Effect evaluation of interleukin-1 receptor antagonist nanoparticles for mesenchymal stem cell transplantation

AIM: To study the efficacy of marrow mesenchymal stem cells (MSCs) transplantation combined with interleukin-1 receptor antagonist (IL-1Ra) for acute liver failure (ALF). METHODS: Chinese experimental miniature swine were randomly divided into four groups (n = 7), and all animals were given D-galactosamine (D-gal) to induce ALF. Group A animals were then injected with 40 mL saline via the portal vein 24 h after D-gal induction;Group B animals were injected with 2 mg/kg IL-1Ra via the ear vein 18 h, 2 d and 4 d after D-gal induction; Group C received approximately 1 × 108 green fluorescence protein (GFP)-labeled MSCs (GFP-MSCs) suspended in 40 mL normal saline via the portal vein 24 h after D-gal induction; Group D animals were injected with 2 mg/kg IL-1Ra via the ear vein 18 h after D-gal induction, MSCs transplantation was then carried out at 24 h after D-gal induction, and finally 2 mg/kg IL-1Ra was injected via the ear vein 1 d and 3 d after surgery as before. Liver function, serum inflammatory parameters and pathological changes were measured and the fate of MSCs was determined.RESULTS: The optimal efficiency of transfection (97%) was achieved at an multiplicity of infection of 80, as observed by fluorescence microscopy and flow cytometry (FCM). Over 90% of GFP-MSCs were identified as CD44+ CD90+ CD45-MSCs by FCM, which indicated that most GFP-MSCs retained MSCs characteristics. Biochemical assays, the levels of serum inflammatory parameters and histological results in Group D all showed a significant improvement in liver injury compared with the other groups (P < 0.05). The number of GFP-MSCs in Group D was also greater than that in Group B, and the long-term cell proliferation rate was also better in Group D than in the other groups.CONCLUSION: MSCs transplantation is useful in ALF, IL-1Ra plays an important role in alleviating the inflammatory condition, and combination therapy with MSCs transplantation and IL-1Ra is a promising treatment for ALF.

Interleukin-22 receptor 1 is expressed in multinucleated giant cells:A study on intestinal tuberculosis and Crohn’s disease

BACKGROUND It is challenging to distinguish intestinal tuberculosis from Crohn’s disease due to dynamic changes in epidemiology and similar clinical characteristics. Recent studies have shown that polymorphisms in genes involved in the interleukin (IL)- 23/IL-17 axis may affect intestinal mucosal immunity by affecting the differentiation of Th17 cells. AIM To investigate the specific single-nucleotide polymorphisms (SNPs) in genes involved in the IL-23/IL-17 axis and possible pathways that affect susceptibility to intestinal tuberculosis and Crohn's disease. METHODS We analysed 133 patients with intestinal tuberculosis, 128 with Crohn’s disease, and 500 normal controls. DNA was extracted from paraffin-embedded specimens or whole blood. Four SNPs in the IL23/Th17 axis (IL22 rs2227473, IL1β rs1143627, TGFβ rs4803455, and IL17 rs8193036) were genotyped with TaqMan assays. The transcriptional activity levels of different genotypes of rs2227473 were detected by dual luciferase reporter gene assay. The expression of IL-22R1 in different intestinal diseases was detected by immunohistochemistry. RESULTS The A allele frequency of rs2227473 (P = 0.030, odds ratio = 0.60, 95% confidence interval: 0.37-0.95) showed an abnormal distribution between intestinal tuberculosis and healthy controls. The presence of the A allele was associated with a higher IL-22 transcriptional activity (P < 0.05). In addition, IL-22R1 was expressed in intestinal lymphoid tissues, especially under conditions of intestinal tuberculosis, and highly expressed in macrophage-derived Langhans giant cells. The results of immunohistochemistry showed that the expression of IL-22R1 in patients with Crohn's disease and intestinal tuberculosis was significantly higher than that in patients with intestinal polyps and colon cancer (P < 0.01). CONCLUSION High IL-22 expression seems to be a protective factor for intestinal tuberculosis. IL-22R1 is expressed in Langhans giant cells, suggesting that the IL-22/IL-22R1 system links adaptive and innate immunity.

Study on Immunoregulation by Interleukin-1 ReceptorAntagonist in NZB/W F_1 Mice

The immunoregulating effect of Interleukin-1-receptor antagonist (ILlra ) in lupus-like NZB/W F, mice was investigated to find possible approach to prevent lupus nephritis. 12 female NZB/W F1 mice of 13 weeks were randomly divlded into 2 groups. Each mouse in the treated group was intraperitoneally injected wlth IL-lra once every 2 weeks for 3 times at the dosage of 100μg each time,while the control group was given injection of 0.1 ml normal saline. All the mice were killed at the age of 9 months and the irnmunologic function was examined.Results showed that this dosage could not completely prevent the development of lupus nephritis, but the renal damage was alleviated and the urine protein was decreased. Moreover, it could improve the immunofunction by significantly reducing the levels of serum IL-1 and obviously increase the activities of NK celIs and IL-2 induced by ConA in mononuclear cells of spleen. There was no significant difference in the levels of serum IL-6 and TNF-α between the treated group and control group. It is concluded that IL-lra has certain regulatory effect on the immunologic function of lupus-like NZB/W F, mice.

The remedial effect of soluble interleukin-1 receptor type Ⅱ on endometriosis in the nude mouse model

Objective： Recent studies have shown that the local expression of soluble interleukin （IL） -1 receptor type Ⅱ （slL-1 R Ⅱ ） in endometrial tissue of women with endometriosis is decreased, and the depression of IL-1 R Ⅱ was more significant in infertile women than that in fertile women with endometriosis. In this research, we investigated the remedial effect of slL-1-R Ⅱ administration on endometriosis in the nude mouse model. Methods： Nineteen nude model mice with endometriosis were randomly divided into three groups： group A was treated by intraperitoneal administration with only slL-1 R Ⅱ for two weeks, group B was similarly treated with only IL- 1, and group C （control） was administered saline. After 2 weeks, the size of the ectopic endometrial lesions was calculated, and the expression of vascular endothelial growth factor （VEGF） and B-cell lymphoma leukemia-2 （Bcl- 2） were detected by immunohistochemistry. The IL-8 and VEGF levels in the peritoneal fluid （PF） and serum were also measured by enzyme-linked immunosorbent assay （ELISA）. Results： The mean size of ectopic endometrial lesion did not differ between the three groups （P 〉 0.05）. Compared with the control, the expression of VEGF and Bcl-2 was significantly lower in group A, and higher in group B. In the three groups, the levels of IL-8 in the PF and serum were highest in group A, and lowest in group B. Conclusion： slL-1 R Ⅱ may suppresse hyperplasia of ectopic endometriosis, perhaps by reducing the expression of certain cytokines, such as VEGF, IL-8, and Bcl-2, which could provide a new clinical strategy for the treatment of endometriosis.

Synergistic effect of interleukin-10-receptor variants in a case of early-onset ulcerative colitis

AIM: To investigated the molecular cause of very early-onset ulcerative colitis (UC) in an 18-mo-old affected child.

Elevated pancreatic enzymes, IgM, soluble interleukin-2 receptor in anti-GADab(+) type 1 diabetes

Type 1 diabetes can be classified into immune-mediated diabetes (type 1A) and idiopathic diabetes, which lacks immunological evidence for beta cell autoimmunity (type 1B). Type 1A diabetes is characterized by the presence of the anti-glutamic acid decarboxylase antibody (anti-GADab). Fulminant type 1 diabetes is classified as type 1B diabetes, and characterized by the absence of anti-GADab, flu-like symptoms, and elevated serum exocrine pancreatic enzymes. We report a type 1 diabetic patient who showed flu-like symptoms, elevated serum exocrine pancreatic enzymes, and an extremely high-titer of anti-GADab, manifesting the characteristics of both type 1A and fulminant type 1 diabetes.

Combined mesenchymal stem cell transplantation and interleukin-1 receptor antagonism after partial hepatectomy

AIM: To study the therapeutic effects of mesenchymal stem cells (MSCs) and an interleukin-1 receptor antagonist (IL-1Ra) in acute liver failure.METHODS: Chinese experimental miniature swine (15 &#x000b1; 3 kg, 5-8 mo) were obtained from the Laboratory Animal Centre of the Affiliated Drum Tower Hospital of Nanjing University Medical School. Acute liver failure was induced via 85% hepatectomy, and animals were treated by MSC transplantation combined with IL-1Ra injection. Blood samples were collected for hepatic function analysis, and the living conditions and survival time were recorded. Liver injury was histologically analyzed. Hepatic cell regeneration and apoptosis were studied by Ki67 immunohistochemistry and terminal deoxynucleotidyl transferase dUTP nick end labeling, respectively. The levels of protein kinase B and nuclear factor-&#x003ba;B expression were analyzed by Western blotting.RESULTS: MSCs were infected with a lentivirus for expression of green fluorescent protein (GFP) for subsequent identification; 97.3% of the MSCs were positive for GFP as assessed by flow cytometry. Additional flow cytometric analysis of cell surface marker expression demonstrated that &#x0003e; 90% of GFP-expressing MSCs were also positive for CD29, CD44, and CD90, indicating that most of these cells expressed typical markers of MSCs, and the population of MSCs was almost pure. Transplantation of MSCs in combination with 2 mg/kg IL-1Ra therapy significantly improved survival time compared to the acute liver failure model group (35.3 &#x000b1; 6.7 d vs 17.3 &#x000b1; 5.5 d, P &#x0003c; 0.05). Combined therapy also promoted improvement in serum inflammatory cytokines and biochemical conditions. The observed hepatic histopathologic score was significantly lower in the group with combined therapy than in the model group (3.50 &#x000b1; 0.87 vs 8.17 &#x000b1; 1.26, P &#x0003c; 0.01). In addition, liver cell apoptosis in the combined therapy group was significantly inhibited (18.1 &#x000b1; 2.1% vs 70.8 &#x000b1; 3.7%, P &#x0003c; 0.01), and hepatic cell regeneration increased. A significant increase in protein kinase B expression and decrease in nuclear factor-&#x003ba;B expression were observed (P &#x0003c; 0.01), which supports their important roles in liver regeneration.CONCLUSION: MSCs and IL-1Ra had a synergistic effect in liver regeneration via regulation of inflammation and apoptotic signaling.

The interleukin-1 receptor antagonist (IL-1-Ra) and soluble tumor necrosis factor receptor I (sTNF RI) in periodontal disease

The course and severity of periodontitis can be significantly affected by bacterial virulence as well as host immunity dysfunction. Periodontal tissue destruction has been proved to result from cascade of cytokines synthesized by reactive cells upon stimulation by pathogenic bacteria and lipopolysaccharides within their cell membranes. The clinical use of genetically programmed cells, producing substances blocking IL-1, based on recombinant IL-1 antagonist, as well as cytokines activating fibroblasts and osteoblasts to regenerate the destroyed periodontal tissue could prove alternative to the conventional treatment. Another cytokine of interest in respect to periodontitis ethiopathogenesis is soluble tumor necrosis factor receptor I (sTNF RI). Observation of soluble TNF receptors as physiologic inhibitors of TNF led to its administration in therapeutic process as well as in therapy selected cases of aggressive periodontitis.

Mudskipper interleukin-34 modulates the functions of monocytes/macrophages via the colony-stimulating factor-1 receptor 1

Interleukin-34(IL-34)is a novel cytokine that plays an important role in innate immunity and inflammatory processes by binding to the colonystimulating factor-1 receptor(CSF-1R).However,information on the function of IL-34 in fish remains limited.In the present study,we identified an IL-34 homolog from mudskippers(Boleophthalmus pectinirostris).In silico analysis showed that the mudskipper IL-34(BpIL-34)was similar to other known IL-34 variants in sequence and structure and was most closely related to an orange-spotted grouper(Epinephelus coioides)homolog.BpIL-34 transcripts were constitutively expressed in various tissues,with the highest level of expression found in the brain.Edwardsiella tarda infection significantly up-regulated the mRNA expression of BpIL-34 in the mudskipper tissues.The recombinant mature BpIL-34 peptide(rBpIL-34)was purified and used to produce anti-rBpIL-34 IgG.Western blot analysis combined with PNGase F digestion revealed that native BpIL-34 in monocytes/macrophages(MOs/MФs)was N-glycosylated.In vitro,rBpIL-34 treatment enhanced the phagocytotic and bactericidal activity of mudskipper MOs/MФs,as well as the mRNA expression of pro-inflammatory cytokines like tumor necrosis factorα(BpTNF-α)and BpIL-1βin these cells.Furthermore,the knockdown of mudskipper CSF-1R1(BpCSF-1R1),but not mudskipper BpCSF-1R2,significantly inhibited the rBpIL-34-mediated enhanced effect on MO/MФfunction.In conclusion,our results indicate that mudskipper BpIL-34 modulates the functions of MOs/MФs via BpCSF-1R1.

Inhibition of Osteoarthritis in Rats by Electroporation with Interleukin-1 Receptor Antagonist

Gene therapy constitutes a promising strategy for the treatment of osteoarthritis (OA). We assessed the use of electroporation (EP) of non-viral gene vectors, and compared its efficacy with that of adeno-associated virus (AAV) vectors. EP- and AAV-mediated delivery of human interleukin-1 receptor antagonist (hIL-1Ra) was localized performed in the joints of rats following induction of OA. mRNA levels for hIL-1Ra, IL-1β, TNF-α, MMP-13 and ADAMTS-4 in the cartilage and synovial tissues were analyzed. Structural analyses of the subchondral bone at the medial femoral condyle were performed by Micro-CT after treatment. Knee joint specimens were staining with hematoxylin and eosin and Saffron O. Induction of hIL-1Ra by both EP and AAV inhibited inflammatory-induced sub-chondral bone reconstruction, and effectively suppressed IL-1β activity, as evidenced by decreased expression of MMP-13 and ADAMTS-4. Histological analyses revealed significant protection of cartilage, proteoglycan by EP and AAV. hIL-1Ra expression was similar in both the EP and AAV groups. Notably, this gene is not easier degraded transduced by EP compared with AAV. Taken together, these results show that EP offers transfection efficiency comparable to that of AAV, with the potential for longer gene expression, making EP a promising candidate for efficient non-viral delivery of OA gene therapy.

Molecular Characterization, 3D Modeling of Grass Carp Interleukin-10 Receptor 1 (IL10R1)

Interleukin-10 (IL-10) is an important cytokine that plays a pivotal role in natural and adaptive immune systems. However, in lower vertebrates, especially in teleost the receptor of this cytokine is still largely unknown. This paper described the cloning and characterization of grass carp interleukin-10 receptor 1 (gcIL10R1) and the 3D structure of its extracellular domain was predicted. The gcIL10R1 cDNA included 180 bp5’ untranslated region (UTR), 870 bp3’ UTR and an open reading frame (ORF) of 1632 bp. The ORF was found to encode a 543 amino acid protein with a putative JAK1 binding site, one STAT3 binding site. The phylogenetic analysis clusters gcIL10R1 with other teleost IL10R1s but independently of the amphibian, avian and mammalian IL10R1s. The 3D structure of its extracellular domain was the first homology model of a fish IL10R1 that revealed a high similarity with its mammalian and avian counterparts.

Analysis of fibronectin, fibronectin receptor and interleukin 1 in patients with cirrhosis treated by Yanggan Jieyu decoction

AIM To investigate the adjusting effects of the Yanggan Jieyu (YGJY, nourishing the liver and alleviate mental depression) decoction on the plasma concentration of fibronectin (FN), fibronectin receptor (FNR), tumor necrosis factor alpha (TNF α) and the activity of interleukin 1 (IL 1) in patients with cirrhosis. METHODS Thirty four cases of cirrhosis (in decompensation) were divided into YGJY decotion treated group and control group treated by routine method. FN, FNR and TNF α were measured with ELESA and expressed as mg/L (FN, FNR) and ng/L (TNF α), and IL 1 was measured by mice thymocyte proliferation using β scintillation counter and expressed as cpm. RESULTS In YGJY decoction treated group, before treatment, FN was 247 9±97 2, FNR 5 6±2 7, TNF α 83 9±7 1 and IL 1 was 2760 8±813 6, and after treatment. FN was 298 3±93 2 ( P <0 01), FNR 4 3±2 3 ( P <0 05, TNF α 93 6±12 0 ( P <0 05) and IL 1 was 1922 3±847 0 ( P <0 05). The FN and TNF α plasma level after treatment increased remarkably, while FNR and IL 1 decreased obviously. In the control group before treatment, FN was 248 8±101 9, FNR 5 5±1 9, TNF α 126 1±48 1 and IL 1 was 2540 6±603 2, and after treatment was 241 6±77 1 ( P >0 05), FNR 5 4±1 2 ( P >0 05), TNF α 100 6±15 5 ( P >0 05) and IL 1 was 2360 6±860 0 ( P >0 05), the plasma levels of FN, TNF α, FNR and IL 1 did not change signifiantly. CONCLUSION YGJY decoction could prevent the process of the hepatic fibrosis by readjusting the plasma levels of FN, FNR, TNF α and IL 1 mediating acivities in cirrhosis, which is of clinical significance.

白细胞介素1受体颉颃剂抑制脂多糖促奶牛外周血单个核细胞氧化应激损伤作用的研究

试验以脂多糖(LPS)为刺激源,以细胞活力、抗氧化指标和炎症因子为判断指标,探讨白细胞介素1受体颉颃剂(IL-1Ra)通过抑制白细胞介素1β(IL-1β)的活性,对LPS诱导外周血单个核细胞(Peripheral blood mononuclear cells,PBMCs)氧化损伤的缓解作用。试验采用单因子完全随机设计,PBMCs被随机分为7个组(每组6个重复),分别给予不同的处理:第1组是阴性对照组(Neg组),完全培养基培养30 h;第2组损伤组(Dam组),是在完全培养基中培养6 h后,再经10μg/mL的LPS工作液培养24 h;第3至7组(R0.25、R0.5、R1、R5组和R10组)细胞分别经浓度为0.25、0.5、1、5、10 ng/mL的IL-1Ra培养6 h,接着经10μg/mL的LPS工作液培养24 h。结果表明:与Neg组相比,Dam组的细胞活力、抗氧化相关酶[包括总抗氧化能力(T-AOC)以及总超氧化物歧化酶(T-SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GPx)和硫氧还蛋白还原酶(TrxR)]的活性显著降低,丙二醛(MDA)浓度、炎症因子白细胞介素-6(IL-6)和IL-1β含量以及诱导型一氧化氮合酶(iNOS)活性、一氧化氮(NO)含量均显著升高(P≤0.05)。与Dam组相比,R1组显著逆转了氧化损伤引起的上述抗氧化活性的降低和炎症因子浓度的升高,其他IL-1Ra处理组对上述指标的逆转效果不同程度地低于R1组(P≤0.05)。上述结果说明,LPS通过诱发PBMCs产生大量IL-1β进而导致细胞氧化损伤,IL-1Ra剂量依赖性地缓解了LPS引起的氧化损伤,添加剂量以1 ng/mL为宜。

血清可溶性髓系细胞触发性受体1、白细胞介素-21、25羟基维生素D在炎症性肠病患儿中的表达及相关性

目的探讨血清可溶性髓系细胞触发性受体1(sTREM-1)、白细胞介素-21(IL-21)、25羟基维生素D[25(OH)D]在炎症性肠病患儿中的表达及相关性。方法选取107例炎症性肠病患儿纳入观察组,另选取同期53例健康体检儿童纳入对照组,依照疾病活动性将观察组患儿分为活动期组54例和缓解期组53例,分别比较观察组与对照组、活动期组与缓解期组sTREM-1、IL-21、25(OH)D表达水平,采用Kendall's tau-b法分析sTREM-1、IL-21、25(OH)D与炎症性肠病活动性的相关性;采用受试者工作特征(ROC)曲线分析sTREM-1、IL-21、25(OH)D诊断炎症性肠病和预测炎症性肠病活动期的曲线下面积(AUC)、敏感度、特异度。结果观察组血清sTREM-1、IL-21水平高于对照组,25(OH)D水平低于对照组,差异有统计学意义(P<0.05)。活动期组血清sTREM-1、IL-21水平高于缓解期组,25(OH)D水平低于缓解期组,差异有统计学意义(P<0.05)。Kendall′s tau-b相关性分析显示,sTREM-1、IL-21与炎症性肠病活动性呈正相关(r=0.460、0.484,P<0.05),25(OH)D与炎症性肠病活动性呈负相关(r=-0.434,P<0.05)。ROC曲线显示,sTREM-1、IL-21、25(OH)D和三者联合诊断炎症性肠病的AUC分别为0.791、0.852、0.808和0.862,敏感度分别为74.80%、81.30%、75.50%和81.30%,特异度分别为75.50%、75.50%、81.30%和79.20%;sTREM-1、IL-21、25(OH)D和三者联合预测炎症性肠病活动期的AUC分别为0.821、0.840、0.799和0.840,敏感度分别为79.60%、75.90%、77.40%和87.00%,特异度分别为79.20%、75.50%、83.30%和79.20%。结论血清sTREM-1、IL-21、25(OH)D水平与儿童炎症性肠病的发生与发展密切关联,动态监测其水平有助于为临床诊断炎症性肠病和评估患儿病情进展提供重要参考依据。

白细胞介素-1受体拮抗剂与骨关节炎及亚型的孟德尔随机化研究

目的 采用双样本孟德尔随机化(Mendelian randomization, MR)的研究方法,评估白细胞介素-1受体拮抗剂(interleukin-1 receptor antagonist, IL-1RA)与骨关节炎及亚型骨关节炎的因果关系。方法 IL-1RA与骨关节炎、膝骨关节炎、髋骨关节炎的单核苷酸多态性位点(single nucleotide polymorphism, SNP)来自公开的全基因组关联研究汇总数据集,选取密切相关的SNP作为工具变量(instrumental variable, IV)。筛选敏感度试验,MR多效性残差和采用离群值检验来验证所识别的IV的异质性和多效性。采用5种不同的模型,包括逆方差加权模型(inverse-variance weighted, IVW)、加权中值估计模型、基于加权模型的方法、MR-Egger回归和简单众数法进行MR分析。结果 研究不存在异质性。固定效应模型的IVW显示,IL-1RA与骨关节炎(OR=1.06,95%CI:1.01~1.11)、膝骨关节炎(OR=1.07,95%CI:1.01~1.13)之间有显著的因果关系,与髋骨关节炎之间具有相关性,因果关系不显著。敏感度分析显示,研究结果具有稳健性。结论 MR研究支持IL-1RA水平与骨关节炎、膝骨关节炎的发病风险具有因果关系。

NapA蛋白诱导巨噬细胞分泌趋化因子单核细胞趋化蛋白1和白细胞介素8的机制

目的:研究幽门螺杆菌NapA蛋白诱导巨噬细胞分泌趋化因子单核细胞趋化蛋白1(monocyte chemoattractant protein-1,MCP-1)和白细胞介素8(interleukin-8,IL-8)的机制。方法:利用NapA蛋白处理巨噬细胞,然后使用ELISA法检测上清中MCP-1和IL-8的表达量。使用C29、ST2825、SB203580、SP600125以及PDTC和巨噬细胞预先共孵育1 h,分别抑制Toll样受体2(toll-like receptors 2,TLR2)、髓样分化因子(myeloid differentiation factor 88,MyD88)、核糖核酸酶p蛋白亚基p38(ribonuclease p-protein subunit p38,p38)、应激活化蛋白激酶(c-Jun N-terminal kinase,c-Jun)和核因子κB(nuclear factor kappa B,NF-κB)的活性,然后再加入NapA蛋白孵育4 h,收集上清并检查其中MCP-1和IL-8的表达量。结果:NapA蛋白刺激巨噬细胞后,MCP-1和IL-8的表达量明显高于未处理组。利用抑制剂C29抑制TLR2的活性,NapA蛋白诱导的MCP-1和IL-8表达量降低。使用ST2825、PDTC以及SB203580分别抑制MyD88、NF-κB以及p38的活性,能够降低NapA蛋白诱导巨噬细胞分泌MCP-1和IL-8的能力,但是抑制c-Jun不影响NapA蛋白诱导巨噬细胞分泌MCP-1和IL-8。结论:幽门螺杆菌NapA蛋白通过TLR2/MyD88/NF-κB通路诱导巨噬细胞分泌MCP-1和IL-8。

血清iNOS、TREM-1、IL-1Ra表达与细菌感染性肠炎患者病情严重程度的关系及其临床意义研究

目的探究细菌感染性肠炎患者血清诱导型一氧化氮合酶(iNOS)、髓样细胞触发受体-1(TREM-1)和白细胞介素-1受体拮抗剂(IL-1Ra)表达的临床意义。方法前瞻性选取2021年2月—2023年2月广州中医药大学东莞医院收治的120例细菌感染性肠炎患者为研究对象。采集患者粪便标本,分析感染病原菌的病原学特点;根据病情严重程度将患者分为轻度组28例、中度组79例和重度组13例。另选取同期本院体检的健康体检者60例为对照组。比较各组炎症因子[血清降钙素原(PCT)、C反应蛋白(CRP)]、iNOS、TREM-1、IL-1Ra水平;采用Pearson相关分析iNOS、TREM-1、IL-1Ra与炎症因子水平的相关性;采用受试者工作特征(ROC)曲线分析血清iNOS、TREM-1、IL-1Ra对重度细菌感染性肠炎的诊断价值。结果120例细菌感染性肠炎患者共检出176株病原菌,其中氏阳性菌38株(21.59%),革兰阴性菌138株(78.41%)。4组血清PCT、CRP、iNOS、TREM-1、IL-1Ra水平比较,差异均有统计学意义(P<0.05);重度组、中度组、轻度组和对照组依次降低(P<0.05)。Pearson相关性分析结果显示,iNOS、TREM-1、IL-1Ra水平与PCT、CRP水平均呈正相关(P<0.05)。ROC曲线分析结果显示,iNOS最佳截断值为50.07 ng/L,诊断重度细菌感染性肠炎的敏感性和特异性分别为76.92%(95%CI:0.462,0.950)、81.31%(95%CI:0.726,0.882);TREM-1最佳截断值为70.11 pg/mL,诊断的敏感性和特异性分别为84.62%(95%CI:0.546,0.981)、85.05%(95%CI:0.769,0.912);IL-1Ra最佳截断值为271.75 ng/L,诊断的敏感性和特异性分别为92.31%(95%CI:0.640,0.998)、66.36%(95%CI:0.566,0.752)。结论细菌感染性肠炎患者血清iNOS、TREM-1、IL-1Ra表达升高,与患者病情严重程度存在相关性;三者在诊断重度细菌感染性肠炎方面具有良好的诊断价值,或可作为临床评估细菌感染性肠炎病情的潜在指标。

非酒精性脂肪性肝病患者血清IL-1RA、CTRP13和CK-18水平变化及其临床意义探讨

目的探讨非酒精性脂肪性肝病(NAFLD)患者血清白细胞介素-1受体拮抗剂(IL-1RA)、补体C1q肿瘤坏死因子相关蛋白13(CTRP13)和细胞角蛋白18(CK-18)水平变化及其临床意义。方法2021年1月~2023年1月我院收治的67例NAFLD患者和55例健康体检者,经肝活检诊断肝脏脂肪变性分级,采用ELISA法检测血清IL-1RA、CTRP13和CK-18水平。应用多元Logistic回归分析危险因素。结果NAFLD组血清IL-1RA和CTRP13水平分别为(328.6±54.3)pg/ml和(2634.2±397.5)pg/ml,显著低于健康人组【分别为(673.1±125.4)pg/ml和(3425.7±423.8)pg/ml,P<0.05】,而血清CK-18水平为(15.2±3.1)ng/ml,显著高于健康人组【(3.9±0.7)ng/ml,P<0.05】;17例F3级肝脂肪变性患者血清IL-1RA和CTRP13水平分别为(256.3±47.6)pg/ml和(2056.3±308.4)pg/ml,显著低于29例F1级患者【分别为(388.3±59.4)pg/ml和(3071.5±409.3)pg/ml,P<0.05】或21例F2级患者【分别为(304.7±50.1)pg/ml和(2498.1±374.2)pg/ml,P<0.05】,而血清CK-18水平为(23.4±4.7)ng/ml,显著高于F1级患者【(8.1±1.3)ng/ml,P<0.05】或F2级患者【(18.5±2.9)ng/ml,P<0.05】;F3级肝脂肪变性患者肥胖、合并糖尿病、合并高脂血症、有代谢综合征家族史、血清IL-1RA≥256.5pg/ml、CTRP13≥2056.5pg/ml和CK-18≥21.6 ng/ml占比分别为70.6%、76.5%、88.2%、70.6%、35.3%、35.3%和70.6%,与50例F1/F2级的38.0%、42.0%、40.0%、30.0%、92.0%、80.0%和10.0%比,差异显著(P<0.05);多因素Logistic回归分析表明,肥胖【OR(95%)为2.0(1.1~3.6)】、合并糖尿病【OR(95%)为2.1(1.1~4.1)】、合并高脂血症【OR(95%)为1.6(1.0~2.6)】、IL-1RA【OR(95%)为0.5(0.3~0.9)】、CTRP13【OR(95%)为0.5(0.3~0.9)】和CK-18【OR(95%)为1.7(1.2~2.5)】为影响NAFLD患者肝脏脂肪变性程度的危险因素(P<0.05)。结论NAFLD患者血清IL-1RA、CTRP13和CK-18水平异常变化可能为评估肝脏脂肪变性程度提供一定的依据。

不同分型急性缺血性脑卒中患者血清OPN、IRAK4和S1P水平及其预后分析

目的探究不同分型急性缺血性脑卒中患者血清骨桥蛋白(OPN)、白介素1受体关联激酶4(IRAK4)和1-磷酸鞘氨醇(S1P)水平及与改良Rankin量表(mRS)评分的关系。方法选取2022年1月—2023年12月东莞松山湖东华医院神经内科收治的急性缺血性脑卒中患者150例为病例组,根据分型分为大动脉粥样硬化型(n=23)、小动脉闭塞型(n=52)、心源性栓塞型(n=60)、其他病因型(n=11)及不明原因型(n=4)。根据mRS评分分为预后良好亚组(n=117)与预后不良亚组(n=33)。另选取健康志愿者120例纳入健康对照组。采用酶联免疫吸附法检测OPN、IRAK4、S1P水平,记录患者神经功能缺损(NIHSS)评分、mRS评分;Pearson相关性分析NIHSS评分、mRS评分与血清OPN、IRAK4和S1P的相关性;受试者工作特征曲线(ROC)分析血清OPN、IRAK4和S1P对急性缺血性脑卒中患者预后的预测价值。结果与健康对照组比较,病例组血清OPN、IRAK4和S1P水平升高(t/P=25.882/<0.001、14.910/<0.001、50.674/<0.001);不同类型急性缺血性脑卒中患者血清OPN、IRAK4和S1P比较,小动脉闭塞型>心源性栓塞型>其他病因型>大动脉粥样硬化型>不明原因型(F/P=60.344/<0.001、17.798/<0.001、67.339/<0.001、124.678/<0.001);与预后良好亚组比较,预后不良亚组血清OPN、IRAK4和S1P水平、NIHSS评分显著更高(t/P=5.377/<0.001、3.829/<0.001、3.285/<0.001、4.805/<0.001);血清OPN、IRAK4和S1P水平与NIHSS评分、mRS评分均呈正相关(NIHSS评分:r/P=0.459/0.009、0.423/0.017、0.525/<0.001;mRS评分:r=0.493、0.479、0.487,P均<0.001);血清OPN、IRAK4、S1P及三者联合预测急性缺血性脑卒中患者预后价值AUC分别为0.656、0.740、0.804、0.872,三者联合预测急性缺血性脑卒中预后的AUC大于OPN、IRAK4、S1P单独预测(Z/P=3.237/0.001,5.181/0.001,2.018/0.035)。结论急性缺血性脑卒中患者血清OPN、IRAK4和S1P水平升高,且小动脉闭塞型和心源性栓塞型分型OPN、IRAK4、S1P水平和NIHSS评分显著高于其他分型,血清OPN、IRAK4及S1P联合检测对急性缺血性脑卒中患者预后具有较高的预测价值。

感染性休克患者IRAK1和TRAF6的表达变化及临床意义研究

目的探讨感染性休克患者白细胞介素-1受体相关激酶1(IRAK1)、肿瘤坏死因子相关受体6(TRAF6)的表达变化及临床意义。方法以2020年11月至2022年11月该院收治的142例感染性休克患者(感染性休克组)为研究对象,并以同期来该院进行体检的体检者为对照组。根据感染性休克组患者住院观察治疗28 d后的生存状况分为生存组100例和死亡组42例,监测感染性休克患者入院时及治疗2、4、6 d后的IRAK1、TRAF6表达变化,并记录患者急性生理学与慢性健康状况评分系统Ⅱ(APACHEⅡ)评分和序贯器官功能衰竭评估(SOFA)评分动态变化;Spearman相关性分析评价感染性休克患者IRAK1、TRAF6与APACHEⅡ评分、SOFA评分的相关性;Pearson相关性分析IRAK1与TRAF6的相关性;Logistic回归分析感染性休克患者生存状况的影响因素。通过受试者工作特征曲线分析IRAK1、TRAF6对感染性休克患者生存状况的诊断价值。结果入院时感染性休克组IRAK1、TRAF6相对表达水平显著低于对照组,APACHEⅡ评分、SOFA评分显著高于对照组,差异有统计学意义(P<0.05)。与入院时比较,治疗2、4、6 d后两组IRAK1、TRAF6相对表达水平均显著升高,APACHEⅡ评分、SOFA评分均显著降低,差异有统计学意义(P<0.05);与死亡组比较,生存组在各个相应时间点IRAK1、TRAF6相对表达水平均较高,APACHEⅡ评分、SOFA评分均较低,差异有统计学意义(P<0.05)。相关性分析显示,感染性休克患者IRAK1、TRAF6与APACHEⅡ评分、SOFA评分均呈负相关,IRAK1与TRAF6呈正相关(r=0.688,P<0.05)。IRAK1、TRAF6及APACHEⅡ评分是影响感染性休克患者生存状况的独立危险因素(P<0.05)。IRAK1、TRAF6联合诊断的曲线下面积(AUC)显著大于IRAK1单独诊断的AUC(Z=2.044,P=0.041),以及TRAF6单独诊断的AUC(Z=2.442,P=0.015)。结论感染性休克患者IRAK1、TRAF6的表达可评估患者生存及预后状况。