核心蛋白聚糖对哮喘小鼠气道重塑的影响

目的研究核心蛋白聚糖(decorin)对哮喘小鼠气道重塑的影响,探讨decorin在哮喘治疗中的价值。方法将30只雌性昆明系小鼠随机分为对照组(A组)、哮喘气道重塑组(B组)及decorin干预组(C组),每组10只。B组和C组小鼠用卵蛋白致敏并反复激发哮喘,C组给予decorin干预。采用酶联免疫吸附试验(ELISA)法测定小鼠血清、肺泡灌洗液(BALF)中转化生长因子β1(TGF-β1)水平;苏木精-伊红染色观察肺组织切片病理改变;Masson染色测定气道胶原沉积程度;图像分析软件测定气道重塑指标;免疫组化法观察肺组织TGF-β1的表达。结果 B组小鼠血清及BALF中TGF-β1水平、气道管壁总厚度、气道内壁厚度、气道平滑肌厚度和胶原沉积以及肺组织TGF-β1表达均较A组显著增高(F=32.36～785.57,t=-18.01～-7.86,P<0.01),而C组较B组显著降低(t=5.58～9.57,P<0.01)。结论 decorin可减轻哮喘小鼠气道重塑。     

中性粒细胞与支气管哮喘的研究进展

1　PMN参与支气管哮喘发病的一些有关证据及可能机制2 0余年前已经发现 ,抗原激发的支气管哮喘 (哮喘 )患者PMN呈活化状态[1] 。以后的时间里 ,也有一些关于PMN与哮喘的关系研究 ,Diaz等[2 ] 给哮喘患者吸入变应原后 ,发现支气管粘膜和支气管肺泡灌洗液中PMN数量显著升高。Sur[3 ] 等发现突发致命性哮喘表现为以PMN浸润为主的气道炎症 ,而嗜酸性粒细胞 (Eos)不增多。稍后的研究证实哮喘患者气道内PMN的数量和活性不论是在稳定期还是急性发作期都会增加[4、5] 。1995年后的研究显示 ,高渗盐水诱导痰细胞组分析和支气管肺泡灌洗与支…     

抗中性粒细胞胞浆抗体在转氨酶升高的乙肝患者中的检测

目的探究抗中性粒细胞胞浆抗体(ANCA)在乙肝转氨酶升高患者中检测阳性率。方法应用间接免疫荧光法(IIF)和酶联免疫吸附法针对临床上乙肝并转氨酶升高的213例患者ANCA用MPO、PR3检测,其中肝硬化39例,肝癌31例,乙肝DNA>103者84例。结果本组患者中ANCA阳性31例,阳性率为14.5%,为抗中性粒细胞胞浆抗体的胞质型(C-ANCA)。结论乙肝并转氨酶升高患者ANCA阳性率相对较高。提示ANCA与乙肝活动期关系密切,HBV感染或引发机体自身免疫紊乱,产生自身抗体。     

阿奇霉素通过抑制Th17细胞功能活性改善小鼠哮喘炎症

目的 研究阿奇霉素对Th17应答增强致气道以中性粒细胞浸润为主的小鼠哮喘炎症的作用.方法 采用卵蛋白(OVA)+内毒素(LPS)联合致敏,OVA激发的方法建立Th17应答增强致气道中性粒细胞浸润为主的哮喘小鼠模型,48只BALB/c雌性小鼠随机分为对照组、哮喘组、阿奇霉素组、地塞米松组(n=12).采用HE染色观察肺组织病理改变;小鼠肺功能仪检测气道高反应性(airway hyperreactivity,AHR);肺泡灌洗液(bronchoalveolar lavage fluid,BALF)行细胞分类计数;ELISA检测外周血OVA特异性IgE及BALF中IL-17、TNF-α、IL-8、IL-5和IFN-γ浓度;Q-PCR检测肺组织Th1、Th2和Th17细胞分化.结果 用OVA联合LPS的方法可以复制既有Th2活化和肺内嗜酸性细胞增多,又有Th17表达增强和明显中性粒细胞炎症的哮喘小鼠模型.与哮喘组比较,阿奇霉素组气道炎症细胞浸润明显改善,特别是中性粒细胞比例显著降低(P＜0.05).同时还有BALF中IL-17、TNF-α、IL-8、IL-5水平显著降低(P＜0.05);肺组织Th17细胞分化减少(P＜0.05)以及AHR改善(P＜0.05).而地塞米松组与哮喘组比较,虽然BALF嗜酸性细胞比例显著降低,但BALF中细胞总数、IL-17、TNF-α、IL-8水平及肺组织Th17细胞分化均无明显差别(P＞0.05).结论 阿奇霉素可抑制Th17细胞分化、减少炎症介质分泌从而抑制炎症细胞浸润,由此减弱Th17应答增强致气道中性粒细胞增高的小鼠哮喘炎症.     

甘露聚糖结合凝集素对人中性粒细胞功能的影响

目的研究甘露聚糖结合凝集素(MBL)对人中性粒细胞(PMN)功能的影响。方法采用ELISA和Dot blot检测MBL与微生物的结合;应用流式细胞术检测及荧光显微镜观察MBL对PMN吞噬功能的影响;用qPCR分析MBL对PMN表达IL-1β、TNF-α和CD11b mRNA的影响,以ELISA检测MBL对PMN分泌TNF-α和IL-6的影响;应用NBT还原法检测MBL对PMN呼吸爆发的影响。结果 MBL与微生物结合并呈浓度依赖关系。无人血清时,MBL对PMN吞噬C.albicans和E.coli无明显影响。存在MBL缺陷人混合血清时,MBL可促进PMN对C.albicans的吞噬且这种作用可被甘露聚糖所阻断,上调PMN IL-1β、TNF-α、IL-6及CD11b表达水平,刺激PMN呼吸爆发。结论 MBL以补体凝集素途径依赖方式增强PMN吞噬功能,并促进炎性细胞因子分泌。     

中性粒细胞型哮喘患者的气道炎症与小气道重构分析

目的：研究支气管哮喘(哮喘)患者的气道炎症表型分布,分析中性粒细胞哮喘表型的炎症标志物和临床特征,以及肺小血管和小气道重构指标。方法：采用横断面研究方法,选择北京大学第三医院呼吸内科2015年1月至12月完成诱导痰细胞学检查的患者63例,收集一般资料,记录哮喘控制测试（ACT）结果和肺功能,分析患者的诱导痰细胞计数及分类、诱导痰活化基质金属蛋白酶（matrix metalloproteinase-9, MMP-9)水平,血清瘦素、IgE、骨膜素及TGF-β1水平,分析肺CT肺小血管横截面积及小气道横截面积。结果：哮喘患者的气道炎症表型分布为嗜酸粒细胞型22例(34.9%),中性粒细胞型22例(34.9%), 混合细胞型15例(23.8%),寡细胞型4例(6.3%)。中性粒细胞型哮喘与嗜酸性粒细胞型相比,痰活化MMP-9水平显著增高［179.1(74.3,395.5) vs. 50.5(9.7,225.8),P<0.05］。痰中性粒细胞计数与第一秒用力呼气量占预测值百分比(predicted percentage of forced expiratory volume in the 1st second, FEV1%pred)呈显著负相关（r=-0.304,P<0.05）, 与痰活化MMP-9水平成显著正相关（r=0.469, P<0.05）,与小气道校正壁厚呈相关趋势（r=0.533, P=0.06）。痰活化MMP 9水平与FEV1%pred呈负相关（r=-0.281, P<0.05）,与小气道校正壁厚呈相关趋势（r=0.612, P=0.06）,与校正管径面积呈正相关（r=0.636, P<0.05）。外周血中性粒细胞计数与痰中性粒细胞计数呈正相关（r=0.355, P<0.05）,与痰MMP 9水平呈正相关（r=0.330, P<0.05）。结论：哮喘患者气道中性粒细胞数量与肺功能相关,中性粒细胞可能通过释放MMP 9加重小气道重构;痰中性粒细胞计数与外周血中性粒细胞计数相关,有可能作为判断炎症亚型的替代物。     

IL-17A抑制Th2细胞分化减轻哮喘小鼠气道嗜酸性粒细胞炎症

目的 研究IL-17A对哮喘小鼠Th2细胞分化及其相关炎症的作用.方法 24只C57BL/6J小鼠按随机数字表法分为对照组、哮喘组和IL-17A处理组(n=8).哮喘组和IL-17A处理组予以卵清蛋白(ovalbumin,OVA)致敏及激发.每次雾化激发前1h,IL-17A处理组给予重组小鼠IL-17A气道滴入.各步对照均予以生理盐水.末次激发后24h处死小鼠,收集支气管肺泡灌洗液(bronchoalveolar lavage fluid,BALF)行细胞总数及分类计数.ELISA检测BALF中IL-4、IL-5、IFN-γ、IL-17A的浓度.HE和PAS染色及半定量评分评估小鼠肺部病理变化.流式细胞术检测脾脏和支气管淋巴结Th细胞分化.免疫磁珠分选健康小鼠幼稚CD4+T细胞,用Th2极化培养基体外培养,并给予IL-17A或等量PBS干预,检测Th2细胞的增殖、凋亡和分化.结果 哮喘组较对照组,BALF中细胞总数、嗜酸性粒细胞数及其比例(P＜0.05)、IL-4、IL-5、IL-17A浓度均显著增高(P＜0.05),IFN-γ浓度显著下降(P＜0.05);支气管、血管周围炎症细胞浸润和杯状细胞化生明显加重(P＜0.01);脾脏和淋巴结Th2细胞分化比例显著增高(P＜0.05).IL-17A处理组较哮喘组,BALF中的细胞总数[(26.00±5.43)×104/mLvs(58.40 ±26.93)×104/mL,P＜0.05]、嗜酸性粒细胞数[(8.04±1.98)×104/mL vs(31.95±12.28)×104/mL,P＜0.05]及其比例[(29.93 ±3.03)％ vs(53.47 ±6.62)％,P＜0.01]显著降低,而中性粒细胞数及其比例无明显变化;BALF中Th2相关因子IL-4浓度[(9.86 ±2.77) pg/mL vs(28.13 ±4.62) pg/mL,P＜0.01]、IL-5浓度[(7.30 ±0.50) pg/mL vs(10.50±1.10) pg/mL,P＜0.01]均显著降低;支气管、血管周围炎症细胞浸润减轻,HE染色半定量评分降低[(2.00 ±0.51)vs(3.12 ±0.64),P＜0.05],杯状细胞化生减少[(0.80 ±0.45)vs(2.40 ±0.55),P＜0.01];脾脏[(2.24±0.44)％vs(4.82±1.83)％,P＜0.01]和淋巴结[(7.05±0.58)％vs(10.57±1.35)％,P＜0.05]中Th2细胞分化比例显著减少.极化培养的幼稚CD4+T细胞,予IL-17A干预后,诱导分化的Th2细胞比例显著减少(P＜0.05),而增殖和凋亡无显著变化.结论 IL-17A有抑制Th2细胞分化,减轻哮喘小鼠气道嗜酸性粒细胞炎症的作用.     

调节性T细胞/Th 17在支气管哮喘小鼠气道炎症过程中的变化

目的 通过观察支气管哮喘小鼠模型T淋巴细胞亚群调节性细胞(Treg)、Th17的变化,探讨淋巴细胞亚群Treg和Th17在哮喘发病中的作用.方法 采用卵清蛋白致敏方法 建立支气管哮喘小鼠模型,Balb/c小鼠16只随机分为正常对照组和哮喘组各8只.采用酶联免疫吸附试验(ELISA)技术检测小鼠肺泡灌-洗液(BALF)、血清中白细胞介素-10(1L-10)、白细胞介素17(IL-17)水平;HE染色评价各组小鼠气道炎症程度;采用流式细胞仪检测各组Treg、Th17细胞占CD4+细胞百分率情况.结果 哮喘组淋巴细胞亚群CD_4+~CD_(25)+~Foxp_3~+细胞占CD_4~+细胞百分率显著低于正常对照组(P<0.01);CD_4+IL-17~+细胞占CD_4~+细胞百分率显著高于正常对照组(P<0.01).CD_4~+CD_(25)~+Foxp_3~+细胞/CD_4~+IL-17细胞比值与嗜酸粒细胞、中性粒细胞、淋巴细胞数呈负相关(r=-0.894,-0.957,-0.886;P均<0.01).结论 Treg/Th17在小鼠哮喘模型中存在失衡表达,提示Treg/Th17失衡参与了哮喘的发病过程,是对哮喘发病免疫机制的重要补充.     

皮肤创伤模型研究进展

皮肤创伤一般指皮肤受到各种因素的作用下所造成的皮肤组织破坏以及可能发生的全身反应。现在常用的创伤模型有急性创伤模型、慢性创伤模型以及病理性瘢痕模型。急性创伤模型根据致伤原因可分为:皮肤切割创伤模型、皮肤切除创伤模型、烧伤模型等。慢性创伤模型根据发病机制可分为:糖尿病溃疡模型、衰老难愈型模型、褥疮溃疡模型等。病理瘢痕模型常用的有裸鼠瘢痕移植型、兔耳增生瘢痕模型。创伤药物研发需要合适的动物模型,本文旨在对近些年皮肤创伤模型及其特点进行归纳,以利于根据实际需求选择适宜的模型工具。     

急性哮喘患者外周血中Th17细胞的变化及其意义

目的:探讨哮喘急性发作期患者外周血中Th17细胞的变化及其与哮喘严重程度的关系.方法:选取轻度急性哮喘患者、重度急性哮喘患者和健康对照者各10名.从血清单个核细胞中分离T淋巴细胞,流式细胞仪检测阳性Th17细胞率,分析其与哮喘严重程度的关系.结果:轻度急性哮喘组和重度急性哮喘组外周血阳性Th17细胞均较健康对照组增高(P＜0.05),而重度哮喘组高于轻度哮喘组(P＜0.05).重度哮喘组外周血IL-17水平明显高于轻度哮喘组和健康对照组(P＜0.05).外周血中Th17阳性细胞数与急性哮喘严重程度呈正相关(r=0.869,P＜0.05).结论:急性哮喘患者外周血Th17细胞表达增加,且与其病情的严重程度呈正相关.     

Sputum interleukin-17 is increased and associated with airway neutrophilia in patients with severe asthma

Asthma is a chronic inflammatory airway disease characterized by the involvement of many cells( including eosinophils, mast cells, T cells,neutrophils and airway epithelial cells ) and their cellular components. 1 While airway eosinophilic inflammation is considered as a characteristic ofasthma, our previous reports and other recent studies have demonstrated that neutrophils may play important roles in airway inflammation,     

Sputum interleukin-17 is increased and associated with airway neutrophilia in patients with severe asthma

Asthma is a chronic inflammatory airway disease characterized by the involvement of many cells (including eosinophils, mast cells, T cells, neutrophils and airway epithelial cells) and their cellular components.1 While airway eosinophilic inflammation is considered as a characteristic of asthma, our previous reports2,3 and other recent studies4,5 have demonstrated that neutrophils may play important roles in airway inflammation, or even in airway remodeling, particularly in severe asthma. The mechanisms underlying the neutrophil accumulation in asthmatic airway remain to be elucidated. Interleukin-8 (IL-8) is a potent chemotactic factor for neutrophils, and was demonstrated to be increased in asthmatic airways.6,7 More recent studies have shown that T-cell derived IL-17 can accumulate neutrophils via a IL-8 dependent pathway.8,9 Whether IL-17/IL-8 mechanism is involved in airway inflammation in severe asthma is not clear.     

Coexistence of Th1/Th2 and Th17/Treg imbalances in patients with allergic asthma

Background  Recent recognition is that Th2 response is insufficient to fully explain the aetiology of asthma. Other CD4⁺ T cells subsets might play a role in asthma. We investigated the relative abundance and activities of Th1, Th2, Th17 and CD4⁺CD25⁺ Treg cells in patients with allergic asthma.

Methods  Twenty-two patients with mild asthma, 17 patients with moderate to severe asthma and 20 healthy donors were enrolled. All patients were allergic to house dust mites. Plasma total IgE, pulmonary function and Asthma Control Questionnaire were assessed. The proportions of peripheral blood Th1, Th2, Th17 and CD4⁺CD25⁺ Treg cells were determined by flow cytometry. The expression of cytokines in plasma and in the culture supernatant of peripheral blood mononuclear cells was determined by enzyme linked, immunosorbent assay.

Results  The frequency of blood Th2 cells and IL-4 levels in plasma and culture supernatant of peripheral blood mononuclear cells were increased in all patients with allergic asthma. The frequency of Th17 cells and the plasma and culture supernatant levels of IL-17 were increased, whereas the frequency of CD4⁺CD25⁺ Treg cells and plasma IL-10 levels were decreased in patients with moderate to severe asthma. Dermatophagoides pteronyssinus specific IgE levels were positively correlated with the percentage of blood Th2 cells and plasma IL-4 levels. Forced expiratory volume in the first second was negatively correlated with the frequency of Th17 cells and plasma IL-17 levels, and positively correlated with the frequency of Treg cells. However, mean Asthma Control Questionnaire scores were positively correlated with the frequency of Th17 cells and plasma IL-17 levels, and negatively correlated with the frequency of Treg cells.

Conclusions  Imbalances in Th1/Th2 and Th17/Treg were found in patients with allergic asthma. Furthermore, elevated Th17 cell responses, the absence of Tregs and an imbalance in Th17/Treg levels were associated with moderate to severe asthma. 

     

支气管哮喘小鼠细胞免疫因子及Th17细胞水平的变化及发病机制研究

目的探讨支气管哮喘小鼠细胞免疫因子及辅助性T细胞（Th）17细胞水平的变化及发病机制,旨在为支气管哮喘的临床治疗提供参考。方法选择SPF级昆明种小鼠24只,采用随机数字表法分为正常对照组和哮喘模型组各12只。哮喘模型组小鼠分别于实验开始当天和第8天腹腔内注入卵清蛋白（OVA）混悬液[含OVA/Al（OH）310mg/g]50滋g/次致敏,并于第16天给予雾化吸入含1%OVA的0.9%氯化钠溶液30~40ml进行激发,持续30~40min,1次/d,连续7d。正常对照组小鼠则给予等量的0.9%氯化钠溶液。比较两组小鼠行为变化情况、肺组织病理切片HE染色结果、肺泡灌洗液（BALF）中炎性细胞分类计数、BALF和血清中细胞免疫因子和Th17细胞水平。结果哮喘模型组小鼠肺组织内可见大量中性粒细胞和嗜酸性粒细胞,且相对阳性着色面积增大。与正常对照组小鼠相比,哮喘模型组小鼠BALF中细胞总数、嗜酸性粒细胞、中性粒细胞和淋巴细胞等炎性细胞分类计数均明显升高,BALF和血清中IL-4、IL-5、IFN-γ和IL-17水平均明显升高,而IL-10水平明显降低,差异均有统计学意义（均P＜0.05）。结论支气管哮喘小鼠BALF中细胞总数、嗜酸性粒细胞、中性粒细胞和淋巴细胞等炎性细胞分类计数均明显升高,可能与BALF和血清中IL-4、IL-5、IFN-γ和IL-17水平明显升高,而IL-10水平明显降低密切相关。     

1,25-Dihydroxyvitamin D3 pretreatment enhances the efficacy of allergen immunotherapy in a mouse allergic asthma model

Background  Allergen-specific immunotherapy can induce immune tolerance to specific allergens by regulating immune status of individuals. However, its clinical application is limited due to individual differences in efficacy among patients and un-confirmed safety. 1,25 Dihydroxyvitamin D₃ (1,25(OH)₂D₃) has been shown to be involved in a variety of physiological processes, including immune response regulation. In the present study we explored the role of 1,25(OH)₂D₃ pretreatment for immunotherapy.

Methods  Seventy-five BALB/c mice were randomly divided into five groups (15 mice per group). The mouse allergic asthma model was established by intra-peritoneal injection of ovalbumin (OVA, 10 μg) and aluminium hydroxide (2 mg) as an adjuvant. Intra-peritoneal injection of 50 ng of 1,25(OH)₂D₃ served as a pretreatment, subcutaneous injection of OVA (100 μg) as an immunotherapy, and 1% OVA inhalation as a challenge. Histopathological analysis was performed on four mice per group. The number of cells and their classification in bronchoalvolar lavage (BAL) fluid were assayed. Levels of serum OVA-specific immunoglobulin E (sIgE) and IFN-γ, IL-4, IL-5 and IL-10 in BAL fluid were measured by ELISA.

Results  After 1,25(OH)₂D₃ pretreatment, immunotherapy could significantly inhibit the infiltration of inflammatory cells into lung tissues and BAL fluid of mice with allergic asthma when compared with un-treated animals (eosinophils: (7.46±1.34)×10⁴/ml vs. (13.41±1.67)×10⁴/ml, P <0.05). In addition, levels of IL-4 ((36.91±7.87) pg/ml vs. (43.70±6.42) pg/ml, P >0.05) and IL-5 ((41.97±7.93) pg/ml vs. (60.14±8.35) pg/ml, P <0.05) in BAL fluid and serum sIgE ((0.42±0.05) vs. (0.75±0.06) OD units, P <0.05) were profoundly reduced. However, the IL-10 level in BAL fluid was significantly increased ((67.74±6.57) pg/ml vs. (44.62±8.81) pg/ml, P <0.05).

Conclusions  These results indicated that 1,25(OH)₂D₃ pretreatment enhanced the inhibitory effects of immunotherapy on allergic airway inflammation. In the treatment of allergic diseases, 1,25(OH)₂D₃ pretreatment may be beneficial for improving the efficacy of immunotherapy. 

     

Th17细胞在过敏性哮喘发病中的作用及其与Notch信号通路的关系

目的探讨辅助性T细胞（Th）17在过敏性哮喘发病中的作用及其与Notch信号通路的关系。方法选择过敏性哮喘患儿40例（哮喘组）和体检儿童40例（健康对照组）。采用流式细胞仪检测其Th17细胞比例,实时荧光定量聚合酶链反应检测外周血单个核细胞Notch1、Notch4、维甲酸相关孤儿核受体（RORγt）mRNA表达水平,ELISA法检测外周血清IL-17水平。过敏性哮喘患儿Notch1mRNA表达水平分别与Th17细胞比例、RORγtmRNA表达水平和IL-17水平进行相关性分析。结果哮喘组Th17细胞比例、Notch1及RORγtmRNA表达水平、IL-17水平均显著高于健康对照组(均P＜0.05),而两组儿童Notch4mRNA表达水平比较差异无统计学意义（P＞0.05)。哮喘组Notch1mRNA表达水平与Th17细胞比例、RORγtmRNA表达水平、IL-17水平均呈正相关（r=0.780、0.555和0.636,均P＜0.01）。结论Th17细胞在过敏性哮喘中发挥重要作用,Notch1可能通过影响Th17表达参与过敏性哮喘的病理过程。     

葎草花粉特异性致敏哮喘动物模型的制备

目的 建立葎草花粉粗浸液诱导的小鼠变态反应气管炎症动物模型.方法 制备葎草花粉粗浸液,将40只清洁级雌性BALB/c小鼠按随机数字表法分为4组,每组10只.①空白对照组:PBS+氢氧化铝致敏激发;②低剂量组:100 μg葎草粗浸液+氢氧化铝致敏激发;③中剂量组:200 μg葎草粗浸液+氢氧化铝致敏激发;④高剂量组:300 μg葎草粗浸液+氢氧化铝致敏激发.通过HE染色观察小鼠肺部炎症和黏液分泌,支气管肺泡灌洗液中细胞总数和细胞分类,酶联免疫吸附试验检测BALF,脾组织匀浆上清的IL- 4、IFN-γ和血清抗原特异的抗体验证哮喘动物模型.结果 随着抗原浓度的升高,肺部病理改变呈明显的变态反应炎症;高剂量组小鼠支气管肺泡灌洗液中的细胞总数为(210.75±78.80)×106/L、巨噬细胞数为(48.65±3.27)%、EOS数为(24.37±4.28)%、IL- 4、血清抗原特异性IgE抗体、IgG1抗体明显高于空白对照组(P<0.05);支气管肺泡灌洗液﹑脾组织匀浆上清的IFN-γ较空白对照组下降(P<0.05).结论 葎草花粉成功构建小鼠变态反应气道炎症动物模型.