合SSH的实验要求。结论建立的旋毛虫抗实体瘤动物模型,可用于旋毛虫抗肿瘤差异基因筛选的实验起始材料,为进一步研究旋毛虫抗肿瘤分子机制创造条件。     

口服卡介菌治疗实验性自身免疫性脑脊髓炎的研究

目的：观察口服卡介菌对实验性变态反应性脑脊髓炎（EAE）的治疗效果。方法：制备EAE大鼠模型,随机分为BCG高、中、低剂量组和PBS对照组,每组各15只,对大鼠治疗后的临床症状及病理组织学进行评估,提取脾脏淋巴细胞,流式细胞术检测T淋巴细胞亚群,3H—TdR掺入法检测淋巴细胞增殖能力。结果：BCG组EAE大鼠与对照组相比,临床症状减轻,发病时间延迟,炎性细胞浸润数减少;急性期,口服BCG各组CD4^＋、CD8^＋T细胞的数量随剂量增加而增加,缓解期CD4^＋、CD8^＋T细胞数量减少;口服BCG可促进EAE大鼠T淋巴细胞增殖能力;高、中剂量组上述变化均较其它分组明显。结论：口服BCG可很好的诱导免疫耐受,延迟EAE发病,减轻炎症反应,改善临床症状。     

不同临床类型乙型病毒感染者外周血T细胞亚群与血清HBVDNA载量及HBeAg滴度相关性分析

目的：探讨慢性乙型肝炎病毒（HBV）感染患者外周血T细胞亚群与血清HBVDNA载量及HbeAg滴度的关系。方法：选取103名HBV感染患者和20名健康者为研究对象。流式细胞术检测外周血T细胞亚群,聚合酶链式反应及酶免疫分析法分别检测血清HBVDNA载量及HbeAg滴度。结果：慢性乙型肝炎患者和慢性HBV携带者外周血CD3可、CD4T淋巴细胞亚群百分数低于健康对照组,结果有统计学意义（P〈0．05或0．01;而CD8＋T细胞亚群则呈现相反趋势,结果亦有统计学意义（P〈0．05或0．01）。HBeAg阴性组中,HBVDNA水平与CD8T细胞亚群百分数呈正相关（r=0．567,P〈0．01）,与CD47CD8＋T细胞亚群百分数比值呈负相关（r=-0．601,P〈0．01）,而与CD3＋T、CD4＋T细胞亚群百分数无相关性。HBeAg阳性组中,HBVDNA水平及HbeAg滴度与cD3＋1r、cD41、CD8叮细胞百分数及CD47CD8＋T细胞百分数均无相关性（P〉0．05）。结论：不同临床类型的慢性乙型肝炎病毒感染患者外周血T细胞亚群存在不同程度细胞免疫功能降低和细胞免疫调节异常。HbeAg阴性的HBV感染患者,其血清HBVDNA水平与外周血T淋巴细胞免疫存在相关性。     

微甘菊次生代谢产物的免疫学活性研究

为了探讨微甘菊次生代谢产物的免疫学活性,用微甘菊水溶性和脂溶性提取物喂食小鼠,用流式细胞仪测定小鼠T淋巴细胞亚群的变化规律,分析微甘菊提取物的免疫学活性。结果显示,微甘菊水溶性和脂溶性提取物均能刺激小鼠CD4^ 和CD8^ 细胞的产生,与对照相比,CD4^ ／CD8^ 比值均明显增加,水溶性提取物的效果更明显。微甘菊次生代谢产物中可能含有某些刺激动物免疫活性和提高抗癌能力的物质。     

梅毒患者外周血淋巴细胞亚群测定的意义

目的检测HIV阴性隐性梅毒患者外周血T淋巴细胞亚群及NK淋巴细胞的比例,并探讨其临床意义.方法应用流式细胞仪检测43例未经治疗的隐性梅毒患者和46例已经数疗程驱梅治疗但RPR持续阳性2年以上的隐性梅毒患者外周血T淋巴细胞亚群及NK淋巴细胞的比例,并与30例健康人群的检测结果相对照.结果1.未经治疗的隐性梅毒患者和已经治疗但RPR持续阳性2年以上的隐性梅毒CD3、CD4及NK淋巴细胞的比例分别与健康人群的检测结果相比,差异均无显著性(P＞0.05);未经治疗的隐性梅毒患者CD8淋巴细胞的比例明显高于对照组(P＜0.001);已经治疗但RPR持续阳性2年以上的隐性梅毒患者CD8淋巴细胞的比例高于对照组(P＜0.05);未经治疗的隐性梅毒患者CD4/CD8的比率明显低于对照组(P＜0.001),而已经治疗但RPR持续阳性2年以上的隐性梅毒患者CD4/CD8的比率与对照组相比差异无显著性(P＞0.05);2.未经治疗的隐性梅毒患者和已经治疗但RPR持续阳性2年以上的隐性梅毒患者的检测结果相比,CD3、CD4及NK淋巴细胞的比例及CD4/CD8的比率差异无显著性(P＞0.05);未经治疗梅毒患者CD8淋巴细胞比例高于已经治疗但RPR持续阳性2年以上的隐性梅毒患者(P＜0.05).结论未经治疗的隐性梅毒患者和已经治疗但RPR持续阳性2年以上的隐性梅毒患者均存在细胞免疫不平衡和免疫抑制,这种异常可降低机体抵抗和消除梅毒螺旋体感染的能力,并且可能是梅毒患者难于治愈,RPR持续阳性的主要原因.     

Gastric mucosal changes induced by long term infection with Helicobacter pylori in Mongolian gerbils: effects of bacteria eradication.

Helicobacter pylori infection has been reported to induce various mucosal changes, including gastric adenocarcinoma, in Mongolian gerbils 62 weeks after inoculation. Using Mongolian gerbils, this study examined whether or not eradication of the bacteria with drugs at specified times after infection prevents the development of mucosal changes. After orally inoculating with H. pylori (TN2GF4, vacA- and cagA-positive), the animals were killed 18 months later. Four or 8 months after H. pylori inoculation, eradication was performed by concurrent treatment with omeprazole+clarithromycin. Immediately after treatment ended, in both the 5 and 9 month groups, it was verified that H. pylori was completely eradicated. Autopsy performed 18 months after H. pylori inoculation revealed gastric hyperplastic polyps with erosive lesions and ulcers that were grossly visible in the non-treated control group. In addition, atrophic gastritis, intestinal metaplasia, carcinoids, and adenocarcinomas were histologically observed in the animals. In animals eradicated after 4 months and autopsied after 18 months, however, such mucosal changes were not observed. In contrast, intestinal metaplasia and mucosal atrophy was observed in animals eradicated after 8 months and autopsied after 18 months. It was concluded that early eradication of H. pylori infection with drug therapy can prevent severe gastric mucosal changes, to include adenocarcinomas, in Mongolian gerbils.     

Proof of an association between Helicobacter pylori and idiopathic thrombocytopenic purpura in Latin America

BACKGROUND: Association between Helicobacter pylori and idiopathic thrombocytopenic purpura (ITP) has been found in Japan and in some European countries. It has also been shown that eradication of H. pylori can increase platelet counts in patients with ITP. The aims of this study were to determine the prevalence of H. pylori infection in patients with ITP in Colombia, and the effect of bacterial eradication on their platelet counts. MATERIALS AND METHODS: Between December 1998 and April 2006, a total of 32 patients diagnosed with ITP were included in the study. Controls were age and sex matched. RESULTS: H. pylori infection in patients with ITP was significantly higher (p = .00006) than in control individuals (90.6% and 43.8%, respectively), as determined by (13)C-urea breath test. A significant association between H. pylori infection and ITP was found (p < .0003), with an odds ratio (OR) of 13.15 (95%CI: 3.24-53.29). Multivariate analysis for the association between H. pylori and ITP showed an OR of 20.44 (95%CI: 3.88-107.49) for women and 19.28 (95%CI: 2.03-183.42) for individuals over 50 years. All 29 H. pylori-positive patients with ITP received eradication treatment. After a median follow up of 12.2 months, 80.8% had a recovery in platelet counts. CONCLUSIONS: According to these results and others from different countries where H. pylori infection rates are high, patients with ITP should be initially tested for H. pylori status, and if present, infection should be eradicated before initiating a drastic conventional ITP treatment. An algorithm for the study and management of patients with ITP in the post-Helicobacter era is presented.     

The isolation and characterization of the human helper inducer T cell subset

Monoclonal antibody anti-4B4 was produced by fusing NS1 myeloma with spleen cells of a mouse immunized with Saguinus oedipus lymphocyte. This anti-4B4 antibody defines a 135-KD cell surface protein that is widely distributed throughout the hematopoietic system. More importantly, anti-4B4 is reactive with functionally unique human T cell subsets. Anti-4B4 antibody was reactive with approximately 41% of unfractionated T cells, 41% of T4+ inducer cells, and approximately 43% of T8+ cytotoxic/suppressor population. This antibody subdivided peripheral blood T4+ cells into two functionally distinct populations. The T4+4B4+ subset proliferates relatively poorly upon stimulation with Con A and autologous cell antigens (AMLR) but well on exposure to soluble antigens, and it provides a good helper signal for PWM-induced Ig synthesis. The T4+4B4- subset, in contrast, proliferates well to Con A stimulation and autologous cell antigen (AMLR) but relatively poorly to soluble antigen stimulation, and provides little help to B cells for PWM-induced Ig synthesis. The T4+4B4- subset is largely 2H4+ and functions as the inducer of the T8+ suppressor cells. Thus, the present results suggest that one can divide the human T4 population into two major subsets that are phenotypically and functionally distinct, the human helper inducer subset (T4+4B4+/H.I.) and its reciprocal population defined by anti-2H4, the suppressor inducer subset (T4+2H4+/S.I.).     

Increase of antigen-presenting cells in the gastric mucosa of Helicobacter pylori-infected children

BACKGROUND: Infection with Helicobacter pylori leads to an increase of T cells in the gastric mucosa of children. In contrast to peripheral blood, where monocytes are the most abundant antigen-presenting cells, CD14+ macrophages are very rare in infected gastric mucosa. We postulated that other types of antigen-presenting cells must be present in infected gastric mucosa. MATERIAL AND METHODS: Antral biopsies were obtained from 56 children. The cellular expression of major histocompatibility complex (MHC) class II molecules, CD1a/b, and CD23, which are involved in antigen presentation were analyzed by immunohistochemistry. In addition, T cells (CD4, CD8, CD25, and gamma/delta-TCR), B cells (anti-IgM), macrophages (CD14) and granulocytes (CD15) were quantified. RESULTS: Twenty-eight children were H. pylori-infected. Thirteen children were healthy, 15 had other gastric pathologies. T cells (p<.0001), B cells (p<.0001), CD23+ (p<.0001), and CD1a/b+ (p<.005) cells were significantly increased in the lamina propria of H. pylori-infected children, whereas macrophages were rare without significant differences among the groups. Within the epithelium, CD8+ T lymphocytes predominated clearly over CD4+ cells. H. pylori-negative children had only few MHC class II-positive cells within the gastric epithelium, whereas MHC class II antigens were strongly expressed on epithelial cells (p<.0001) of all H. pylori-infected children. CONCLUSION: Helicobacter pylori infection leads to an enhanced expression of antigen-presenting molecules together with a parallel rise of T cells in the lamina propria. This may represent an effort of the immune system to optimize local immune responses against H. pylori. We speculate that the epithelium participates in the initiation of a local immune response against H. pylori.     

肠道菌群与过敏性紫癜性肾炎患儿肾功能及免疫功能的相关性研究

探讨肠道菌群与过敏性紫癜性肾炎患儿肾功能及免疫功能的相关性研究。

选取2021年9月—2023年9月于本院治疗的85例过敏性紫癜性肾炎患儿,标记为研究组。并纳入同期进行健康体检的68例同年龄段健康儿童作为对照组。采集患者空腹静脉血和粪便,采用qRT-PCR法定量分析肠道中大肠杆菌和双歧杆菌的数量,计算双歧杆菌/大肠杆菌（B/E）比值。使用全自动特定蛋白分析系统ARRAY360和流式细胞仪检测IgM、IgG、IgA、外周血CD4⁺ T淋巴细胞和CD8⁺ T淋巴细胞,计算CD4⁺/CD8⁺比值。过敏性紫癜性肾炎患儿肠道菌群与肾功能及免疫功能之间的相关性分析采用Pearson分析。

两组的性别、年龄、体质量指数差异均无统计学意义（P＜0.05）。与对照组相比,研究组大肠杆菌数量增加（P＜0.05）,血肌酐、尿素氮、血清尿酸、IgM、IgG、IgA、CD8⁺ T细胞水平升高（P＜0.05）,但双歧杆菌数量降低（P＜0.05）,B/E比值、CD4⁺ T细胞、CD4⁺/CD8⁺比值显著降低（P＜0.05）。过敏性紫癜性肾炎患儿肠道中的大肠杆菌数量分别与血肌酐、尿素氮、血清尿酸、IgM、IgG、IgA、CD8⁺ T细胞水平呈正相关（P＜0.001）,与CD4⁺ T细胞水平、CD4⁺/CD8⁺比值呈负相关（P＜0.001）;双歧杆菌、B/E比值分别与血肌酐、尿素氮、血清尿酸、IgM、IgG、IgA、CD8⁺ T细胞水平呈负相关（P＜0.001）,与CD4⁺ T细胞、CD4⁺/CD8⁺比值呈正相关（P＜0.001）。

过敏性紫癜性肾炎患儿肠道B/E比值显著降低,并与其肾功能及免疫功能指标存在相关性。

     

Helicobacter pylori infection and immune thrombocytopenic purpura: an update

Data are accumulating on the association between Helicobacter pylori infection and idiopathic thrombocytopenic purpura (ITP) and the significant increase in platelet count after bacterial eradication. The aim of this review was to consider the studies so far published on H. pylori infection and ITP in order to evaluate a possible correlation between these two conditions. A review of the literature showed that 278 out of the 482 ITP patients investigated (58%) were positive for H. pylori infection and that the bacterium was eradicated in 88% of cases. Eradication therapy was accompanied by a complete or partial platelet response in approximately half the cases. Overall, these data show that H. pylori eradication in patients with ITP is effective in increasing platelet count. However, because the studies so far published are few, are sometimes controversial and involve small series of patients, further studies on larger numbers of patients with longer follow-up are needed to confirm these preliminary findings.     

Direct demonstration of the human suppressor inducer subset by anti-T cell antibodies

Prior studies indicated that sera of patients with active juvenile rheumatoid arthritis (JRA) contain anti-T cell antibodies reactive with the T4+ inducer population. More important, depletion of this T cell subset with JRA anti-T cell antibodies (JRA+ T cells) and C abrogated T5/T8+ suppressor T cell function. In the present study, we utilized Ig-coated plate techniques and JRA anti-T cell antibodies to fractionate the T4+ population into T4+JRA+ and T4+JRA- subsets and characterize the individual T4+ inducer subset. It was shown that whereas only the T4+JRA- population responded maximally to the soluble antigens, TT and mumps, both T4+JRA+ and T4+JRA- subsets proliferated equally well to mitogens and alloantigens. Furthermore, B cell immunoglobulin production induced by T4+JRA- T cells was approximately twice that induced by the reciprocal T4+JRA+ subset. In contrast, the T4+JRA+ subset alone activated T8+ T cells to become suppressor effector cells. These results suggest that the T4+JRA+ subset is the inducer of suppressor subpopulation whereas the T4+JRA- subset functions maximally as the inducer of B cells. It is believed that the suppressor inducer population may have a central role in the immunoregulatory network in man.     

Contributions of T Lymphocyte Abnormalities to Therapeutic Outcomes in Newly Diagnosed Patients with Immune Thrombocytopenia

T cell abnormalities have been reported to play an important role in pathogenesis of immune thrombocytopenia (ITP) besides specific autoantibodies towards platelet. The aim of this study was to explore the clinical importance of T lymphocyte subsets in adult patients with newly diagnosed ITP before and after first-line treatment. Elderly ITP patients were also studied and we tried to analyze the relationships between these items and therapeutic outcomes. The patients were treated with intravenous immunoglobulin (IVIG) plus corticosteroids and therapeutic responses were evaluated. As a result, compared with the controls, absolute lymphocyte counts in ITP patients decreased significantly before treatment. After treatment, lymphocyte counts restored to control level regardless of their treatment outcomes. In addition, we observed increased IgG and CD19⁺ cell expression and decreased CD4⁺/CD8⁺ cell ratio in both whole ITP group and elderly group before treatment. After treatment, the increased IgG and CD19⁺ cell expression could be reduced in both respond and non-respond group regardless of patient age, while CD4⁺/CD8⁺ cell ratio could not be corrected in non-respond ITP patients. In non-respond ITP patients, increased CD8⁺ cell expression was noticed and could not be corrected by first-line treatment. Furthermore, even lower NK cell expression was found in non-respond elderly patients after treatment when compared with that in controls. Our findings suggest that ITP patients usually had less numbers of peripheral lymphocytes and patients with higher levels of CD8⁺ cells or lower levels of CD4⁺/CD8⁺ cell ratio were less likely to respond to first-line treatment. Lower levels of NK cells made therapies in elderly ITP patients even more difficult.