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Autoantibodies against cytochrome P450s in sera of children treated with immunosuppressive drugs 免疫抑制药物治疗儿童血清抗细胞色素p450自身抗体的研究
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01754.x
S. Lytton, U. Berg, A. Németh, M. Ingelman-Sundberg
Treatment with the immunosuppressive drugs cyclosporin and tacrolimus, the mainstays of anti‐graft rejection and autoimmune disease therapy, is limited by their hepato‐ and nephrotoxicity. The metabolic conversion of these compounds to more easily excretable products is catalysed mainly by hepatic cytochrome P4503A4 (CYP3A4) but also involves extrahepatic CYP3A5 and other P450 forms. We set out to study whether or not exposure to cyclosporin and FK506 in children undergoing organ transplantation leads to formation of autoantibodies against P450s. Immunoblotting analysis revealed anti‐CYP reactivity in 16% of children on CyA for anti‐graft rejection or treatment of nephrosis (n = 67), 31% of kidney transplant patients switched from CyA to FK506 (n = 16), and 21% of kidney and or liver transplant patients on FK506 (n = 14). In contrast, the frequency of reactive immunoblots was only 8·5% among the normal paediatric controls (n = 25) and 7% among adult kidney transplant patients on CyA or FK506 (n = 30). The CYP2C9+ sera were able to immunoprecipitate in vitro translated CYP2C9 and the immunoblot reactivity showed striking correlation to peaks in the age at onset of drug exposure. Sera were isoform selective as evidenced from Western blotting using human liver microsomes and heterologously expressed human P450s. These findings suggest that anti‐cytochrome P450 autoantibodies, identified on the basis of their specific binding in immunoblots, are significantly increased among children on immunosuppressive drugs and in some cases are associated with drug toxicity and organ rejection.
免疫抑制药物环孢素和他克莫司是抗移植排斥反应和自身免疫性疾病治疗的主要药物,由于其肝和肾毒性而受到限制。这些化合物代谢转化为更容易排泄的产物主要由肝细胞色素P4503A4 (CYP3A4)催化,但也涉及肝外CYP3A5和其他形式的P450。我们着手研究接受器官移植的儿童暴露于环孢素和FK506是否会导致针对p450的自身抗体的形成。免疫印迹分析显示,16%接受CyA治疗的儿童(n = 67)具有抗CYP反应性,31%的肾移植患者从CyA转向FK506 (n = 16), 21%的肾和/或肝移植患者接受FK506 (n = 14)。相比之下,在正常儿童对照组(n = 25)中,反应性免疫印迹的频率仅为8.5%,在使用CyA或FK506的成人肾移植患者(n = 30)中,反应性免疫印迹的频率仅为7%。CYP2C9+血清能够免疫沉淀体外翻译的CYP2C9,免疫印迹反应性与药物暴露开始年龄的峰值有显著的相关性。通过使用人肝微粒体和异源表达的人p450进行Western blotting,证明了血清具有异构体选择性。这些发现表明,抗细胞色素P450自身抗体(基于其在免疫印迹中的特异性结合)在使用免疫抑制药物的儿童中显著增加,在某些情况下与药物毒性和器官排斥有关。
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引用次数: 22
Monocyte intracellular cytokine production during human endotoxaemia with or without a second in vitro LPS challenge: effect of RWJ‐67657, a p38 MAP‐kinase inhibitor, on LPS‐hyporesponsiveness 在有或没有第二次体外LPS刺激的人内毒素血症中,单核细胞内细胞因子的产生:p38 MAP激酶抑制剂RWJ‐67657对LPS低反应性的影响
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01765.x
M. Faas, H. Moes, J. Fijen, A. Kobold, J. Tulleken, J. Zijlstra
In the present study, we investigated the effect of RWJ‐67657, a p38 MAP kinase inhibitor, upon in vivo LPS‐induced monocyte cytokine production and upon monocyte LPS‐hyporesponsiveness. Thirty minutes before a single injection of LPS (4 ng/kg BW), healthy male volunteers received a single oral dose of RWJ‐67657 at increasing dosages (0–1400 mg). Blood samples (pre‐medication, 3, 6 and 24 h after LPS) were immediately incubated with LPS (reflecting LPS‐hyporesponsiveness) or without LPS (reflecting in vivo monocyte stimulation) for 4 h at 37°C. Following red blood cells lysis and white blood cell permeabilization, cells were labelled with α‐CD14‐FITC and α‐IL‐1β, α‐IL‐12 or α‐TNFα (PE‐labelled), fixed, and analysed using flow cytometry. In vivo LPS injection resulted in an increased percentage of circulating monocytes producing IL‐1β, TNFα and IL‐12 only at 3 h after the LPS injection. This was dose‐dependently inhibited by RWJ‐67657 treatment. LPS‐hyporesponsiveness to in vitro LPS treatment was most prominent at 3 and 6 h after the in vivo LPS injection; compared with pre‐medication monocytes, at these intervals a reduced percentage of monocytes produced IL‐1β, TNFα or IL‐12 after the in vitro LPS stimulus. At t = 6 h, this LPS‐hyporesponsiveness could dose‐dependently be inhibited by RWJ‐67657 treatment of the volunteers. We therefore conclude that p38 MAP kinase inhibition with RWJ‐67657 inhibited monocyte production of cytokines following in vivo LPS injection. Treatment with RWJ‐67657 also reversed the LPS‐hyporesponsiveness. Whether this result can be extended to the clinical situation remains to be elucidated. Patients with sepsis or an otherwise high risk for multi‐organ failure are potential study groups.
在本研究中,我们研究了p38 MAP激酶抑制剂RWJ‐67657对体内LPS诱导的单核细胞因子产生和单核细胞LPS低反应性的影响。在单次注射LPS (4 ng/kg BW)前30分钟,健康男性志愿者接受RWJ‐67657单次口服,剂量逐渐增加(0-1400 mg)。血液样本(给药前,LPS后3、6和24小时)立即用LPS(反映LPS低反应性)或不加LPS(反映体内单核细胞刺激)在37°C下孵育4小时。在红细胞裂解和白细胞渗透后,细胞用α‐CD14‐FITC和α‐IL‐1β、α‐IL‐12或α‐TNFα (PE‐标记)进行标记,固定,并用流式细胞术进行分析。体内注射LPS后,仅在注射后3小时,循环单核细胞产生IL - 1β、TNFα和IL - 12的百分比增加。RWJ - 67657治疗可剂量依赖性地抑制这一现象。LPS‐对体外LPS处理的低反应性在体内LPS注射后3和6小时最为明显;与用药前的单核细胞相比,体外LPS刺激后产生IL - 1β、TNFα或IL - 12的单核细胞百分比降低。在t = 6 h时,RWJ - 67657可以剂量依赖性地抑制LPS -低反应性。因此,我们得出结论,RWJ‐67657抑制p38 MAP激酶抑制体内LPS注射后单核细胞产生细胞因子。RWJ - 67657治疗也能逆转LPS -低反应性。这一结果是否可以推广到临床情况还有待阐明。脓毒症或其他多器官衰竭高风险患者是潜在的研究对象。
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引用次数: 44
Age‐dependent preference in human antibody responses to Streptococcus pneumoniae polypeptide antigens 人对肺炎链球菌多肽抗原抗体反应的年龄依赖性偏好
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01745.x
S. Lifshitz, R. Dagan, M. Shani-Sekler, N. Grossman, G. Fleminger, M. Friger, Y. M. Nebenzahl
Vulnerability to Streptococcus pneumoniae is most pronounced in children. The microbial virulence factors and the features of the host immune response contributing to this phenomenon are not completely understood. In the current study, the humoral immune response to separated Strep. pneumoniae surface proteins and the ability to interfere with Strep. pneumoniae adhesion to cultured epithelial cells were analysed in adults and in children. Sera collected from healthy adults recognized Strep. pneumoniae separated lectin and nonlectin surface proteins in Western blot analysis and inhibited on average 80% of Strep. pneumoniae adhesion to epithelial cells in a concentration‐dependent manner. However, sera longitudinally collected from healthy children attending day care centres from 18 months of age and over the course of the following 2 years revealed: (a) development of antibodies to previously unrecognized Strep. pneumoniae surface proteins with age; (b) a quantitative increase in antibody responses, measured by densitometry, towards separated Strep. pneumoniae surface proteins with age; and (c) inhibition of Strep. pneumoniae adhesion to epithelial cells, which was 50% on average at 18 months of age, increased significantly to an average level of 80% inhibition at 42 months of age equalling adult sera inhibitory values. The results obtained in the current study, from the longitudinally collected sera from healthy children with documented repeated Strep. pneumoniae colonization, show that repeated exposures are insufficient to elicit an immune response to Strep. pneumoniae proteins at 18 months of age. This inability to recognize Strep. pneumoniae surface proteins may stem from the inefficiency of T‐cell‐dependent B‐cell responses at this age and/or from the low immunogenicity of the proteins.
对肺炎链球菌的易感性在儿童中最为明显。导致这一现象的微生物毒力因素和宿主免疫反应的特征尚不完全清楚。在目前的研究中,分离链球菌的体液免疫反应。肺炎表面蛋白和干扰链球菌的能力。分析了成人和儿童肺炎菌对培养上皮细胞的粘附。从健康成人收集的血清中识别出链球菌。在Western blot分析中,肺炎球菌分离了凝集素和非凝集素表面蛋白,平均抑制80%的链球菌。肺炎菌以浓度依赖的方式粘附于上皮细胞。然而,从日托中心18个月大的健康儿童身上纵向收集的血清和随后2年的过程显示:(a)产生了以前未被识别的链球菌抗体。肺炎表面蛋白与年龄的关系;(b)通过密度测定,对分离链球菌的抗体反应定量增加。肺炎表面蛋白与年龄的关系;(c)链球菌的抑制作用。肺炎菌对上皮细胞的粘附,在18个月大时平均为50%,在42个月大时显著增加到80%的平均抑制水平,相当于成人血清的抑制值。目前的研究结果来自于纵向收集的有重复链球菌记录的健康儿童的血清。肺炎定植,表明反复暴露不足以引起对链球菌的免疫反应。18个月大时肺炎蛋白。无法识别链球菌。肺炎表面蛋白可能源于这个年龄的T细胞依赖性B细胞反应的低效率和/或蛋白质的低免疫原性。
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引用次数: 16
Smoking and disease severity are independent determinants of serum adhesion molecule levels in Graves’ ophthalmopathy 吸烟和疾病严重程度是Graves眼病患者血清黏附分子水平的独立决定因素
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01726.x
I. Wakelkamp, M. Gerding, J. V. D. Meer, M. Prummel, W. Wiersinga
Adhesion molecules play a key role in autoimmune disorders, and serum concentrations of soluble adhesion molecules are increased in Graves’ ophthalmopathy (GO). Whether this is due to the strong association with smoking is unknown. It is also not known if the severity or activity of GO determine the serum levels of adhesion molecules. We measured serum concentrations of sICAM‐1, sVCAM‐1 and sELAM‐1 in 62 euthyroid Graves’ patients with untreated GO, in 62 healthy controls matched for sex, age and smoking habits, and in 26 euthyroid Graves’ patients without GO. GO severity was assessed by the Total Eye Score and the activity by the Clinical Activity Score. Adhesion molecules were measured by highly sensitive ELISAs. GO patients had higher levels than controls (median values in ng/ml with range): sICAM‐1 300 [171–575] versus 244 [119–674], P < 0·001; sVCAM‐1 457 [317–1060] versus 410 [238–562], P < 0·001; and sELAM‐1 61 [19–174] versus 53 [23–118], P = 0·021. Euthyroid Graves’ disease patients without GO had levels similar to controls: sICAM‐1 273 138–453), sVCAM‐1 386 [260–1041] and sELAM‐1 46 [22–118]. Smoking had an independent effect and was associated with higher levels of sICAM‐1 and lower levels of sVCAM‐1 in both GO patients and controls; sELAM‐1 levels were comparable. In the 62 GO patients, sICAM‐1 correlated significantly with severity of eye disease (r = 0·40, P = 0·002). No correlation was found with the duration of GO, the Clinical Activity Score or TBII levels. Multivariate analysis of all 150 subjects showed that the presence of GO and smoking are independent determinants of sICAM‐1 and sVCAM‐1 concentrations. In GO patients, the Total Eye Score was a stronger determinant than smoking. It is concluded that (i) smoking is associated with increased sICAM‐1 and decreased sVCAM‐1 levels; (ii) independent from smoking, euthyroid GO patients have higher levels of sICAM‐1, sVCAM‐1 and sELAM‐1 than patients with euthyroid Graves’ disease or healthy controls; (iii) the major determinant of sICAM‐1 in GO patients is the severity of their eye disease.
黏附分子在自身免疫性疾病中起关键作用,Graves眼病(GO)患者血清中可溶性黏附分子浓度升高。这是否与吸烟密切相关尚不清楚。氧化石墨烯的严重程度或活性是否决定黏附分子的血清水平也尚不清楚。我们测量了62例未治疗氧化石墨烯的甲状腺功能正常Graves患者、62例性别、年龄和吸烟习惯相匹配的健康对照以及26例未治疗氧化石墨烯的甲状腺功能正常Graves患者的血清中sICAM‐1、sVCAM‐1和sELAM‐1的浓度。GO的严重程度由总视力评分评估,活动度由临床活动评分评估。采用高灵敏度elisa检测粘附分子。GO患者的水平高于对照组(中位数为ng/ml,有范围):sICAM‐1 300 [171-575]vs . 244 [119-674], P < 0.001;sVCAM‐1 457 [317-1060]vs . 410 [238-562], P < 0.001;sELAM‐1 61[19-174]对53 [23-118],P = 0.021。无氧化石墨烯的甲状腺功能亢进Graves病患者的水平与对照组相似:sICAM‐1 273(138-453)、sVCAM‐1 386(260-1041)和sELAM‐1 46(22-118)。吸烟具有独立的影响,并且在GO患者和对照组中与较高水平的sICAM‐1和较低水平的sVCAM‐1相关;sELAM‐1水平具有可比性。在62例GO患者中,sICAM‐1与眼病严重程度显著相关(r = 0.40, P = 0.002)。未发现与GO持续时间、临床活动评分或TBII水平相关。对所有150名受试者的多变量分析表明,氧化石墨烯和吸烟是sICAM‐1和sVCAM‐1浓度的独立决定因素。在GO患者中,总视力评分是比吸烟更强的决定因素。结论:(1)吸烟与sICAM‐1水平升高和sVCAM‐1水平降低有关;(ii)与吸烟无关,甲状腺功能正常的GO患者的sICAM‐1、sVCAM‐1和sELAM‐1水平高于甲状腺功能正常的Graves病患者或健康对照者;(iii) GO患者中sICAM‐1的主要决定因素是其眼病的严重程度。
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引用次数: 35
Analysis of the B cell repertoire against autoantigens in patients with giant cell arteritis and polymyalgia rheumatica 巨细胞动脉炎和风湿性多肌痛患者抗自身抗原的B细胞库分析
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01751.x
R. Schmits, B. Kubuschok, S. Schuster, K. Preuss, M. Pfreundschuh
The analysis of the antibody repertoire of patients with giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) might identify target antigens of the autoimmune response with potential relevance to our understanding of the pathogenesis of the disease and to the development of serodiagnostic tests. To detect such antigens, we screened a cDNA library derived from normal human testis for antigens reacting with IgG antibodies in the 1 : 250 diluted sera of three patients with untreated GCA using SEREX, the serological identification of antigens by recombinant cDNA expression cloning. Of 100 000 clones screened with each serum, six, 28 and six clones, respectively, were positive, representing a total of 33 different antigens. Most of the antigens reacted only with the serum used for identification and/or at a similar frequency with normal control sera. However, lamin C and the nuclear antigen of 14 kD reacted specifically with 32% of GCA/PMR, but with none of the control sera, while human cytokeratin 15, mitochondrial cytochrome oxidase subunit II, and a new gene product were detected preferentially, but not exclusively by sera from GCA/PMR patients. We conclude that patients with GCA/PMR develop antibodies against a broad spectrum of human autoantigens. Antibodies against human lamin C, the nuclear autoantigen of 14 kD as well as human cytokeratin 15, mitochondrial cytochrome oxidase subunit II and the product of a new gene should be investigated further to determine their value as tools for the diagnosis and/or the definition of clinical subgroups of patients with GCA/PMR.
巨细胞动脉炎(GCA)和风湿性多肌痛(PMR)患者的抗体库分析可能确定自身免疫反应的靶抗原,这可能与我们对疾病发病机制的理解和血清诊断测试的发展有关。为了检测这些抗原,我们从正常人睾丸中提取cDNA文库,用SEREX筛选3例未经治疗的GCA患者1:25 0稀释血清中与IgG抗体反应的抗原,通过重组cDNA表达克隆对抗原进行血清学鉴定。在用每种血清筛选的10万个克隆中,分别有6个、28个和6个克隆呈阳性,共代表33种不同的抗原。大多数抗原仅与用于鉴定的血清和/或与正常对照血清的反应频率相似。然而,层合蛋白C和14 kD核抗原与32%的GCA/PMR特异性反应,但与对照血清无特异性反应,而人细胞角蛋白15、线粒体细胞色素氧化酶亚基II和一种新的基因产物优先被检测到,但不完全被GCA/PMR患者血清检测到。我们得出结论,GCA/PMR患者产生针对广谱人类自身抗原的抗体。针对人纤层蛋白C、核自身抗原14kd、人细胞角蛋白15、线粒体细胞色素氧化酶亚基II和新基因产物的抗体应进一步研究,以确定其作为诊断和/或定义GCA/PMR患者临床亚群的工具的价值。
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引用次数: 47
Increased levels of serum tissue inhibitor of metalloproteinase‐1 but not metalloproteinase‐3 in atopic dermatitis 特应性皮炎患者血清金属蛋白酶- 1组织抑制剂水平升高,而金属蛋白酶- 3不升高
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01740.x
N. Katoh, S. Hirano, M. Suehiro, K. Ikenaga, H. Yasuno
Matrix metalloproteinases and their specific inhibitors, tissue inhibitors of metalloproteinases (TIMPs), contribute to inflammation‐induced tissue destruction and subsequent remodeling for maintenance of tissue homeostasis. Since the production of these enzymes and their inhibitors is regulated by mediators such as proinflammatory cytokines and growth factors, elevated levels of serum TIMPs and/or MMPs have been documented in patients with several inflammatory disorders. In this study, we examined the role of TIMPs and MMPs in the pathogenesis of atopic dermatitis (AD) by evaluating the serum levels of TIMP‐1 and MMP‐3 in 40 patients with AD and 20 control subjects by ELISA. The serum TIMP‐1 levels were significantly higher in AD patients in exacerbation status than in nonatopic subjects, whereas serum MMP‐3 levels were not significantly different between them. As a result, AD patients revealed significantly elevated TIMP‐1/MMP‐3 ratios. The levels of serum TIMP‐1 were significantly reduced in AD patients following conventional treatments. Significantly higher values of peripheral eosinophil counts, serum levels of IgE and lactate dehydrogenase, eruption score, and eruption area were noted in the AD patients with elevated TIMP‐1 levels when compared with those with normal values. Moreover, the points of chronic eruptions such as lichenification and prurigo were significantly higher in the patients with elevated TIMP‐1 levels than those with normal TIMP‐1, while those of acute lesions such as oozy/microvesicles and oedema were not different between these groups. Serum TIMP‐1 level may be a useful marker to estimate the long‐term disease activity of AD.
基质金属蛋白酶及其特异性抑制剂,组织金属蛋白酶抑制剂(TIMPs),有助于炎症诱导的组织破坏和随后的重塑,以维持组织稳态。由于这些酶及其抑制剂的产生受促炎细胞因子和生长因子等介质的调节,在几种炎症性疾病患者中已记录到血清TIMPs和/或MMPs水平升高。在这项研究中,我们通过ELISA检测40例AD患者和20例对照者血清中TIMP‐1和MMP‐3的水平,研究了TIMP和MMPs在AD发病机制中的作用。AD患者在加重状态下的血清TIMP‐1水平明显高于非特应性受试者,而血清MMP‐3水平在他们之间无显著差异。结果显示,AD患者TIMP‐1/MMP‐3比值显著升高。常规治疗后,AD患者血清TIMP‐1水平显著降低。TIMP‐1水平升高的AD患者外周血嗜酸性粒细胞计数、血清IgE和乳酸脱氢酶水平、出疹评分和出疹面积均显著高于正常值的患者。此外,TIMP‐1水平升高的患者的慢性皮疹点(如地衣变和瘙痒)明显高于TIMP‐1水平正常的患者,而急性病变点(如渗出/微泡和水肿)在这两组之间没有差异。血清TIMP‐1水平可能是评估AD长期疾病活动性的有用指标。
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引用次数: 27
Characterization of Herpesvirus saimiri‐transformed T lymphocytes from common variable immunodeficiency patients 猴疱疹病毒转化T淋巴细胞的特性研究
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01716.x
J. A. Cabanillas, R. Cambronero, A. Pacheco-Castro, M. García-Rodríguez, J. M. Martín-Fernández, G. Fontán, J. R. Regueiro
Common variable immunodeficiency (CVID) is a very frequent but heterogeneous syndrome of antibody formation. The primary defect remains unknown, but many reports describe peripheral blood T lymphocyte dysfunctions in a substantial proportion of CVID patients, which may impair T–B cell collaboration. In order to investigate whether such putative defects were intrinsic to T cells or, rather, secondary to quantitative differences in T cell subset distribution, or to other described disorders, we have used Herpesvirus saimiri (HVS) for the targeted transformation of CVID CD4+ and CD8+ T cells and subsequent functional evaluation by flow cytometry of their capacity to generate cell surface (CD154, CD69) or soluble (IL‐2, TNF‐α, IFN‐γ) help after CD3 engagement. Unexpectedly, the results showed that 40 different CVID blood samples exposed to HVS gave rise with a significantly increased frequency to transformed CD4+ T cell lines, compared to 40 age‐matched controls (27%versus 3%, P≤ 0·00002) suggesting the existence of a CVID‐specific signalling difference which affects CD4+ cell transformation efficiency. The functional analysis of 10 CD4+ and 15 CD8+ pure transformed T cell lines from CVID patients did not reveal any statistically significant difference as compared to controls. However, half of the CD4+ transformed cell lines showed CD154 (but not CD69) induction (mean value of 46·8%) under the lower limit of the normal controls (mean value of 82·4%, P≤ 0·0001). Exactly the same five cell lines showed, in addition, a significantly low induction of IL‐2 (P≤ 0·04), but not of TNF‐α or IFN‐γ. None of these differences were observed in the remaining CD4+ cell lines or in any of the transformed CD8+ cell lines. We conclude that certain CVID patients show selective and intrinsic impairments for the generation of cell surface and soluble help by CD4+ T cells, which may be relevant for B lymphocyte function. The transformed T cell lines will be useful to establish the biochemical mechanisms responsible for the described impairments.
常见的可变免疫缺陷(CVID)是一种非常常见但异质性的抗体形成综合征。主要缺陷尚不清楚,但许多报道描述了相当比例的CVID患者外周血T淋巴细胞功能障碍,这可能损害T - b细胞的协同作用。为了研究这些假定的缺陷是T细胞固有的,还是继发于T细胞亚群分布的数量差异,或其他描述的疾病,我们使用猴疱疹病毒(HVS)对CVID CD4+和CD8+ T细胞进行靶向转化,并随后通过流式细胞术评估它们在CD3参与后产生细胞表面(CD154, CD69)或可溶性(IL‐2,TNF‐α, IFN‐γ)帮助的能力。出乎意料的是,结果显示,与40个年龄匹配的对照组相比,暴露于HVS的40个不同的CVID血液样本中转化CD4+ T细胞系的频率显著增加(27%对3%,P≤0.002),这表明存在CVID特异性信号传导差异,影响CD4+细胞转化效率。对来自CVID患者的10个CD4+和15个CD8+纯转化T细胞系的功能分析与对照组相比,没有发现任何统计学意义上的差异。然而,一半的CD4+转化细胞系显示CD154(但不显示CD69)诱导(平均值为46.8%),低于正常对照的下限(平均值为82.4%,P≤0.0001)。此外,同样的5个细胞系显示,IL - 2的诱导水平显著降低(P≤0.04),但TNF - α和IFN - γ的诱导水平不高。在剩余的CD4+细胞系或任何转化的CD8+细胞系中均未观察到这些差异。我们得出结论,某些CVID患者在CD4+ T细胞产生细胞表面和可溶性帮助方面表现出选择性和内在的损伤,这可能与B淋巴细胞功能有关。转化的T细胞系将有助于建立造成上述损伤的生化机制。
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引用次数: 14
Reduced efficacy of treatment of strongyloidiasis in HTLV‐I carriers related to enhanced expression of IFN‐γ and TGF‐β1 HTLV‐I携带者治疗类圆线虫病的疗效降低与IFN‐γ和TGF‐β1表达增强有关
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01733.x
M. Satoh, H. Toma, Yoshiya Sato, M. Takara, Y. Shiroma, S. Kiyuna, K. Hirayama
Strongyloidiasis, a human intestinal infection caused by Strongyloides stercoralis (S. stercoralis), is difficult to cure with drugs. In particular, a decrease of the efficacy of treatment has been reported in patients dually infected with S. stercoralis and human T‐cell leukaemia virus type I (HTLV‐I), both of which are endemic in Okinawa, Japan. However, the factors influencing this resistance remain unclear. In the present study, patients infected with S. stercoralis, with or without HTLV‐I infection, were treated with albendazole, followed up for one year and separated into two groups, cured and non‐cured. The cure rate of S. stercoralis was lower in HTLV‐I carriers (P < 0·05). Serum levels of S. stercoralis‐specific IgA, IgE, IgG, IgG1 and IgG4 antibodies were estimated, and a decrease of IgE (P < 0·05) and an increase of IgG4 (P < 0·05) were observed in the non‐cured group, especially in HTLV‐I carriers. RT‐PCR of cytokines using peripheral blood mononuclear cells revealed that S. stercoralis patients with HTLV‐I showed a high frequency of expression of IFN‐γ and TGF‐β1, whereas those without HTLV‐I showed no expression of these cytokines. IFN‐γ‐ and TGF‐β1‐positive HTLV‐I carriers showed a decrease of IgE (P < 0·05), an increase of IgG4 (P < 0·01) and a lower cure rate (P < 0·01) compared with those who were negative for both cytokines. These results suggest that persistent infection with HTLV‐I affected S. stercoralis‐specific immunity and reduced therapeutic efficacy.
类圆线虫病是一种由粪类圆线虫引起的人类肠道感染,目前很难用药物治愈。特别是,据报道,双重感染粪球菌和人T细胞白血病病毒I型(HTLV - I)的患者治疗效果下降,这两种病毒都是日本冲绳的地方性疾病。然而,影响这种耐药性的因素仍不清楚。本研究采用阿苯达唑治疗伴有或未伴有HTLV - I感染的粪球菌患者,随访1年,分为治愈组和未治愈组。HTLV‐I携带者的粪球菌治愈率较低(P < 0.05)。检测血清粪球菌特异性IgA、IgE、IgG、IgG1和IgG4抗体水平,未治愈组,特别是HTLV - I携带者,IgE降低(P < 0.05), IgG4升高(P < 0.05)。利用外周血单核细胞对细胞因子进行RT - PCR检测发现,携带HTLV‐I的粪球菌患者IFN‐γ和TGF‐β1的表达频率较高,而未携带HTLV‐I的患者则不表达这些细胞因子。IFN‐γ‐和TGF‐β1‐阳性HTLV‐I携带者与两种细胞因子均阴性者相比,IgE降低(P < 0.05), IgG4升高(P < 0.01),治愈率降低(P < 0.01)。这些结果表明,HTLV - 1持续感染会影响粪球菌特异性免疫,降低治疗效果。
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引用次数: 65
Interleukin‐1 receptor antagonist gene polymorphism and mortality in patients with severe sepsis 白细胞介素- 1受体拮抗剂基因多态性与严重脓毒症患者的死亡率
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01743.x
F. Arnalich, D. López-Maderuelo, R. Codoceo, Julia López, L. M. Solís-Garrido, C. Capiscol, C. Fernández‐Capitán, R. Madero, C. Montiel
This study aims to determine the influence of the polymorphism within the intron 2 of the interleukin‐1 receptor antagonist gene (IL‐1RN*) on the outcome of severe sepsis, and to assess its functional significance by correlating this polymorphism with the total production of interleukin‐1 receptor antagonist (IL‐1Ra) protein determined in stimulated peripheral blood mononuclear cells (PBMC). A group of 78 patients with severe sepsis (51 survivors and 27 nonsurvivors) was compared with a healthy control group of 130 blood donors, and 56 patients with uncomplicated pneumonia. We found a significant association between IL‐1RN* polymorphism and survival. Thus, after adjusting for age and APACHE II score, multiple logistic regression analysis showed that patients homozygotes for the allele *2 had a 6·47‐fold increased risk of death (95% CI 1·01–41·47, P = 0·04). Besides, compared with patients homozygous or heterozygous for the allele *1, IL‐1RN*2 homozygotes produced significantly lower levels of IL‐1Ra from their PBMC. Our results suggest that insufficient production of this cytokine might contribute, among other factors, to the higher mortality rate found in severe sepsis patients with the IL‐1RN*2 homozygous genotype.
本研究旨在确定白细胞介素- 1受体拮抗剂基因(IL - 1RN*)内含子2多态性对严重脓毒症预后的影响,并通过将这种多态性与受刺激的外周血单个核细胞(PBMC)中白细胞介素- 1受体拮抗剂(IL - 1Ra)蛋白总量的相关性来评估其功能意义。78名严重脓毒症患者(51名幸存者和27名非幸存者)与130名献血者和56名无并发症肺炎患者组成的健康对照组进行了比较。我们发现IL - 1RN*多态性与生存率之间存在显著关联。因此,在调整年龄和APACHE II评分后,多元logistic回归分析显示,等位基因*2纯合子的患者死亡风险增加6.47倍(95% CI 1.01 - 41.47, P = 0.04)。此外,与等位基因*1纯合子或杂合子的患者相比,IL - 1RN*2纯合子在PBMC中产生的IL - 1Ra水平显著降低。我们的研究结果表明,除其他因素外,IL - 1RN*2纯合子基因型严重脓毒症患者死亡率较高的原因可能是这种细胞因子的产生不足。
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引用次数: 128
Local immunostimulation induced by intravesical administration of autologous interferon‐gamma‐activated macrophages in patients with superficial bladder cancer 浅表性膀胱癌患者膀胱内注入自体干扰素激活巨噬细胞诱导的局部免疫刺激
Pub Date : 2002-02-01 DOI: 10.1046/j.1365-2249.2002.01766.x
F. Pagès, S. Lebel‐Binay, Annick Vieillefond, L. Deneux, M. Cambillau, O. Soubrane, B. Debré, D. Tardy, J. Lemonne, J. Abastado, W. Fridman, N. Thiounn
We conducted a phase I/II clinical trial of the safety and efficacy of intravesical administration of autologous IFN‐γ‐activated macrophages (MAK) in patients with superficial bladder cancer. Monocyte‐derived MAK cells were prepared in vitro and patients received six instillations of 1·4 × 108 to 2·5 × 108 cells, once a week, for five consecutive weeks. Treatment was well tolerated, with seven grade 1 and five Grade 2 protocol‐related adverse effects. Nine out of 17 included patients had no recurrences during the year following the first instillation of MAK. The aim of the present study was to search for immune parameters related to local immunostimulation induced by MAK. Monitoring of the patients showed that urinary IL‐8, GM‐CSF and, to a lesser extent, IL‐18 were increased following MAK instillations, with inter‐individual differences. The urinary IL‐8 level was about 10‐fold higher than that observed for other cytokines, and its biological activity was reflected by a concomitant increase of urinary elastase, indicating neutrophil activation and degranulation. We also showed that nine out of 12 patients investigated presented an increase of urinary neopterin, a marker of IFN‐γ‐activated macrophages, 7 days after MAK instillation, while serum neopterin levels were almost stable. These results are in line with persistence of activated macrophages in the bladder wall after infusions. Moreover, there was evidence of macrophages in urine smears 2 months after the sixth MAK instillation, and the score of macrophages correlated with the quantity of neutrophils in the urine. Overall, this study provides evidence of a local immunostimulation induced by this novel and safe immunotherapeutic approach of MAK instillations in patients with superficial bladder cancer.
我们开展了一项I/II期临床试验,研究浅表性膀胱癌患者膀胱内给药自体IFN - γ活化巨噬细胞(MAK)的安全性和有效性。体外制备单核细胞来源的MAK细胞,患者接受6次1·4 × 108至2·5 × 108细胞滴注,每周1次,连续5周。治疗耐受性良好,有7个1级和5个2级不良反应。17例患者中有9例在首次注射MAK后的一年内没有复发。本研究的目的是寻找与MAK局部免疫刺激有关的免疫参数。对患者的监测显示,在注射MAK后,尿IL - 8、GM - CSF和IL - 18(在较小程度上)均增加,且存在个体间差异。尿IL - 8水平比其他细胞因子高约10倍,其生物活性通过尿弹性酶的增加反映出来,表明中性粒细胞活化和脱颗粒。我们还发现,在接受调查的12名患者中,有9名患者在注射MAK 7天后尿中新蝶呤(IFN‐γ‐活化的巨噬细胞的标志物)升高,而血清中新蝶呤水平几乎稳定。这些结果与输注后激活的巨噬细胞在膀胱壁上的持久性一致。此外,在第六次注射MAK 2个月后,尿涂片中有巨噬细胞,巨噬细胞的评分与尿中中性粒细胞的数量相关。总之,本研究为浅表性膀胱癌患者注射MAK这种新颖且安全的免疫治疗方法所诱导的局部免疫刺激提供了证据。
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引用次数: 17
期刊
Clinical & Experimental Immunology
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