外周血CD4^(+)CD25^(+)Treg细胞、TLR4、hCMV-IgM与动脉粥样硬化型急性脑梗死患者颈动脉粥样硬化的关系

目的探讨外周血CD4^(+)CD25^(+)Treg细胞、TLR4、人巨细胞病毒(hCMV)-IgM与动脉粥样硬化型急性脑梗死(As-ACI)患者颈动脉粥样硬化的关系。方法选取89例As-ACI患者(脑梗死组),另选取健康体检者43例(对照组)。根据颈内动脉超声结果将As-ACI患者分为内膜正常组、内膜增厚组、斑块组、狭窄组。比较各组外周血CD4^(+)CD25^(+)Treg细胞水平、单个核细胞TLR4表达水平、hCMV-IgM抗体阳性率和内膜中膜厚度(IMT)。分析As-ACI患者颈动脉狭窄的危险因素,分析CD4^(+)CD25^(+)Treg细胞、TLR4与IMT的相关性及其对颈动脉狭窄的预测价值。结果脑梗死组CD4^(+)CD25^(+)Treg细胞、HDLC水平低于对照组,TLR4表达、hCMV-IgM抗体阳性率、TC、TG、LDLC、hs-CRP水平、IMT高于对照组(P<0.05)。内膜正常组、内膜增厚组、斑块组、狭窄组CD4^(+)CD25^(+)Treg细胞水平依次降低,TLR4表达、hCMV-IgM抗体阳性率、IMT依次增高(P<0.05)。CD4^(+)CD25^(+)Treg细胞水平与IMT呈负相关,TLR4表达与IMT呈正相关(P<0.05)。高血压、CD4^(+)CD25^(+)Treg表达、TLR4表达、hCMV-IgM抗体阳性是As-ACI患者颈动脉狭窄的危险因素(P<0.05)。CD4^(+)CD25^(+)Treg细胞、TLR4表达水平联合检测的预测价值高于单独检测(P<0.05)。结论外周血CD4^(+)CD25^(+)Treg细胞、TLR4、hCMV-IgM抗体阳性率与As-ACI患者颈动脉粥样硬化进展有关,外周血CD4^(+)CD25^(+)Treg细胞、TLR4联合可以较好预测病变过程。

RhoA、CD4^(+)CD25^(+)调节性T细胞、MYBL2在胃癌患者中的表达及对预后和生存时间的影响

目的:探讨RhoA、CD4^(+)CD25^(+)调节性T细胞、成髓细胞瘤转录因子第2亚型(MYBL2)在胃癌患者中的表达及对预后和生存时间的影响。方法:选取2017年1月至2019年1月于本院就诊的134例胃癌患者术后癌组织标本作为研究对象,另选取其中62例胃癌患者相应的癌旁组织标本及40例同期非胃癌患者正常胃黏膜组织标本进行对照,检测癌组织、癌旁组织、正常胃黏膜组织中RhoA、CD4^(+)CD25^(+)调节性T细胞、MYBL2的表达情况,分析其对胃癌预后及生存时间的影响。结果:RhoA,CD4^(+)CD25^(+)调节性T细胞、MYBL2在癌组织中的阳性率均明显高于癌旁组织和正常胃黏膜组织(P<0.05)。胃癌患者术后平均生存时间为(28.61±1.34)个月,其中RhoA、CD4^(+)CD25^(+)调节性T细胞、MYBL2阳性患者的生存时间均短于阴性患者(P<0.05)。RhoA(+)、CD4^(+)CD25^(+)调节性T细胞(+)、MYBL2(+)是胃癌患者预后的危险因素(P<0.05)。结论:检测RhoA,CD4^(+)CD25^(+)调节性T细胞、MYBL2的表达可作为胃癌病情严重程度、预后及生存时间评估的重要补充手段。

An Association between Immunosenescence and CD4^+CD25^+ Regulatory T Cells: A Systematic Review

Objective Age-related increment of the prevalence of CD4^＋CD25^＋ regulatory T （Treg） cells were described controversially, and whether such changes explain immune dysfunction in the elderly is still unclear. The aim of this systematic review is to evaluate the role of the Tregs in immunosenescence. Methods Medline and manual searches were performed to identify all published epidemiological and animal studies investigating the efficacy of the association between immunosenescence and Treg cells. Results It was founded that the frequency, phenotypic characteristics, and number/function of Tregs were altered significantly with aging. Medical conditions in individuals with advanced ageas well as apoptosis intensity of Treg cells had an impact on the accumulation of Tregs which in turn could deteriorate cytotoxic activity of CD8＋ T and NK cells and production of IL-2. The range of immune cells that could be suppressed by Treg cells was quite wide and covered CD4^＋CD25^＋ T cells, NK cells, dendritic cells and even monocytes. These changes were observed both in humans and experimental animals. Besides, it was believed that frequency of Tregs increased with age and was accompanied by intensified suppressive activity for Tregs in patients, for example, with Alzheimer disease （AD） and Parkinson disease （PD）. The impaired condition of CD4＋ T cells, so-called immunosenescence, rendered transplant recipients less responsive to an allogeneic kidney graft, an effect that was limited to transplant recipients who were aged over 60 years. Conclusions Treg cells are associated with immunosenescence. All these changes contribute to the aging-related decline of immune responses and lead to the higher risk of immune-mediated diseases, cancer or infections in aged individuals.

Analysis of CD4^+CD25^+ Regulatory T Cells and Foxp3 mRNA in the Peripheral Blood of Patients with Asthma

The changes of CD4^＋CD25^＋ regulatory T cells （CD4^＋CD25^＋ Treg） and Foxp3 mRNA in peripheral blood mononuclear cells （PBMCs） from patients with asthma were investigated in order to elucidate the possible roles of CD4^＋CD25^＋ Treg in the development of asthma. The peripheral blood samples were collected from 29 healthy controls （normal control group） and 78 patients with asthma which included 30 patients in exacerbation group, 25 patients in persistent group, and 23 patients in remission group. By using flow cytometry and RT-PCR, the CD4^＋CD25^＋ Treg ratio and Foxp3 mRNA in PBMCs were detected. The CD4^＋CD25^＋ Treg ratio and Foxp3 mRNA in PBMCs of exacerbation and persistent groups were lower than that of remission and normal control groups （P〈0.05）. Although the CD4^＋CD25^＋ Treg ratio and Foxp3 mRNA of remission group were also lower than that of normal control group, there was no significant difference between them （P〉0.05）. As compared with persistent group, exacerbation group had lower CD4^＋CD25^＋ Treg ratio and Foxp3 mRNA （P〈0.05）. It was indicated that the decrease of CD4^＋CD25^＋ Treg ratio and its function in PBMCs may be responsible for pathogenesis of asthma.

Depletion of CD4^+CD25^+ regulatory T cells can promote local immunity to suppress tumor growth in benzo[a]pyrene-induced forestomach carcinoma

AIM： To elucidate the distribution of CD4^＋CD25^＋ regulatory T cells （Tregs） in different lymphoid tissues and its local enhancement on tumor growth before and after depletion of CD4^＋CD25^＋ Tregs. METHODS： Female ICR mice were garaged with benzo[a]pyrene （BaP） to induce forestomach carcinoma. CD4^＋CD25^＋ Tregs were intraperitoneally depleted with monoclonal antibody PC61. These mice were divided into BaP-only, BaP ＋ IgG, BaP ＋ PC61, and control groups. The forestomach of mice was dissected for histological analysis, and tunnel test was performed for apoptosis of tumor cells. CD4^＋CD25^＋ Tregs were sorted from different lymphoid tissues and expression of Foxp3, IL-10, and chemokine receptors was analyzed by flow cytometry, semi-quantitative and veal-time polymerase chain reaction. RESULTS： The mice gavaged with only BaP showed increased forestomach papilloma and carcinoma at wk 16 and 32. The proportion of CD4^＋CD25^＋ Tregs was significantly higher in peri-stomach regional lymph nodes than in other lymphoid tissues. These CD4^＋CD25^＋ Tregs in regional lymph nodes expressed higher levels of Foxp3 and IL-10, enriched in the CD62L-subset, and CCR1 and CCR5 chemokine receptors. In mice gavaged with BaP ＋ PC61, the number of tumor nodules and tumor volume decreased significantly with massive infiltrating cells and apoptosis of tumor cells. In the draining regional lymph nodes, the number of CD4^＋CD25^＋ Tregs also decreased significantly. CONCLUSION： Inducible and activated CD4^＋CD25^＋ Tregs in the draining regional lymph nodes suppress host local immunity during tumor growth. Depletion of CD4^＋CD25^＋ Tregs can promote host local immunity to suppress tumor growth.

Changes of CD4^+CD25^+ Regulatory T Cells in Patients with Acute Coronary Syndrome and the Effects of Atorvastatin

The function of CD4＋CD25＋ regulatory T lymphocytes （Treg） in patients with acute coronary syndrome （ACS） and the effects of atorvastatin were investigated. Forty-eight patients with ACS were randomly divided into two groups： group C receiving conventional therapy （n=24）, and group C＋A receiving conventional therapy＋atorvastatin （10 mg/day, n=24）. T lymphocytes from ACS patients （before and 2 weeks after the treatment） or 18 healthy subjects were separated and the flow cytometry was used to measure the percentage of Treg. The inhibitory ability of Treg on effector T cells was determined by mixed lymphocyte reaction （MLR）. ELISA was used to measure the serum levels of cytokines （IL-10, TGF-β1 and IFN-γ） before and after treatment. The results showed that as compared with normal control group, Treg percentage was decreased significantly （P〈0.01）, the inhibitory ability of Treg on the T lymphocytes proliferation was reduced （P〈0.01）, IFN-γ levels were increased and IL-10 and TGF-β1 levels were lowered in ACS patients. After treatment with atorvastatin, Treg percentage and the inhibitory ability of Treg on T lymphocytes proliferation were significantly increased in ACS patients. Serum IFN-γ was decreased significantly, while IL-10 and TGF-β1 were elevated significantly as compared with the non-atorvastatin group. The number of Treg was positively correlated with serum TGF-β1, but negatively with serum IFN-γ and CRP. It was concluded that ACS was associated with decreased number and defected function of Treg, which may play an important role in initiating immune-inflammatory response in ACS. The inhibitory effects of atorvastatin on inflammation in ACS may be due to its beneficial effects on Treg and restoration of immune homeostasis.

Increase of CD4^+CD25^+ T cells in Smad3^(-/-) mice

AIM： To investigate the changes of lymphocyte subpopulations, especially CD4^＋CD25^ T regulatory cells in Smad3^-/- mice. METHODS： Hematological changes and changes of lymphocyte subpopulations were detected in Smad3＂/- mice using cell counter and flow cytometry, respectively, and compared to their littermate controls. RESULTS： The numbers of neutrophils and lymphocytes in peripheral blood were significantly increased in Smad3^-/- mice compared to littermate controls. CD19^＋ expressing cells in blood and spleen, and CD8^＋ T cells in thymus were all markedly decreased in Smad3^-/- mice. More important, Smad3^-/- mice had an increased population of CD4^＋CD25^＋ T cells in peripheral lymphoid tissues, including thymus, spleen, and lymph nodes. CONCLUSION： These observations suggest that the changes of lymphocyte subpopulations might play a role in susceptibility to inflammation of Smad3^-/- mice.

Influence of Danshen Injection on airway inflammation and CD4^+ CD25^+ regulatory T cells of asthmatic rats

Objective： To investigate the influence of Danshen Injection on airway inflammation and CD4^＋CD25^＋ regulatory T cells（CD4^＋CD25^＋ Tr） of asthmatic rats, and elucidate the possible mechanism of Danshen Injection in treatment of asthma. Methods： 30 Wister rats were randomly divided into control group, asthma group and Danshen Injection treated group. Bronchoalveolar lavage fluids （BALF） were collected, and cytology studies were conducted. Lung tissues were obtained and pathologic analyses were done with hematoxylin and eosin stain （HE）. Flow cytometry was used to detect the CD4^＋CD25^＋ Tr ratio in peripheral blood mononuclear cells （PBMCs）. Results： Total cell, the percentage of lymphocytes, neutrophils and eosinophils （Eos） in BALF of Danshen Injection-treated group were lower than that in asthma group （P〈0.05, P〈0.01）. Compared with asthma group, less infiltration of inflammatory cells in lung tissues was observed in Danshen Injection-treated group. CD4^＋CD25^＋ Tr of asthma group was lower than that of control and Danshen Injection treated group （P〈0.05）. Conclusion： Danshen Injection can suppress airway inflammation of asthmatic rats, probably by increasing the number of CD4^＋CD25^＋ Tr.

外周血CD4^(+)CD25^(+)、CD8^(+)CD28^(+)调节性T细胞水平对早期宫颈癌患者腹腔镜根治术后预后的预测价值

目的分析外周血CD4^(+)CD25^(+)、CD8^(+)CD28^(+)调节性T细胞水平对早期宫颈癌(CC)患者腹腔镜根治术后预后的预测价值。方法招募2018年9月至2020年9月于儋州市人民医院接受腹腔镜根治术治疗的早期CC患者204例,根据患者术后随访期间预后情况分为预后不良组(43例)和预后良好组(161例)。比较两组临床资料。采用Spearman秩相关分析外周血CD4^(+)CD25^(+)调节性T细胞水平与CD8^(+)CD28^(+)调节性T细胞水平的相关性。采用多因素logistic回归分析早期CC患者腹腔镜根治术后预后不良的影响因素。采用受试者工作特征(ROC)曲线评估外周血CD4^(+)CD25^(+)、CD8^(+)CD28^(+)调节性T细胞水平对早期CC患者腹腔镜根治术后预后不良的预测价值。结果预后不良组CD4^(+)CD25^(+)调节性T细胞、癌胚抗原(CEA)、糖类抗原125(CA125)水平,术后切缘阳性占比以及术中宫旁浸润占比高于预后良好组,CD8^(+)CD28^(+)调节性T细胞水平低于预后良好组,差异有统计学意义(P<0.05)。Spearman秩相关分析结果显示,早期CC患者外周血CD4^(+)CD25^(+)调节性T细胞水平与CD8^(+)CD28^(+)调节性T细胞水平呈负相关(r_(s)=-0.478,P<0.05)。多因素logistic回归分析结果显示,较高的CEA、CA125、CD4^(+)CD25^(+)调节性T细胞水平是促进早期CC患者腹腔镜根治术后预后不良发生的独立危险因素(P<0.05),较高的CD8^(+)CD28^(+)调节性T细胞水平是抑制早期CC患者腹腔镜根治术后预后不良发生的独立保护因素(P<0.05)。ROC曲线分析结果显示,外周血CD4^(+)CD25^(+)、CD8^(+)CD28^(+)调节性T细胞水平能有效预测早期CC患者腹腔镜根治术后预后不良(P<0.05),两项指标联合可进一步提高预测效能[AUC(95%CI)=0.939(0.898~0.979),P<0.001],灵敏度和特异度分别为86.00%、88.20%。结论外周血CD4^(+)CD25^(+)、CD8^(+)CD28^(+)调节性T细胞水平与早期CC患者腹腔镜根治术后预后不良有关,二者能有效预测早期CC患者腹腔镜根治术后预后不良。

Correlation between CD4^＋CD25^＋Treg Cells and CCR4 in Nasopharyngeal Carcinoma

OBJECTIVE CD4^＋CD25^＋ T regulatory （Treg） cells are a population of T cells which suppress an overactive immune system. CCR4 is a chemokine receptor involved in the recruitment of lymphocytes. Nasopharyngeal carcinoma （NPC） is resistant to immunosurveillance, owing to the increased number of tumor-infiltrating Treg cells which are recruited to the tumor bv CCR4.

血清IL-18、IL-22、CD4^(+)CD25^(+)CD127^(low)Treg水平联合检测对狼疮性肾炎患者活动期的诊断效能

目的:分析血清白细胞介素-18(IL-18)、白细胞介素-22(IL-22)、CD4^(+)CD25^(+)CD127^(low)调节性T细胞(Treg)水平联合检测对狼疮性肾炎患者活动期的诊断效能。方法:回顾性分析2022年1月至2023年9月该院收治的64例狼疮性肾炎患者的临床资料,设为研究组,并根据病情严重程度将其分为活动期、稳定期,另选取同期64名健康体检者设为对照组。比较两组及不同病情严重程度患者血清IL-18、IL-22、CD4^(+)CD25^(+)CD127^(low)Treg水平,并分析各指标水平与狼疮性肾炎患者病情严重程度的相关性,采用受试者工作特征(ROC)曲线分析各指标水平单项及联合检测对狼疮性肾炎患者活动期的诊断效能。结果:研究组血清IL-18、IL-22水平均高于对照组,CD4^(+)CD25^(+)CD127^(low)Treg水平低于对照组,差异有统计学意义(P<0.05);活动期患者血清IL-18、IL-22水平均高于稳定期患者,CD4^(+)CD25^(+)CD127^(low)Treg水平低于稳定期患者,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,血清IL-18、IL-22水平与狼疮性肾炎患者病情严重程度均呈正相关(r>0,P<0.05),CD4^(+)CD25^(+)CD127^(low)Treg水平与狼疮性肾炎患者病情严重程度呈负相关(r<0,P<0.05);ROC曲线分析结果显示,血清IL-18、IL-22、CD4^(+)CD25^(+)CD127^(low)Treg水平单项及联合检测诊断狼疮性肾炎患者活动期的曲线下面积分别为0.828、0.817、0.788、0.921,联合检测诊断效能高于三者单项检测。结论:IL-18、IL-22、CD4^(+)CD25^(+)CD127^(low)Treg水平联合检测诊断狼疮性肾炎患者活动期的效能高于三者单项检测。

Isolation and identification of CD4^+CD25^+ regulatory T cells in rat

Objective： To establish a stable and high efficient method for collection of CD4^＋CD25^＋ regulatory T cells from rats in vitro. Methods： CD4^＋CD25^＋ regulatory T cells were isolated from the rat splenic cells through two steps by magic cell sorting （MACS） system. The first step was negative selection of CD4^＋T cells by cocktail antibodies and anti-IgG magic microbeads, and the second step was positive selection of CD25^＋T cells by anti-CD25 PE and anti-PE magic microbeads. The purity and viability of separated cells were measured by flow cytometry （FACS） and Trypan blue staining. The suppressive ability of seperated cells on the proliferation of CD4^＋CD25^- T cells was assessed by cell proliferation assay. Results： The purity of negatively enriched CD4^＋ T cells was 79%-87% （83.6%±2.5% ） , and the purity of positively enriched CD4^＋CD25^＋ T cells was 86%- 93% （ 90.2±1.8% ） with the viability of 92%～95% （92.8% ± 3.4% ）. The enriched cells significantly suppressed the proliferation of CD4^＋CD25^- T cells in mixed lymphocyte culture （P 〈 0.05）. Conclusion： An effective method can be established for enrichment of CD4^＋CD25^＋ regulatory T cells in two steps by MACS, with satisfied cell purity, viability and function.

非小细胞肺癌不同胸腔积液严重程度及预后患者lncRNA MEG3表达及其与Th17/CD4^(+)T细胞的关系

目的:研究非小细胞肺癌(NSCLC)不同胸腔积液严重程度及预后患者lncRNA MEG3表达及其与Th17/CD4^(+)T细胞的关系。方法:选取2020年1月至2022年12月福建医科大学附属泉州第一医院收治的104例NSCLC恶性胸腔积液患者作为研究对象,根据胸腔积液量分为3组:少量胸腔积液组(35例)、中量胸腔积液组(42例)、大量胸腔积液组(27例)。根据患者疾病实际发展转归分为预后良好组(29例未出现复发和转移)和预后不良组(75例出现复发和转移)。另选取同期于福建医科大学附属泉州第一医院治疗的60例肺炎良性胸腔积液患者作为对照组。实时荧光定量PCR检测两组胸腔积液中MEG3表达。收集受试者外周静脉血,流式细胞术检测外周血Th17细胞、CD4^(+)T细胞比例,并计算Th17/CD4^(+)T。对比各组患者lncRNA MEG3及外周血Th17、CD4^(+)T细胞水平。Logistic回归分析NSCLC胸腔积液及预后的影响因素。结果:NSCLC组胸腔积液lncRNA MEG3表达及CD4^(+)T细胞百分比低于对照组,Th17细胞百分比、Th17/CD4^(+)T高于对照组(P<0.05)。大量胸腔积液组lncRNA MEG3表达及CD4^(+)T细胞百分比低于少量胸腔积液组、中量胸腔积液组,中量胸腔积液组lncRNA MEG3表达及CD4^(+)T细胞百分比低于少量胸腔积液组,大量胸腔积液组Th17细胞百分比、Th17/CD4^(+)T高于少量胸腔积液组、中量胸腔积液组,中量胸腔积液组Th17细胞百分比、Th17/CD4^(+)T高于少量胸腔积液组(P<0.05)。预后不良组lncRNA MEG3表达及CD4^(+)T百分比低于预后良好组,而Th17细胞百分比、Th17/CD4^(+)T高于预后良好组(P<0.05)。Logistic回归分析结果显示,lncRNA MEG3为NSCLC胸腔积液的保护因素,Th17/CD4^(+)T为危险因素(P<0.05);lncRNA MEG3为NSCLC预后的保护因素,Th17/CD4^(+)T为危险因素(P<0.05)。结论:NSCLC不同胸腔积液严重程度及预后患者lncRNA MEG3表达及Th17/CD4^(+)T不同,且lncRNA MEG3为NSCLC胸腔积液及预后的保护因素,Th17/CD4^(+)T为危险因素,可作为胸腔积液严重程度及预后诊断的有效生物标志物。

(1-3)-β-D葡聚糖联合降钙素原、CD4^(+)T淋巴细胞多指标在艾滋病患者马尔尼菲篮状菌感染早期诊断临床研究

目的探讨(1-3)-β-D葡聚糖联合降钙素原(procalcitonin,PCT)、CD4^(+)T淋巴细胞多指标在艾滋病患者马尔尼菲篮状菌感染早期诊断临床研究。方法回顾性选取我院2020年1月—2022年6月住院的120例艾滋病患者为研究对象。依据实验室结果,将其分为马尔尼菲篮状菌感染确诊组(血或组织液培育养出马尔尼菲篮状菌),简称A组(62例),及马尔尼菲篮状菌感染临床诊断组[根据临床症状、体征、血常规及(1-3)-β-D葡聚糖、PCT、CD4^(+)T淋巴细胞多指标诊断],简称B组(58例)。检测患者(1-3)-β-D葡聚糖、PCT、CD4^(+)T淋巴细胞的表达水平,采用受试者工作特征(receiver-operating characteristic,ROC)曲线下面积(area under the curve,AUC)评估上述指标联合检测对艾滋病患者感染马尔尼菲篮状菌的诊断效能。结果A组的(1-3)-β-D葡聚糖和PCT水平均高于B组,CD4^(+)T淋巴细胞个数低于B组(P<0.05);(1-3)-β-D葡聚糖、PCT、CD4^(+)T淋巴细胞联合检测的AUC为0.933,(1-3)-β-D葡聚糖单独检测的AUC是0.812,PCT单独检测的AUC为0.883,CD4^(+)T淋巴细胞单独检测的AUC是0.810,(1-3)-β-D葡聚糖、PCT和CD4^(+)T淋巴细胞联合检测的AUC皆优于三项单独检测,表明(1-3)-β-D葡聚糖、PCT和CD4^(+)T淋巴细胞联合检测的诊断价值皆优于单一指标诊断,且联合检测的特异度、约登指数分别为92.43%和0.580,均高于三项单独检测。结论(1-3)-β-D葡聚糖联合PCT和CD4^(+)T淋巴细胞多指标对艾滋病马尔尼菲篮状菌感染具有非常高的临床诊断价值,能够帮助医生分析出高危风险患者,及时制定治疗方案,同时也承担预后效果的判断依据,对治疗艾滋病马尔尼菲篮状菌感染具有非常重要的研究价值。

人类白细胞抗原-DR/CD4^(+)T淋巴细胞白细胞介素6联合降钙素原预测ICU重症急性胰腺炎继发感染效能及对抗菌药物合理使用的指导价值

目的:分析人类白细胞抗原-DR/CD4^(+)T淋巴细胞(HLA-DR/CD4^(+))、白细胞介素6(IL-6)及降钙素原(PCT)在ICU重症急性胰腺炎(SAP)继发感染患者中的诊断效能及对抗菌药物合理使用的指导价值。方法:2020年5月至2023年12月在我院ICU收治的SAP患者80例纳入研究。按照是否继发感染将患者分为感染组(n=43)及未感染组(n=37)。收集所有患者临床资料,包括一般资料、实验室指标、抗菌治疗情况。比较两组一般资料及实验室指标,采用Logistic回归分析重症SAP继发感染的独立危险因素,采用受试者工作特征曲线(ROC)分析血清HLA-DR/CD4^(+)、IL-6及PCT预测SAP继发感染的效能。结果:感染组APACHEⅡ评分大于未感染组(P<0.05)。两组性别、年龄、病因、并发症(高血压、2型糖尿病及高脂血症)情况比较无显著差异(P>0.05)。感染组脂肪酶、IL-6及PCT水平高于未感染组(P<0.05),HLA-DR/CD4^(+)水平低于未感染组(P<0.05)。脂肪酶高表达(OR=2.354,95%CI 1.491~3.716)、HLA-DR/CD4^(+)高表达(OR=3.508,95%CI 1.283~9.588)、IL-6高表达(OR=4.284,95%CI 1.469~12.493)及PCT高表达(OR=5.743,95%CI 1.530~21.563)均是SAP继发感染的独立危险因素(P<0.05)。血清HLA-DR/CD4^(+)、IL-6及PCT及三者联合诊断SAP继发感染的AUC值分别为0.809、0.778、0.819及0.959,具有一定预测价值。联合诊断的AUC值及诊断效能明显大于单独HLA-DR/CD4^(+)(z=3.161,P=0.002)、IL-6(z=3.822,P<0.001)及PCT(z=3.346,P=0.001)诊断。局部感染组血清HLA-DR/CD4^(+)水平高于严重感染组,IL-6及PCT水平均低于严重感染组(P<0.05)。局部感染组抗菌药物使用时间、ICU住院时间及总住院时间均较严重感染组显著缩短(P<0.05)。结论:HLA-DR/CD4^(+)高表达、IL-6高表达及PCT高表达均是SAP继发感染的独立危险因素,可有效预测SAP继发感染。

急性痛风性关节炎患者外周血脂联素与CD4^(+)T细胞亚群的分析及相关性研究

目的比较急性痛风性关节炎患者与健康对照组外周血脂联素及CD4+T细胞亚群的差异,并探究痛风患者脂联素与血尿酸、疾病活动度、CT4^(+)T细胞亚群及部分细胞因子的相关性。方法收集急性痛风组(n=90)及健康对照组(n=72)的临床资料(包括一般资料、中性粒细胞、红细胞沉降率、C反应蛋白、血尿酸、CT4^(+)T细胞亚群及部分细胞因子);检测两组外周血脂联素水平,比较两组间外周血脂联素及CD4+T细胞亚群的差异;分析脂联素与各临床资料的相关性。结果与健康对照组比较,急性痛风组外周血脂联素水平明显降低(P<0.001),且Th2、Th17、Th17/Treg均升高(P<0.05),Treg、Th1/Th2均降低(P<0.05)。急性痛风组外周血脂联素与中性粒细胞、红细胞沉降率及C反应蛋白均呈负相关(r=-0.244,P<0.05;r=-0.311,P<0.05;r=-0.506,P<0.001),而与血尿酸无相关性。急性痛风组外周血脂联素与Th1和Th1/Th2均呈正相关(r=0.252,P<0.05;r=0.218,P<0.05)。急性痛风组外周血脂联素与白细胞介素-2(interleukin-2,IL-2)、白细胞介素-4(interleukin-4,IL-4)和白细胞介素-10(interleukin-10,IL-10)均呈正相关(r=0.323,P<0.05;r=0.377,P<0.05;r=0.359,P<0.05);而与白细胞介素-6(interleukin-6,IL-6)和肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)呈负相关(r=-0.265,P<0.05;r=-0.299,P<0.05)。多元线性回归分析显示,急性痛风组外周血脂联素与红细胞沉降率、C反应蛋白、IL-6及TNF-α均呈负相关(B _(ESR)=-12.541,P=0.003;B_( CRP)=-8.256,P=0.024;B_( IL-6)=-15.907,P=0.037;B _(TNF-α)=-79.770,P=0.040),而与Th1呈正相关(B _(Th1)=2.959,P=0.006)。结论急性痛风性关节炎患者外周血脂联素水平降低,Th2和Th17升高,而Treg降低,脂联素降低与急性痛风性关节炎患者免疫紊乱及免疫炎症相关。

降钙素原、C反应蛋白及CD4^(+) T淋巴细胞在人类免疫缺陷病毒感染患者结核分枝杆菌感染早期诊断中的应用价值

目的:探讨降钙素原(procalcitonin,PCT)、C反应蛋白(C reactive protein,CRP)及CD4^(+)T淋巴细胞水平在人类免疫缺陷病毒(HIV)感染患者结核分枝杆菌(Mycobaterium tuberculosis,MT)感染早期诊断中的应用价值。方法:选取2021年1月—2024年5月常州市第三人民医院收治的69例HIV感染患者为研究对象,根据是否合并MT感染分为单纯HIV感染组(n=35)和HIV合并MT感染组(n=34)。检测两组患者的PCT、CRP及CD4^(+)T淋巴细胞水平,比较两组以上指标的差异,并对HIV合并MT感染患者的以上指标进行相关性分析。通过受试者操作特征(ROC)曲线评估PCT、CRP及CD4^(+)T淋巴细胞水平在MT感染早期诊断中的效能。结果:HIV合并MT感染组的PCT、CRP水平均显著高于单纯HIV感染组,CD4^(+)T淋巴细胞水平显著低于单纯HIV感染组,差异均有统计学意义(P<0.05)。HIV合并MT感染患者中,PCT与CRP水平呈显著正相关(rs=0.607,P<0.001),CD4^(+)T淋巴细胞水平与PCT、CRP均呈负相关(rs=-0.751、-0.700,P<0.001)。ROC曲线分析显示,PCT、CRP及CD4^(+)T淋巴细胞联合检测MT感染的曲线下面积(AUC)为0.911,特异度为97.1%,均显著高于单独检测。结论:PCT、CRP及CD4^(+)T淋巴细胞水平的联合检测在HIV患者MT感染的早期诊断中有较高价值。

CD4^+CD25^(high) Regulatory Cells in Peripheral Blood of NSCLC Patients

The proportion and changes of CD4^＋CD25^high regulatory T cells （Trs） in peripheral blood of non-small cell lung cancer （NSCLC） patients were analyzed and their clinical significance explored. The peripheral blood was collected from 61 patients with NSCLC and 15 healthy controls. By using monoclonal antibodies, the blood samples were evaluated with the flow cytometry for lymphocyte subsets （CD3^＋, CD4^＋ and CD8^＋） and CD4^＋CD25^high Tr cells. The results showed that the proportion of CD4^＋CD25^high Tr cells in NSCLC group was significantly higher than in control group [（4.36 ±2.07） % vs （2.04±1.03） %, P〈0.01]. The proportion of CD4^＋CD25^ high Tr cells in late stage was higher than that in early stage [stages Ⅰ ＋Ⅱ （2.264±0.6） %; stage Ⅲ（3.284± 1.38） %; stage IV （6.06 4±4.08） %] （P〈0.05）. Kaplan-Meier survival analysis revealed that the prognosis of the patients who had higher proportion of CD4^＋CD25^high Tr cells in peripheral blood was worse （P=0.0026）. In conclusion, the relative increase in CD4^＋CD25^high Tr cells in peripheral blood may be related to im- munosuppression and tumor progression in patients with NSCLC. This finding suggests that CD4^＋CD25^high Tr cells in peripheral blood of NSCLC may be positive for prognosis analysis. The use of depletion of the CD4^＋CD25^high Tr cell therapy to treat NSCLC patients may be an effective strategy.

Immunotherapy of rat glioma without accumulation of CD4^+CD25^+FOXP3^+ regulatory T cells

Immunotherapy may be used for the treatment of glioblastoma multiforme; however, the induced immune response is inadequate when either T cells or dendritic cells are used alone. In this study we established a novel vaccine procedure in rats, using dendritic cells pulsed with C6 tumor cell lysates in combination with adoptive transfer of T lymphocytes from syngenic donors. On day 21 after tumor inoculation, all the rats were sacrificed, the brains were harvested for calculation of glioma volume, cytolytic T lymphocyte responses were measured by cytotoxic assay, and the frequency of regulatory T lymphocytes （CD4＋CD25~FOXP3~） in the peripheral blood was investigated by flow cytometric analysis. The survival rate of rats bearing C6 glioma was observed. Results showed that the co-immunization strategy had significant anti-tumor potential against the pre-established C6 glioma, and induced a strong cytolytic T lymphocyte response in rats. The frequency of peripheral blood CD4＊CD25＊FOXP3＊ regulatory T lymphocytes was significantly decreased following the combination therapy, and the rats survived for a longer period. Experimental findings indicate that the combined immunotherapy of glioma cell lysate-pulsed dendritic cell vaccination following adoptive transfer of T cells can effectively inhibit the growth of gliomas in rats, boost anti-tumor immunity and produce a sustained immune response while avoiding the accumulation of CD4＋CD25＋FOXP3＋ regulatory r lymphocytes.

Effect of CD4^+CD25^+ regulatory T cells in the development of anterior chamber-associated immune deviation

AIM: To investigate whether CD4(+)CD25(+) regulatory T (Treg) cells play a role in the development of anterior chamber-associated immune deviation (ACAID). METHODS: The dynamic changes in the frequency of CD4(+)D25(+) T cells, CD4(+)D25(+) FoxP3(+) T cells and CD4(+)CD25(+) PD-1(+) T cells from spleens of mice with ACAID were analyzed by flow cytometry. Foxp3 mRNA expression in purified CD4(+)CD25(+) T cells was analyzed using real-time PCR. The suppressive effect of purified CD4(+)CD25(+) T cells on the proliferation of CD4(+)CD25(-) T cells was evaluated by [H-3] thymidine incorporation. A blocking experiment was performed to further address the role of CD4(+)CD25(+) T cells in ACAID. The expression of IL-10 in purified CD4(+)CD25(+) T cells was evaluated by ELISA. RESULTS: Increased frequencies of CD4(+)CD25(+) T cells, CD4(+)CD25(+) Foxp3(+) T cells and CD4(+)CD25(+) PD-1(+) T cells were observed in ACAID. The CD4(+)CD25(+) T cells from mice with ACAID showed enhanced suppressive effect on the proliferation of CD4(+)CD25(-) T cells. Treatment of BALB/c mice with anti-CD25 antibody after injection of OVA into the anterior chamber significantly inhibited the induction of ACAID. Furthermore, purified CD4(+)CD25(+) T cells from ACAID mice secreted IL-10. CONCLUSION: Our results demonstrate that Treg cells are induced in the mice undergoing ACAID. These Treg cells may play a role in the development of ACAID.