阿尔茨海默病患者免疫功能状态研究

目的探讨阿尔茨海默病(AD)患者的免疫功能状态。方法随机收集AD患者125例与健康对照组40例,分别检测2组对象的外周血T淋巴细胞亚群、IgA、IgG、IgM、C3、C4、白细胞介素(IL)-1β、IL-2、IL-6、干扰素(IFN)-γ等指标来评定受试者的免疫功能状态,并进行比较。结果 AD患者的血清C3浓度明显高于健康对照组(P <0. 05),AD患者的静脉血CD4^+浓度及CD4^+/CD8^+均明显高于健康对照组(P <0. 05),AD患者的静脉血CD8^+浓度明显低于健康对照组(P <0. 05),AD患者的血清IL-1β、IL-2、IL-6、IFN-γ等指标均明显高于健康对照组,上述差异均有统计学意义(P <0. 05),Logistic回归分析提示外周血C3与IL-6升高增加AD患病风险。结论 AD患者存在免疫功能状态的改变,后者在AD的发生发展中起着重要作用。     

肺结核合并慢性乙型肝炎患者T淋巴细胞免疫应答研究 FREE

目的研究结核病合并慢性乙型肝炎（乙肝）患者血清中Th1型细胞的细胞因子水平变化以及Th1、Th2的表达水平及意义。方法对21例肺结核并乙肝表面抗原（HBsAg）阳性患者、30例单纯肺结核患者及30例健康对照者,应用酶联免疫吸附试验（ELISA）测定其血清中肿瘤坏死因子（TNF） α、干扰素（IFN） γ、白细胞介素（IL） 12水平;运用流式细胞术检测外周血中CD4＋T淋巴细胞及细胞内Th1、Th2的表达水平。结果单纯肺结核及肺结核并HBsAg阳性组TNF α水平均显著高于健康对照组（均P＜0.01）;单纯肺结核组IFN γ、IL 12水平均显著低于健康对照组（均P＜0.05）,而肺结核并HBsAg阳性组IFN γ、IL 12水平均显著低于单纯肺结核组（均P＜0.01）。单纯肺结核组外周血CD4＋T淋巴细胞及细胞内Th1表达水平均显著低于健康对照组（分别P＜ 0.05,P＜0.01）;细胞内Th2表达水平显著高于健康对照组（P＜0.05）。肺结核并HBsAg阳性组CD4＋T淋巴细胞及细胞内Th1表达水平显著低于单纯肺结核组(分别P＜ 0.05,P＜ 0.01)。结论肺结核患者存在细胞内Th1反应减弱,Th2反应增强;而肺结核合并慢性乙肝的患者则进一步致细胞内Th1反应减弱,Th2反应增强。     

接触马拉硫磷对免疫功能的影响

随着环境污染与人群健康关系的研究工作不断深入,人们对农药的免疫毒性极为重视。为了探讨马拉硫磷对人体的免疫毒性,我们对某农药厂63例马拉硫磷作业工人的血清T淋巴细胞亚群CD3^ 、CD^ 、CD3^ 。免疫球蛋白IgG、IgA、IgM含量进行检测。结果报告如下。     

2860例巨细胞病毒不同水平感染患者T淋巴细胞亚群免疫状态的研究

目的:从细胞及基因不同水平观察育龄妇女巨细胞病毒(HCMV)感染的细胞免疫功能变化及临床意义。方法:用RT-PCR及ELISA法检测2860例育龄妇女HCMV-IgM及HCMV-mRNA阳性率,流式细胞仪免疫荧光法检测其T淋巴细胞亚群细胞含量。SPSS11.5软件进行相应的统计分析。结果:HCMV-IgM(+)组CD4+、CD4+/CD8+、NK细胞显著降低,与HCMV-IgM(—)组比较,P<0.05;HCMVmRNA(-)组与HCMVmRNA(+)组比较,P<0.01;统计学有显著性差异。结论:病毒活动性感染时会一定程度地抑制机体的细胞免疫系统发挥正常功能,患者外周血T亚群细胞比值变化与病毒的复制活跃程度有明显关系。对指导育龄妇女感染的临床治疗、判断预后有一定意义。     

尖锐湿疣患者HPV亚型及免疫功能

尖锐湿疣容易复发，这与尖锐湿疣患者感染的人乳头瘤病毒亚型及机体免疫功能密切相关。以人乳头瘤病毒16／18型为代表的高危感染，外周血T淋巴细胞亚群和自然杀伤细胞异常，以及细胞因子产生失衡所引起一系列细胞免疫抑制是最主要原因。本文就这两方面的研究进展作了综述，为尖锐湿疣的防治提供理论依据。     

脑出血患者的免疫功能研究

摘要:目的　分析脑出血患者外周血T淋巴细胞亚群、免疫球蛋白的变化,探讨其在脑出血患者中的应用价值。方法　用流式细胞仪测定85例脑出血患者和50例对照组外周血T淋巴细胞亚群,采用免疫比浊法测定血清IgA、IgG、IgM含量。结果　脑出血患者全血CD8+明显高于健康对照组（t＝4.48,P＜0.05）,而血CD3+、CD4+及CD4+/CD8+比值则显著低于健康对照组（t＝10.10;t＝7.82;t＝3.59,P＜0.05）。IgG、IgM水平均高于对照组（t＝6.32;t＝5.35;P＜0.05）,而IgA水平2组无统计学差异（t＝0.58,P＞0.05）。神经损伤的损失越严重,CD3+、CD4+及CD4+/ CD8+比值越低（F＝7.84;F＝3.65;F＝1.32,P＜0.05）;CD8+ IgG、IgM水平越高,差异有统计学意义（F＝3.62;F＝2.23;F＝1.52,P＜0.05）。结论　脑出血患者细胞免疫功能降低,体液免疫功能增强。外周血T 细胞亚群和免疫球蛋白的检测对判断脑出血患者的病情、预后以及机体的免疫功能的观察有一定意义。     

辅助性T细胞17及调节性T细胞调节初治肺结核患者免疫功能的作用

目的 探讨外周血辅助性T细胞17(Th17)和调节性T细胞(Treg)在调节初治肺结核患者免疫功能中的作用.方法 选取2012年1月至2013年6月在绍兴市第六人民医院就诊的初治肺结核患者169例,根据有无空洞分成空洞组(73例)和无空洞组(96例);根据空洞所占肺野将空洞组的73例患者分成1～2个肺野组、3～4个肺野组和5～6个肺野组.另外选取同期健康体格检查者51名作为健康对照组.流式细胞仪动态检测治疗前、治疗2个月时患者外周血CD4+T细胞上Th17和Treg细胞水平,并比较各组间Th17细胞和Treg细胞水平的差异.结果 肺结核组治疗前及治疗2个月后外周血Th17细胞表达水平分别为(1.63±0.38)％和(2.57±0.82)％,均低于健康对照组的(3.85±1.13)％,差异有统计学意义(t=4.18、2.69,P＜0.01);外周血Treg细胞表达水平分别为(7.53±1.77)％和(5.39±1.22)％,显著高于健康对照组的(3.99±0.84)％,差异有统计学意义(t=6.27、3.34,P＜0.01).空洞组Th17的细胞的表达水平为(1.49±0.25)％,低于无空洞组的(1.87±0.46)％;Treg细胞水平为(7.94±1.85)％,高于无空洞型组的(6.88±1.14)％,组间差异均有统计学意义(t=2.35、2.59,P＜0.05).1～2个肺野组、3～4个肺野组和5～6个肺野组间Th17细胞水平随着空洞数量增加而降低,但Treg细胞逐渐升高,组间差异有统计学意义(F=3.10、3.82,P＜ 0.05).结论 外周血Th17和Treg细胞水平与肺结核的严重程度密切相关,对结核免疫反应起重要调节作用.     

微量元素和人体免疫功能

微量元素对正常免疫功能的维持具有重要作用。反复感染时不仅有免疫功能受损，而且伴有多种微量元素缺乏或失衡，临床上及时补充多种维生素、微量元素制剂，能改善免疫功能，防治反复感染。     

恶性肿瘤患者免疫状态研究进展

近年来,免疫治疗已成为肿瘤治疗中较为常用的一种手段,机体抗肿瘤免疫效应以细胞免疫为主,自然杀伤细胞（natural killer,NK）,T淋巴细胞亚群在肿瘤免疫监视中起中心调控作用。树突状细胞（dendritic cell,DC）在机体免疫反应过程与T细胞功能密切相关,T细胞的致敏、激活和扩增都有赖于抗原提呈细胞（antiger presenting cells,APC）,     

大鼠急性胰腺炎模型脾脏免疫状态的研究

目的 检测大鼠急性胰腺炎模型外周血及脾脏T淋巴细胞亚群，探讨急性胰腺炎病情发展过程中脾脏免疫功能状态的改变。方法 雄性SD大鼠随机分为对照组和实验组，胰管内逆行注射4％牛磺胆酸钠建立实验组胰腺炎模型，两组分别在3、6、12h分3批处死，每批12只。每只大鼠取胰腺组织观察病理改变，取股静脉血2ml及脾脏2g制成单细胞悬液，用流式细胞仪测定T淋巴细胞亚群CD3^ 、CD4^ 、CD8^ 及CD4^ ，／CD8^ 比值。结果 在胰腺组织炎性水肿阶段T淋巴细胞亚群无明显改变，在出血坏死阶段外周血CD3^ 、CD4^ 降低、CD8^ 轻度升高、CD4^ ／CD8^ 明显降低，脾脏细胞与外周血相比CD3^ 、CD4^ 及CD4^ ／CD8^ ，明显降低，脾脏呈现负性免疫状态，且随着炎症的加重变化更加明显。结论脾脏在重症急性胰腺炎中起负性免疫作用，加重SAP病情发展。     

肺结核患者细胞免疫功能与CD4＋T淋巴细胞凋亡相关性研究

目的 检测肺结核患者外周血CD4＋T淋巴细胞凋亡及免疫功能状态,探讨其与结核病发病的临床意义.方法 分离结核病患者和正常人外周血单个核细胞,标记后用流式细胞仪测定CD4＋T淋巴细胞凋亡率;用链霉亲和素碱磷酶法（SAP法）检测其外周血CD3＋T、CD4＋T、CD8＋T淋巴细胞及CD4/CD8比值;采用酵母菌花环法检测其红细胞受体花环率及红细胞免疫复合物花环率.结果 结核病患者外周血CD4＋T淋巴细胞凋亡率（15.882 ±4.65）％、CD8＋T淋巴细胞比例（27.69±0.74）％、红细胞免疫复合物阳性率（19.40±0.58）％显著高于对照组（P＜0.01）,CD3＋T淋巴细胞比例（46.48±1.34）％、CD4＋T淋巴细胞比例（28.12±0.69）％,CD4/CD8比值（1.0223±0.09362）和红细胞C3b受体阳性率（17.73±0.63）％明显降低（P＜0.01）;结核病患者CD4＋T淋巴细胞凋亡率与CD4＋T淋巴细胞比例之间以及T淋巴细胞亚群与红细胞免疫功能之间存在一定的相关性.结论 结核病患者CD4＋T淋巴细胞凋亡率显著增加致CD4＋T淋巴细胞数减少,T淋巴细胞免疫功能与红细胞免疫功能存在正相关,且均有所下降,可能与肺结核的免疫发病有关.     

Host immunity to Mycobacterium tuberculosis and risk of tuberculosis: A longitudinal study among Greenlanders

BackgroundHuman immune responses to latent Mycobacterium tuberculosis (Mtb) infection (LTBI) may enable individuals to control Mtb infection and halt progression to tuberculosis (TB), a hypothesis applied in several novel TB vaccines. We aimed to evaluate whether immune responses to selected LTBI antigens were associated with subsequent reduced risk of progression to TB.MethodsWe conducted a population-based cohort study in East Greenland (2012–2014) including individuals aged 5–31 years. A personal identifier allowed follow-up in national registers including the TB notification register. Mtb infection was defined by a positive Quantiferon test. Immune responses to LTBI antigens were assessed by whole blood antigen stimulation and interferon gamma measurement.ResultsAmong 978 participants, 67 previously had TB. LTBI antigen (Rv1284, Rv2659, Rv2660c) immune response prevalence was 18%, 50%, 2% among Mtb-infected and 7%, 40%, 4% among non-infected (Quantiferon negative) participants. Among 911 participants without prior notified TB, 31 were notified with TB during study follow-up. Immune responses to LTBI antigens were not associated with reduced risk of subsequent TB; Rv1284 HR 0.92 (95%CI 0.28–3.04), Rv2659 HR 1.05 (95%CI 0.51–2.13), Rv2660c HR 3.06 (95%CI 0.70–13.37).ConclusionIn this large population-based study, human immune responses to selected LTBI antigens were not found to be strongly associated with reduced risk of subsequent TB.     

Effect of cationic liposomes on BCG trafficking and vaccine-induced immune responses following a subcutaneous immunization in mice

While formulating Mycobacterium bovis BCG in lipid-based adjuvants has been shown to increase the vaccine's protective immunity, the biological mechanisms responsible for the enhanced potency of lipid encapsulated BCG are unknown. To assess whether mixing BCG in adjuvant increases its immunogenicity by altering post-vaccination organ distribution and persistence, mice were immunized subcutaneously with conventional BCG Pasteur or BCG formulated in DDA/TDB adjuvant and the bio-distribution of BCG bacilli was evaluated in mouse lungs, spleens, lymph nodes, and livers for up to 1 year. Although BCG was rarely detected in mouse livers, mycobacteria were found in mouse lungs, spleens, and lymph nodes for at least 1 year post-vaccination. However, at various time points during the 1 year study, the frequency of lung and spleen infections and the number of mycobacteria in infected organs of individual mice were highly variable. In contrast, mycobacteria were nearly always detected in the lymph nodes of vaccinated mice. While the frequency and extent of lymph node infections generally were not significantly different between mice vaccinated with adjuvanted or nonadjuvanted BCG preparations, multiparameter flow cytometry analysis of lymph node cells showed significantly higher frequencies of CD4+ and CD8+ T cells expressing IFN-γ and IFN-γ/TNF-α in mice immunized with adjuvanted BCG. Overall, our data suggest that the relationship between lymph node infection and the generation of anti-tuberculosis protective responses following BCG vaccination should be further investigated.     

Prevention and early detection of tuberculosis

1,570 subjects with known TB contacts (active TB, old TB and primary infection) and individuals with no known contacts but belonging to efined TB risk groups were screened at the Department of Tuberculosis Prevention at the La Fe Hospital in Valencia. The total infection rate was 40.13% and active TBC was diagnosed in 2.23% of the population screened. Infection and disease rates were significant in all the groups examined, showing the need for correct screening not only for active TB contacts but also for child primary infection contacts, old TB cases not previously screened and subjects with no known contacts but belonging to a TB risk group.     

酶联免疫斑点法在感染性免疫中的实际应用

酶联免疫斑点法(ELISPOT)是一种新型的免疫学检测手段,近年来在感染性疾病的免疫诊断、免疫水平的评估方面作用颇广,在结核、HIV、HBV及疫苗方面都有应用。现综述ELISPOT在上述几个方面的研究进展。     

PPD induced in vitro interferon gamma production is not a reliable correlate of protection against Mycobacterium tuberculosis

Correlates of protection against tuberculosis are crucial for the evaluation of new vaccine candidates and for the demonstration of their potential efficacy. Such correlates can be proposed on the basis of animal models. In this study, we hypothesized that protection against tuberculosis (TB) induced by bacillus Calmette-Guerin (BCG) correlates with in vitro TB antigen-specific IFN-gamma production. BCG vaccination, known to provide effective protection against TB in animals, was used to investigate the use of in vitro IFN-gamma production as a marker of BCG-induced protection against TB. Our results show that BCG vaccination does provide substantial protection against challenge with Mycobacterium tuberculosis. However, despite previous compelling evidence that Th1 type immune responses are essential for TB immunity, the magnitude of in vitro purified protein derivative (PPD)-specific IFN-gamma production assessed during the course of TB infection did not correlate with protection. This emphasizes the need to identify further correlates of protection, in addition to IFN-gamma, to be used as markers of protective immunity against M. tuberculosis and/or to identify M. tuberculosis antigens inducing IFN-gamma that correlate with protective immunity.     

以多表位融合抗原检测结核分枝杆菌抗体、TB-SA抗体检测和噬菌体裂解法快速检测在结核病诊断中应用价值研究

目的:评价以融合抗原检测结核分枝杆菌抗体、TB-SA抗体检测和噬菌体裂解法快速检测在结核病诊断中应用价值。方法:选择结核组病例134例与非结核组265例按说明书方法进行检测。结果:噬菌体裂解法灵敏度72.39%,特异度91.7%;TB-SA抗体灵敏度75.37%,特异度77.7%;融合抗原检测抗体灵敏度85.8%,特异度92.1%。结论:融合抗原检测抗体与噬菌体裂解法和TB-SA抗体试验相比敏感度更高,值得在各级医疗单位使用。     

食物不耐受与人体免疫功能关系探讨

目的 探讨食物不耐受在体检人群中的检测现状及对机体免疫、炎症指标的早期影响.方法 采用酶联免疫吸附法对257例体检人群的血清标本进行食物特异性IgG抗体检测,比较检测结果阳性组和阴性组血白细胞、嗜酸性粒细胞、球蛋白、红细胞沉降率(ESR)、C反应蛋白(CRP)、类风湿因子(RF)、抗核抗体(ANA)及T细胞功能差异.采用SAS软件对相关资料进行t检验或卡方检验.结果 257例受检人群中,食物特异性IgG抗体阳性134例,阳性率为52.14％.排名前三位的阳性食物分别是鸡蛋、螃蟹、牛奶,中、重度不耐受食物主要是鸡蛋和牛奶.比较食物不耐受检测阳性组和阴性组的血嗜酸性粒细胞、球蛋白水平,差异均有统计学意义(t=-0.07,x2=8.91,P＜0.05)；比较两组血白细胞、ESR、CRP、RF、ANA及T细胞功能,均差异无统计学意义(P＞0.05).结论 在临床症状或慢性疾病发生之前,食物不耐受人群的血嗜酸性粒细胞、球蛋白有明显升高,建议加强对这些人群的监测；而对机体血白细胞、ESR、CRP、RF、ANA及T细胞功能等免疫炎症指标无明显影响.     

广州市海珠区肺结核患者就诊延误影响因素的研究

目的 分析广州市海珠区肺结核患者就诊延误情况及其影响因素,为制定减少就诊延误发生的干预措施提供科学依据。方法 采取随机抽样调查方法,应用编制的问卷对2014年1月1日~2014年12月31日登记发现的150例广州市海珠区肺结核患者进行面对面的问卷调查,并收集患者病历资料,分别从基本情况、经济因素及临床因素分析就诊延误的影响因素。结果 150例肺结核患者就诊延误率为52.0%（78/150）。多因素分析结果表明转诊（OR=0.121,95% CI：0.028~0.513）、咯血（OR=0.291,95% CI：0.098~0.860）是减少就诊延误的因素;就诊交通费支出≥50 元/月（OR=7.334,95% CI：1.729~31.113）、因症就诊（OR=3.225,95% CI：1.337~7.775）是增加就诊延误的因素。结论 广州市海珠区肺结核患者存在一定的就诊延误,提高人群结核病相关知识的知晓水平,加强转诊,改善结核病定点医疗机构服务的可及性和便利性,增强人群健康体检意识,从而减少肺结核患者就诊延误。