AIM: To investigate the clinical efficacy of leukocytapheresis (LCAP) in patients with active ulcerative colitis (UC), and to elucidate the mechanisms by determining the changes in the cytokine levels in the periphera...AIM: To investigate the clinical efficacy of leukocytapheresis (LCAP) in patients with active ulcerative colitis (UC), and to elucidate the mechanisms by determining the changes in the cytokine levels in the peripheral blood and of the functions of the peripheral blood leukocytes in these patients. METHODS: The subjects were 19 patients with active UC, with a mean clinical activity index (CAI) of 9.2. The LCAP was conducted using Cellsorba E. In each session of LCAP, 2-3 L of blood at the flow rate of 30-50 mL/min was processed. The treatment was carried out in approximately 1-h sessions, once a week, for 5-10 wk. Blood samples for determination of the cytokine levels were collected from the inflow side of the column (site of dehematization; at the start of LCAP) and outflow side of the column (at the end of LCAP). Blood samples for the determination of reactive-oxygen-producing cells were collected from the peripheral blood before and after LCAP. RESULTS: LCAP resulted in clinical improvement in all the 19 patients of UC recruited for this study. Remission (CAI: ≤4) was noted in 15 (79%) of the 19 patients. The blood level of the pro-inflammatory cytokine IL-6 was found to be decreased following treatment by LCAP, and the level of the anti-inflammatory cytokine IL-10 at the outflow side of the LCAP column was found to be significantly elevated as compared to that at the inflow side of the column. The reactive-oxygen-producing granulocytes in the peripheral blood of UC patients was increased as compared to that in healthy persons and the increase was found to be decreased following treatment by LCAP. CONCLUSION: LCAP exerted a high therapeutic efficacy in patients with active UC. Our findings suggest that LCAP is associated with enhanced production of the inhibitory cytokine IL-10 to indirectly inhibit the functions of the inflammatory leukocytes, and that inflammation is also considerably attenuated by the direct removal of reactive-oxygen-producing neutrophils from the peripheral blood.展开更多
OBJECTIVE: To observe the effect of Liandouqingmai recipe(Chinese herbal medicine compound preparation) on the quality of life(QOL) and inflammatory reaction of patients with coronary heart disease(CHD).METHODS: A tot...OBJECTIVE: To observe the effect of Liandouqingmai recipe(Chinese herbal medicine compound preparation) on the quality of life(QOL) and inflammatory reaction of patients with coronary heart disease(CHD).METHODS: A total of 101 CHD patients were randomized into two groups: treatment group(n=45)receiving standard treatment for CHD plus Liandouqingmai recipe, and control group(n=56) receiving standard treatment only. The control group contained 16 normal healthy subjects. Changes in hs-C-reactive protein(CRP), peripheral blood leucocytes(PBL), and interleukin(IL)-6 and IL-10 levels were measured. The Seattle Angina Questionnaire(SAQ) was used to determine patient QOL before and after treatment for 2 weeks.RESULTS: Before treatment, SAQ scores [physical limitation(PL), angina stability(AS), angina frequen-cy(AF), treatment satisfaction(TS), and disease perception(DP)] were not statistically different between groups. After treatment, AS and DP levels of controls were significantly increased compared with the other groups, while PL, AS, AF, TS, and DP levels of the treatment group were significantly increased compared with controls. Treatment group SAQ scores(PL, AS, AF, TS, and DP) were significantly higher than for controls. CHD patient IL-6 and IL-10 levels were significantly higher than controls.Before treatment, mean levels of IL-6, hs-CRP and PBL of the two groups were not statistically different. After treatment, mean levels of IL-6, IL-10,hs-CRP and PBL of the two groups were significantly decreased compared with their before treatment values, and levels of IL-6, hs-CRP, and PBL of the treatment group were lower than controls. Although mean IL-10 levels of both groups decreased, there was no significant difference in between-group and in-group comparisons before and after treatment. Mean levels of IL-6 and IL-10 in the normal group were lower than in CHD patients.SAQ scores of QOL were negatively associated with the inflammatory index(IL-6/IL-10), and there was a significant negative association of IL-10 with AS(r=﹣0.15, P<0.05).CONCLUSION: Inflammatory reactions in CHD patients are related to angina status. Coadministration of CHD standard treatment and Liandouqingmai recipe increased patient SAQ scores by decreasing IL-6, IL-10, hs-CRP, and PBL levels in CHD patients, which might inhibit endothelial inflammation to improve patient QOL.展开更多
文摘AIM: To investigate the clinical efficacy of leukocytapheresis (LCAP) in patients with active ulcerative colitis (UC), and to elucidate the mechanisms by determining the changes in the cytokine levels in the peripheral blood and of the functions of the peripheral blood leukocytes in these patients. METHODS: The subjects were 19 patients with active UC, with a mean clinical activity index (CAI) of 9.2. The LCAP was conducted using Cellsorba E. In each session of LCAP, 2-3 L of blood at the flow rate of 30-50 mL/min was processed. The treatment was carried out in approximately 1-h sessions, once a week, for 5-10 wk. Blood samples for determination of the cytokine levels were collected from the inflow side of the column (site of dehematization; at the start of LCAP) and outflow side of the column (at the end of LCAP). Blood samples for the determination of reactive-oxygen-producing cells were collected from the peripheral blood before and after LCAP. RESULTS: LCAP resulted in clinical improvement in all the 19 patients of UC recruited for this study. Remission (CAI: ≤4) was noted in 15 (79%) of the 19 patients. The blood level of the pro-inflammatory cytokine IL-6 was found to be decreased following treatment by LCAP, and the level of the anti-inflammatory cytokine IL-10 at the outflow side of the LCAP column was found to be significantly elevated as compared to that at the inflow side of the column. The reactive-oxygen-producing granulocytes in the peripheral blood of UC patients was increased as compared to that in healthy persons and the increase was found to be decreased following treatment by LCAP. CONCLUSION: LCAP exerted a high therapeutic efficacy in patients with active UC. Our findings suggest that LCAP is associated with enhanced production of the inhibitory cytokine IL-10 to indirectly inhibit the functions of the inflammatory leukocytes, and that inflammation is also considerably attenuated by the direct removal of reactive-oxygen-producing neutrophils from the peripheral blood.
基金Supported by the Bureau of Traditional Chinese Medicine of Jiangsu Province(No.HZ07097)
文摘OBJECTIVE: To observe the effect of Liandouqingmai recipe(Chinese herbal medicine compound preparation) on the quality of life(QOL) and inflammatory reaction of patients with coronary heart disease(CHD).METHODS: A total of 101 CHD patients were randomized into two groups: treatment group(n=45)receiving standard treatment for CHD plus Liandouqingmai recipe, and control group(n=56) receiving standard treatment only. The control group contained 16 normal healthy subjects. Changes in hs-C-reactive protein(CRP), peripheral blood leucocytes(PBL), and interleukin(IL)-6 and IL-10 levels were measured. The Seattle Angina Questionnaire(SAQ) was used to determine patient QOL before and after treatment for 2 weeks.RESULTS: Before treatment, SAQ scores [physical limitation(PL), angina stability(AS), angina frequen-cy(AF), treatment satisfaction(TS), and disease perception(DP)] were not statistically different between groups. After treatment, AS and DP levels of controls were significantly increased compared with the other groups, while PL, AS, AF, TS, and DP levels of the treatment group were significantly increased compared with controls. Treatment group SAQ scores(PL, AS, AF, TS, and DP) were significantly higher than for controls. CHD patient IL-6 and IL-10 levels were significantly higher than controls.Before treatment, mean levels of IL-6, hs-CRP and PBL of the two groups were not statistically different. After treatment, mean levels of IL-6, IL-10,hs-CRP and PBL of the two groups were significantly decreased compared with their before treatment values, and levels of IL-6, hs-CRP, and PBL of the treatment group were lower than controls. Although mean IL-10 levels of both groups decreased, there was no significant difference in between-group and in-group comparisons before and after treatment. Mean levels of IL-6 and IL-10 in the normal group were lower than in CHD patients.SAQ scores of QOL were negatively associated with the inflammatory index(IL-6/IL-10), and there was a significant negative association of IL-10 with AS(r=﹣0.15, P<0.05).CONCLUSION: Inflammatory reactions in CHD patients are related to angina status. Coadministration of CHD standard treatment and Liandouqingmai recipe increased patient SAQ scores by decreasing IL-6, IL-10, hs-CRP, and PBL levels in CHD patients, which might inhibit endothelial inflammation to improve patient QOL.