维生素D缺乏与儿童反复呼吸道感染的关系及机制

呼吸道感染是常见的儿科疾病,有着显著的发病率和死亡率,反复呼吸道感染会严重影响儿童的生活质量和身体健康。维生素D具有一系列与人体健康有关的作用,包括与呼吸道的感染有关。为了分析维生素D与儿童反复呼吸道感染的关系,探讨维生素D影响呼吸道感染的机制,本研究通过临床分析了维生素D缺乏与儿童反复呼吸道发生之间的相关性,通过构建炎症模型,观察了外源维生素D对人气道上皮细胞增殖分化的影响,运用ELISA检测了维生素D对人气道上皮细胞和中性粒细胞释放炎症因子(IL-1β,IL-6和TNF-α)的影响。本结果表明,维生素D缺乏与儿童反复呼吸道感染相关,并且维生素D能促进人气道上皮细胞的增殖分化,但对人气道上皮细胞和中性粒细胞炎症因子的产生无显著影响。     

适当浓度的过氧化氢诱导人支气管上皮细胞发生钙振荡

包括过氧化氢（Hzoz）在内的活性氧通过引起细胞内钙的变化而造成细胞损伤。然而,不同浓度的H202可以导致细胞内不同的钙变化,并激活不同的信号通路。细胞内钙振荡是其中的一种钙信号变化形式,钙振荡可以调控转录因子NF—KB的活性。该研究探讨可以诱导支气管上皮细胞内钙振苏发生的H2o2浓度。体外培养人支气管上皮细胞,采取钙离子荧光探针Fura_2标记细胞。并使用离子成像系统,观测不同浓度的H：0：（0～1000μmol／L）作用下细胞内钙浓度的变化。结果发现,低于50μmol／L的H202仅仅引起“钙火花”;50～500μmol／L的H202导致细胞内钙振荡的发生;而1000μmol／L的H202引起细胞内持续的高钙;同时也证实150μmol／L的H202诱发明显的钙振荡,而钙振荡随后引起了NF—KB活性的升高。该研究提示,适当浓度的H：0：可以诱发支气管上皮细胞内钙振荡的发生,推测可能是活性氧导致慢性气道炎症损伤的一个机制。     

先天性支气管动脉-肺动脉瘘儿童咯血的介入治疗临床分析

目的:总结先天性支气管动脉-肺动脉瘘患儿的临床特点及诊治经验,探讨介入治疗支气管动脉-肺动脉瘘所致咯血的安全性及有效性。方法:回顾性分析我院自2009年7月至2017年6月收治的先天性支气管动脉-肺动脉瘘所致咯血患儿36例,行支气管动脉数字减影血管造影(DSA),选择300-700μm聚乙烯醇(PVA)微栓颗粒或微球颗粒行支气管动脉栓塞术治疗,评价疗效,患者在术后1个月、3个月、半年、1年门诊复查。结果:多层螺旋CT血管造影(MSCTA)显示支气管动脉-肺动脉瘘直接征象的诊出率为55.5%(20/36),16例为假阴性(44.4%),未发现假阳性病例;36例患者栓塞术后治疗即刻成功率为100%,复发率13.9%(5/36),复发时间出现于术后2-6个月,表现为再次咯血,但咯血量较初次封堵前减少,均行二次栓塞术。结论:介入治疗对于支气管动脉-肺动脉瘘所致咯血是一种创伤小、操作简便、疗效明确、并发症少的治疗方法。为进一步减少复发风险,患者术前应仔细进行MSCTA检查,行全面DSA下血管造影,根据患者病变血管情况选择合适的永久栓塞剂,运用恰当的栓塞技术。     

Particulate matter 2.5 induced bronchial epithelial cell injury via activation of 5′-adenosine monophosphate-activated protein kinase-mediated autophagy

The impact of particulate matter 2.5 (PM2.5) on the respiratory system is a worldwide concern. However, the mechanisms by which PM2.5 causes disease are still unclear. In this study, we investigated the effect of PM2.5 on autophagy and studied the effect of PM2.5-induced autophagy and 5′-adenosine monophosphate-activated protein kinase (AMPK) on cell proliferation, cell cycle, apoptosis, reactive oxygen species (ROS), and airway inflammation using human bronchial epithelial cells 16HBE140 cells. Results showed that exposure of cells to PM2.5 at a concentration of 100 μg/mL for 24 hours was most effective for inhibiting cell viability. PM2.5 induced cell arrest in the G0/G1 phase and increased mitochondrial membrane potential, ROS, and cell apoptosis with increasing concentration. PM2.5 downregulated cyclin D and matrix metallopeptidase-9 (MMP-9) expression but upregulated tissue inhibitor of metalloproteinases-1 (TIMP-1) expression, significantly promoted interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) production, and enhanced the level and activation of AMPK. The levels of autophagy-related protein 5 (ATG5), Beclin-1, and LC3II/I were significantly increased by PM2.5. The activation of Unc-51-like autophagy activating kinase 1 was significantly inhibited by PM2.5. Moreover, ATG5 knockdown inhibited PM2.5-induced autophagy, ROS, and cell apoptosis significantly. The expression of cyclin D, MMP-9, and TIMP-1 was reversed by ATG5 suppression. PM2.5-induction of IL-6 and TNF-α was significantly inhibited by knockdown of ATG5. Thus, inhibition of autophagy protected the cells from PM2.5-induced injury. PM2.5 induced injury in human bronchial epithelial cells via activation of AMPK-mediated autophagy, suggesting possible therapeutic targets for the treatment of respiratory diseases.     

Effects of catalpol on bronchial asthma and its relationship with cytokines

An animal (BALB/c mice) model of catalpol associated with bronchial asthma in vivo was established, and the effects of catalpol and its relationship with cytokines were investigated. A total of 30 adult BALB/c mice were randomly divided into a positive control group, a model group, and a catalpol group, with 10 mice in each group. The lung function of mice, the cell count, and the cytokine concentrations in bronchoalveolar lavage fluid (BALF) were detected. The levels of cytokines [interleukin 4 (IL-4), interleukin 5 (IL5), and interferon gamma (IFN-γ)] in BALF were measured with enzyme-linked immunosorbent assay methods. The total number of cells in the BALF of the group treated with catalpol was significantly lower than the model group. After treatment with catalpol, the eosinophils and neutrophils of the mice were remarkably reduced compared with the model group. The malondialdehyde content in the lung tissue homogenate of the mice was also decreased in the catalpol group. The cytokines IL-5 and IL-4 exhibited a similar tendency: the concentrations of IL-4 and IL-5 for the catalpol group were dramatically decreased compared with the model group. However, the IFN-γ concentration for the catalpol group was higher than the model group. The results indicated that IL-5 may involve in the pathologic process of asthma-like IL-4, and an inflammatory reaction may still exist in the airway during the remission stage of asthma. The imbalances of the cytokine network might be an important molecular basis in the asthma pathogenesis. It is suggested that catalpol may be a potential drug for the clinical treatment of asthma.     

纤维连接蛋白对支气管上皮细胞抗氧化损伤保护作用的研究

目的和方法：为验证整合素分子激活对支气管上皮细胞（BEC）的抗氧化性保护作用,本实验用臭氧（O3）攻击培养的兔BEC,测定细胞的^3H释放率、乳酸脱氢酶（LDH）释放活性及脂质过氧化产物丙二醛（MDA）含量,反映细胞损伤程度;观察纤维连接蛋白（Fn）及人工合成的精－甘－天冬氨酸片段（RGD肽）的保护效应。结果：①臭氧攻击使BEC的^3H释放率增高,Fn处理可减少臭氧所致的^3H释放,钙调素抑制剂W7能抑制Fn的这一作用,RGD可减轻臭氧所致的^3H释放;②臭氧攻击后细胞上清液中LDH释放增多,Fn或RGD处理均能降低LDH释放,W7阻断Fn的这一效奕;③臭氧作用后明显提高细胞内MDA含量,Fn或RGD可降低MDA含量;④臭氧攻击使细胞内GSH含量下降,Fn或RGD可增加BEC内GSH的含量;⑤Fn可增强BEC内过氧化氢酶（CAT）活性,但可被W7阻断,RGD则显示有剂量依赖性促进作用。结论：Fn及其特异识别片段与BEC的整合素分子结合后,可减轻臭氧对BEC细胞的损伤,其机理与经钙调素途径上调BEC抗氧化能力有关。     

肺内调节肽对兔支气管上皮细胞与嗜酸性粒细胞粘附功能的影响及机制探讨

为了探讨肺内调节肽在各类过敏性炎症发生,发展中的作用,我们观察了血管活性肠肽（vasoactive intestinal peptide,VIP)、表皮生长因子（epidermal growth factor,EGF)、内皮素-1（endothelin-1,ET-1)、降钙素基因相关肽（calcitonin gene-related peptide,CGRP)在未受应激与臭氧应激两种条件下对支气管上皮细胞（bronchial epithelial cell,BEC)与嗜酸性粒细胞（eosinophil,EOS)粘附的影响,结果发现,VIP、EGF可使O3应激的BEC与EOS的粘附率下降,下调气道上皮炎症反应：ET-1、CGRP可使未受应激的BEC与EOS的粘附率增加,诱发炎症损伤反应;CGRP还能加重臭氧的应激反应;ET-1、CGRP的效应可被W7、H7阻断,抗细胞间粘附分子-1（intercel-lular adhesion molecule,ICAM-1)抗体能阻断BEC与EOS的粘附,提示介导BEC与EOS粘附的粘附分子可能是ICAM-1。     

Non-small-cell lung carcinoma cells invade human bronchial mucosa In vitro

Summary To study invasion of lung cancer in vitro a novel three-dimensional coculture assay consisting of living human tissues has been developed. Multicellular spheroids initiated from a new large-cell lung carcinoma cell line (GaL23), found to be invasive in immunodeficient mice, were confronted with precultured bronchial fragments derived from mucosal biopsies obtained during routine fiberoptic bronchoscopy. The bronchial fragments consist of a stromal core with scattered fibroblasts covered by a continuous surface epithelium resting on a basal lamina. During the first 2 wk of confrontation, a gradual retraction of the bronchial epithelium with subsequent adhesion of the tumor cells to the underlying basal lamina occurred. The following week, a limited invasion of tumor cells into the bronchial stroma was seen. To facilitate the entrance of tumor cells through the mucosal surface, the surface epithelium was removed prior to coculture by ethylenediaminetetraacetic acid (EDTA) buffer treatment. Upon confrontation, GaL23 cells then rapidly attached to and migrated on the exposed basal lamina and an increasing number of tumor cells was seen in the stroma during the first week of culture. This model offers opportunities for studying mechanisms of lung cancer adhesion, migration, and invasion using human bronchial mucosa as the natural target tissue.     

Development of motavizumab, an ultra-potent antibody for the prevention of respiratory syncytial virus infection in the upper and lower respiratory tract

Respiratory syncytial virus (RSV) is the leading cause of viral bronchiolitis and pneumonia in infants and children. Currently, palivizumab is the only approved monoclonal antibody (mAb) for prophylaxis of RSV. However, a small percentage of patients are not protected by palivizumab; in addition, palivizumab does not inhibit RSV replication effectively in the upper respiratory tract. We report here the development and characterization of motavizumab, an ultra-potent, affinity-matured, humanized mAb derived from palivizumab. Several palivizumab variants that enhanced the neutralization of RSV in vitro by up to 44-fold were generated; however, in vivo prophylaxis of cotton rats with these antibodies conferred only about a twofold improvement in potency over palivizumab. This unexpected small increase of in vivo potency was caused by poor serum pharmacokinetics and lung bio-availability that resulted from unexpectedly broad tissue binding. Subsequent analyses revealed that changes at three amino acids arising from the affinity maturation markedly increased the non-specific binding to various tissues. Our results suggested that k(on)-driven mutations are more likely to initiate non-specific binding events than k(off)-driven mutations. Reversion of these three residues to the original sequences greatly diminished the tissue binding. The resulting mAb, motavizumab, binds to RSV F protein 70-fold better than palivizumab, and exhibits about a 20-fold improvement in neutralization of RSV in vitro. In cotton rats, at equivalent concentrations, motavizumab reduced pulmonary RSV titers to up to 100-fold lower levels than did palivizumab and, unlike palivizumab, motavizumab very potently inhibited viral replication in the upper respiratory tract. This affinity-enhanced mAb is being investigated in pivotal clinical trials. Importantly, our engineering process offers precious insights into the improvement of other therapeutic mAbs.