Intracellular Cytokine Expression Profile in Patients with Condyloma Acuminata

Objective: To study the immunological mechanisms ofCondyloma acuminata(CA) through investigating Tlymphocyte subset levels and cytokine profile in theperipheral blood of patients with CondylomaAcuminata. Methods: Tricolor and bicolor immunofluorescentstaining antibody of cell surface antigen and intracel-lular IL-2, IL-4, IL-12, IFN-Y in CD4^+ and CD8^+ T-lymphocytes from 20 patients with CA were performedand followed by flow cytometry. Results: The number of CD3^+T, CD4^+T-lymphocytescells and CD4^+/CD8^+T cells ratio were significantlydecreased(P<0.01) in patients with CA Compared tocontrols, and IL-2, IL-12, IFN-γ production in CD4^+Tcells was decreased(P<0.01), IL-4 and IFN-γ produc-tion in CD4^+T cells was not significantly different (P>0.05), while IL-2 and IL-12 production in CD8^+Tc cellswas decreased (P<0.01), whereas IFN-γ and IL-4 pro-ducing in CD4^+T cells were of no significantlydifference(P>0.05). Conclusions: There was an imbalance of T lympho-cyte subsets, Th1/Th2 cytokines and Tc1/Tc2 in theperipheral blood of CA patients, which may play animportant role in the pathogenesis and progression ofCA.

Correlation between the Expression of Fas, Bcl-2 in Peripheral Blood Lymphocytes and the LeveL of IFN-γ,IL-4 in Serum of Patients with Condyloma Acuminata

In order to investigate the correlation between the expression of the apoptotic regulatory proteins (Fas, Bcl 2) in peripheral blood lymphocytes (PBLC) and the level of IFN γ and IL 4 in serum of the patients with condyloma acuminata (CA) in the immune pathogenesis of CA, indirect immunofluorescence labeling method of flow cytometer and solid sandwich ELISA method were performed for detecting the expression of Fas, Bcl 2 in PBLC and the level of IFN γ and IL 4 in serum of 60 cases of CA. The results showed the expression level of Fas in PBLC of CA was significantly higher than in the normal control group, but the expression level of Bcl 2 was significantly lower (both P< 0.01). The level of IFN γ in serum of CA was significantly lower than in the normal control group ( P< 0.01), but IL 4 was significantly lower (both P< 0.01). The expression of Fas in PBLC had a negative correlation with the level of IFN γ in serum of patients with CA, but had a positive correlation with the level of IL 4; The expression of Bcl 2 had a positive correlation with the level of IFN γ, but had a negative correlation with the level of IL 4. All the correlation coefficients had significant differerce by t test ( P< 0.01). It was suggested abnormal apoptosis in PBLC, the suppressed secretion of the THl associated cytokines (eg: IFN γ) and the increased secretion of the TH2 asssociated cytokines (eg: IL 4) existed in the patients with CA and might play an important role in the immune pathogenesis of CA.

The Expression of Fas/FasL in Peripheral Blood Lymphocytes and the Level of IL-2 in Serum of Patients with Condyloma Acuminata

In order to investigate the role of the expression of the Fas/FasL in peripheral blood lymphocytes and the level of IL 2 in serum of patients with condyloma acuminata in the immune pathogenesis of CA, flow cytometry, indirect immunofluorescence labeling and ELISA were performed to detect the expression of the apoptotic regulatory proteins Fas/FasL in PBLC and the level of IL 2 in serum of 60 patients with different course of CA. The results showed that the expression of Fas/FasL in PBLC of the group of short course in CA was significantly higher than that of the normal controls ; the expression of Fas, FasL in PBLC of the group of long course CA was significantly higher than that of the group of short course and the normal controls ( P <0.05 and P <0.01, respectively); the level of IL 2 in serum of the group of short and long course CA was significantly lower than that of the group of normal controls ; the negative relation was revealed between the expression of Fas/FasL in PBLC and the level of IL 2 in serum of patients with CA . It was suggested that the abnormal apoptosis in PBLC and decreased level of IL 2 in serum of CA might play an important role in the course of CA.

COMPARISON BETWEEN IMMUNOFLUORESCENCE AND PCR IN DETECTING HUMAN PAPILLOMA VIRUS IN CONDYLOMA ACUMINATA

Objective To compare the effectiveness of immunofluorescence and polymerase chain reaction （PCR） in detecring human papilloma virus （HPV） in condyloma acuminata （CA）. Methods HPVs in CA tissues from 60 patients were detected by immunofluorescence and PCR, respectively. Different subtypes of HPVs were also identified with restriction fragment length polymorphism （RFLP） . Resuits The positive detective rates of immunofluorescence and PCR were 56. 67 % （34/60） and 96. 67 % （58/ 60）, respectively （ P 〈 0. 01 ）. RFLP results showed HPV6 and HPV11 were the main subtypes in the detected virus, which accounted for 98.28%. Conclusion The sensibility of PCR is superior to that of immunofluorescence.

Evaluation of the Effectiveness of Nd:YAG Laser under Urethroscope in the Treatment of Intraurethral Condyloma Acuminata (CA) in Males

Objective: To evaluate the therapeutic effect of Nd:YAGlaser under urethroscope for the treatment of intraurethralCandyloma Acuminata (CA) in males. Method: Nd:YAG laser under urethroscope was employed toremove the warts. Result: Seventeen patients out of eighteen cases with CAwere cured after the first procedure. The cure rate was 94.4%.For second treatment, the cure rate was 100% and no relapseoccurred after observation for 12-24 months. Conclusion: Nd:YAG laser by urethroscope is a very goodmethod for treatment of intraurethral CA.

TLMA Expression in Condyloma Acuminata from Patients with High and Low Risk HPV

Objective: To detect the activated expression oftelomerase in condyloma acuminata lesions in low-risk (6/11)and high-risk (16/18) human papilloma virus (HPV)infection and examine the role played by telomerase in theoccurrence, development and carcinomatous change ofcondyloma acuminata. Methods: Assaying the expression of telomerase and thetype of HPV in damaged skin of 42 CA patients and normalskin of 30 healthy control individuals through telomeraserepeat amplification protocol (TRAP) and polymerase chainreaction (PCR). Results: In all the normal skin controls, PCR for HPV wasnegative and only 16.7% of samples were positive for TLMAexpression; in CA lesions, HPV testing was positive in all (32cases were low-risk, 3 were high-risk, and 7 were of mixedtype) and all were positive for TLMA expression. Conclusion: TLMA may be activated by HPV infection,and in turn cause the hyperplasia of epidermal cells. It wasalso indicated that HPV, especially high risk types, canactivate TLMA. The activation of TLMA may play animportant role in abnormal hyperplasia and carcinomatouschanges in CA lesions.

DIFFERENTIATION OF PSEUDOCONDYLOMA OF VULVA AND CONDYLOMA ACUMINATA BY DOT BLOT HYBRIDIZATION AND POLYMERASE CHAIN REACTION

This study differentiated pseudocondyloma of vulva from condyloma acuminata using dot blot hybridization and polymerase chain reaction (PCR). A total of 27 cases of pseudocondyloma of vulva and 65 cases of condyloma acuminata were selected for the study. The genital lesions were examined clinically and were biopsied. Each biopsy was subjected to histological examination and HPV DNA analysis by dot blot hybridization and PCR. Dot blot analysis detected HPV DNA in 19(82. 6%) out of 23 cases of condyloma acuminata and 2(25% ) out of 8 cases pseudocondyloma of vulvae (P<0. 05). PCR detected HPV DNA in 51 (92. 7%) out of 55 cases of condyloma acuminata , compared with none in 23 cases of pseudocondyloma (P<0.001 ). HPV DNA was present in the majority of condyloma acuminata specimens. HPV 6 and 11 were the predominant types. Peudocondyloma is probably not associated with HPV. PCR was the most sensitive and useful technique for HPV DNA detection.

从“伏邪发病”论复发性尖锐湿疣

尖锐湿疣是由人乳头瘤病毒(HPV)感染引起的以皮肤黏膜疣状增生性病变为主的性传播疾病。虽然临床治愈率高,但极易复发,极大影响患者身心健康,预防其复发是预后阶段的重要任务。中医学基于“伏邪”学说理论体系认为尖锐湿疣复发是基于正气亏虚,伏湿、伏毒为患,并确立补虚、祛湿、引邪之法予以预防。本文基于“伏邪”学说经典考证和现代研究结果对中医药预防尖锐湿疣复发进行综述。

2005—2020年陕西省尖锐湿疣流行特征分析

目的 了解2005—2020年陕西省尖锐湿疣疾病的流行趋势和特征,为制定防控策略提供科学依据。方法 本文的研究对象为中国疾病监测信息报告管理系统中2005—2020年39535例陕西省尖锐湿疣患者,人口资料摘自陕西省统计局。使用Excel软件建立数据库进行归纳整理,应用SPSS 26.0软件进行数据统计分析,采用描述性流行病学方法对资料进行三间分布描述,用卡方检验进行流行趋势分析,以P<0.05为差异有统计学意义。结果 2005—2020年陕西省累计报告尖锐湿疣病例39 535例,2011年发病例数最多(3 404例),报告发病率为9.04/10万。每月均有发病,2月份报告发病数最少,为2 507例(6.3%),3月份报告发病数最多,为3 790例(9.6%)。尖锐湿疣感染病例以男性为主,为22 487例(56.9%);各年龄组均有病例报告,男性发病年龄为25~29岁者报告病例数最多,男性为4 763例,占男性总报告例数的21.19%(2.13/10万);女性发病年龄为20~24岁者报告病例数最多;病例职业以农民为主,共12 016例(30.4%),其次分别为家务及待业(24.5%)、工人(12.1%)。婚姻状况以已婚最多,有14 674例(66%);文化程度以初中最多,有8 902例数(22.5%)。结论 陕西省尖锐湿疣发病率较低,青年人群发病率高,应及时制定针对性防控策略,控制疫情流行。

Etiology and Prevention of Recurrent Condyloma Accuminata

The possible causes of condyloma acuminatarecurrence arc summarized: such as patients with cellularimmune denciencies, physical therapy triggering subclinicalinfective foci, sowing of the virus particles, and insufficienttherapy. Corresponding preventive measures are addressed,including: immunomodulators improving cellular immunity,ensuring the range and depth of physical therapy, and trcatingsexual partners simultaneously.

环磷酰胺联合光动力疗法治疗尖锐湿疣的临床研究

目的探讨环磷酰胺联合光动力疗法(PDT)治疗尖锐湿疣(CA)的临床效果。方法收集2017年5月—2020年5月本院就诊的120例CA患者临床资料,按随机数字表法分为A、B、C 3组。A组实施PDT联合25 mg/d环磷酰胺方案,B组实施PDT联合50 mg/d环磷酰胺方案,C组实施PDT联合75 mg/d环磷酰胺方案。术后进行为期3个月的随访,比较3组患者治疗前及治疗3个疗程后的细胞因子指标[白细胞介素-4(IL-4)、IL-10、IL-2和干扰素-γ(IFN-γ)]、免疫功能指标(CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+))、不良反应以及复发率发生率差异。结果与治疗前比较,3组治疗后IL-2、IFN-γ、CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)均明显升高(均P<0.05),与A组比较,B组和C组升高较为明显,C组升高更为显著(均P<0.05);3组治疗后IL-4、IL-10均明显降低,且C组降低更为显著(均P<0.05)。3组治疗期间不良反应发生率比较差异均无统计学意义(均P>0.05)。3组复发率比较C组<B组<A组[2.50%(1/40)<7.50%(3/40)<20.00%(8/40),均P<0.05]。结论在CA患者中实施PDT联合75 mg/d环磷酰胺方案,能有效诱导IL-2和IFN-γ的表达、抑制IL-4和IL-10的表达,改善患者免疫功能指标,降低复发率,不会明显增加用药不良反应。

尖锐湿疣患者外周血IL-2、IL-12、IFN-γ、IL-4因子水平检测及临床价值研究

目的探讨采用外周血IL-12水平、IFN-γ水平、IL-2水平、IL-4因子水平检测方法对尖锐湿疣患者进行诊断后获得临床效果。方法选取2020年2月—2022年5月枣庄市皮肤病性病防治院100例尖锐湿疣患者作为研究组;选取同一时间段100名健康体检者作为参照组;针对所有研究对象的外周血IL-12、IFN-γ、IL-2、IL-4因子水平、Th1/Th2、CD3^(+)、CD8^(+)、CD4^(+)以及CD4^(+)/CD8^(+)水平展开对应分析。结果研究组IL-12(2.39±0.52)pg/mL、IFN-γ(1.85±0.55)pg/mL、IL-2(2.25±0.22)pg/mL以及Th1/Th2(1.13±0.25),均低于参照组的IL-12(4.49±0.25)pg/mL、IFN-γ(6.03±0.22)pg/mL、IL-2(6.78±1.13)pg/mL以及Th1/Th2(5.69±0.49),差异有统计学意义(t=36.396、70.564、39.349、82.895,P<0.05)。研究组CD3^(+)、CD4^(+)以及CD4^(+)/CD8^(+)均低于参照组,CD8^(+)高于参照组,差异有统计学意义(P<0.05)。结论患者在患有尖锐湿疣疾病后,临床对其实施IL-12、IFN-γ、IL-2水平检测,会发现同健康者比较异常情况显著,对尖锐湿疣患者展开上述指标检测具有临床价值。

Fas FasL TRAIL分子在尖锐湿疣皮损中的分布

目的 探讨Fas、FasL和TRAIL介导的细胞凋亡在尖锐湿疣发病中的可能作用及意义。方法 用免疫组化方法检测了 30例尖锐湿疣患者皮损中Fas、FasL和TRAIL的表达。结果 所有尖锐湿疣标本 ( 10 0 % )Fas均阳性 ,2 3例 ( 76 .7% )FasL阳性 ,2 1例 ( 70 .0 % )TRAIL阳性 ,三者分布基本一致 ,正常表皮基本不表达。且FasL和TRAIL分子与真皮单一核细胞浸润呈显著负相关 (γ =-0 .5 0 6和γ =-0 .45 0 ,P均 <0 .0 5 )。结论 尖锐湿疣组织中细胞凋亡相关分子Fas、FasL和TRAIL表达异常 ,且Fas、TRAIL分子表达影响局部免疫反应 ,考虑凋亡失控可能参与尖锐湿疣发病 ,引起复发。

更昔洛韦静脉滴注治疗尖锐湿疣54例

目的 观察更昔洛韦治疗尖锐湿疣 (CA)后的复发率降低情况。方法 CA患者祛除疣体后静脉滴注更昔洛韦 0 .2 5g ,1次 /d ,共 6天。观察 3个月内CA的复发率。结果 观察组CA 3个月的复发率为 2 4.1% ,比对照组显著性降低 (P <0 .0 1)。结论 更昔洛韦安全、有效 ,能降低CA的复发 ,有较好的抗HPV作用。

肛管及肛门区尖锐湿疣组织中人乳头瘤病毒基因类型的研究

目的高危型人乳头瘤病毒(high-risk human papillomavirus,HPV)感染是宫颈癌的主要致病原因,现已发现HPV感染可诱发人类的许多肿瘤和疣。文中旨在探讨南京地区肛管及肛门区尖锐湿疣(condyloma acuminata,CA)患者中HPV基因类型的感染情况及其临床意义。方法从86份肛管及肛门区CA石蜡组织标本中提取23种HPVDNA,采用基因扩增芯片技术对其组织进行23种HPV基因类型的检测,并对其患者进行临床病理资料分析。结果 86份肛管及肛门区CA患者组织标本中检出HPV阳性66例,感染率为76.74%(66/86),其中单一型的阳性检出率为56.98%(49/86);单一型的感染中HPV11型为26例,其阳性检出率为30.23%(26/86),是最主要的感染类型;其次HPV6型为23例,阳性检出率为26.74%(23/86);混合型HPV感染17例,阳性检出率为19.77%(17/86);其中HPV6+11型8例,占混合型感染的47.06%(8/17),是混合型感染的主要类型;其次是5例4种类型的混合感染,占混合型感染的29.41%(5/17)。结论 HPV11型、6型、6+11型、4种类型的混合感染是肛管及肛门区CA的主要致病类型,基因扩增芯片检测技术是一种比较适合临床进行HPV分型检测的、敏感性高和特异性好的诊断方法,尤其适合开展某种病变中HPV感染的分子流行病学的研究。

尖锐湿疣皮损中朗格汉斯细胞的变化

目的了解尖锐湿疣(CA)皮损中朗格汉斯细胞(LC)的变化。方法采用免疫组化法对34例CA皮损进行LC染色,光镜下观察其形态和数量变化,并对其中6例标本行电镜观察。结果与正常皮肤相比,CA皮损表皮内LC分布不规则,少见典型的树突状细胞,细胞突明显减少、缩短或消失,半定量计数显示CA皮损中LC为(13.15±9.42)个,较正常明显降低(P<0.01)。超微结构表明LC中的特征性结构———朗格汉颗粒(LG)不仅数目减少,而且形态也不典型。结论CA皮损中LC形态及数量均发生变化,可能在CA的发病中起着一定作用。

326例尖锐湿疣患者肛门及肛管组织HPV基因型检测及性别对比研究

目的国内有关肛门及肛管尖锐湿疣(CA)组织HPV分型研究的大样本资料报道极少。文中旨在探讨以江苏省为主的区域性男女肛门及肛管CA组织中HPV感染基因型分布状况和分型的临床意义。方法收集1985年8月至2017年7月江苏省和安徽省4家医院病理组织学诊断为两性肛门及肛管乳头瘤样增生伴挖空细胞(疑似CA)的石蜡组织标本326例。从其CA组织中抽提HPV DNA,对HPV感染型别分布状况进行分析。结果 326例两性肛门及肛管CA患者中,HPV总检出率为74.85%(244/326)。其中女147例,男179例,HPV总检出率分别为73.47%、75.98%。两性肛门及肛管CA组织阳性者检出不同型别HPV出现频数合计342次,低危型HPV出现频数合计267次,高危型HPV出现频数合计75次。其中6、11、16、18型HPV感染频数占前4位。30岁以下女性CA发病率较男性显著升高(32.65%vs 16.20%,P<0.05)。结论两性肛门及肛管CA组织中,以6、11、16、18型HPV感染最为常见;30岁以下女性CA发病率较高,应引起疾病预防和临床诊治的高度重视。

尖锐湿疣的临床与实验研究

对本科性接触传播疾病（ STD）专科门诊 1989～ 1996年间的各种 STD数据统计发现，尖锐湿疣位居各种性传播疾病病例数的第一位或第二位。用 PCR和斑点杂交等方法检测尖锐湿疣组织标本中 HPV DNA，表明 PCR方法更加敏感。用 PCR方法检测宫颈鳞癌及宫颈和外阴尖锐湿疣 HPV感染，证实宫颈鳞癌以高危型 HPV16为主，而外阴及宫颈尖锐湿疣均以低危型 HPV6/11为主。为了鉴别尖锐湿疣与假性湿疣，进行了组织病理、电镜观察和 HPV DNA检测，结果显示超微结构的某些变化有助于两者的鉴别诊断 ,证实 HPV DNA检测是鉴别尖锐湿疣与假性湿疣的较有用的方法。研制高纯度鬼臼毒素并对其进行药效学研究，结果其与进口鬼臼毒素治疗生殖器疣的疗效相当，使用 3周的治愈率均超过 80％。局部注射不同的干扰素治疗尖锐湿疣具有一定疗效。

尖锐湿疣人乳头瘤病毒的基因分型

目的 检测尖锐湿疣中人乳头瘤病毒 (HPV )的基因型别。方法 用通用引物进行聚合酶链反应 ,扩增尖锐湿疣中HPVDNA ,用生物素标记的特异性基因分型探针 ,对聚合酶链反应扩增后的HPVDNA进行斑点杂交。结果 5 0例尖锐湿疣标本经PCR扩增后 48例HPVDNA阳性 ,阳性标本中HPV 6、11、16、18型的检出率分别为 16.7% ( 8/48)、3 7.5 % ( 18/48)、14 .6% ( 7/48)、4.2 % ( 2 /48) ,多重型别检出率为 2 2 .9% ( 11/48)。结论 HPV11型感染是尖锐湿疣发病的首要原因。

重组人干扰素α-2a凝胶预防尖锐湿疣复发的随机双盲多中心临床研究

目的评价重组人干扰素α-2a凝胶(抗尖锐湿疣凝胶)预防尖锐湿疣复发的有效性和安全性。方法与安慰剂对照,尖锐湿疣患者经激光、冷冻或电灼清除疣体后,每日外用药物4次,疗程8周,再随访至第20周。共入选尖锐湿疣患者154例。结果在用药第2,4,8,12,16,20周,试验组复发率明显低于安慰剂组,统计学上有显著性差异。结论重组人干扰素α-2a凝胶对尖锐湿疣治愈后、预防复发的疗效肯定,耐受性好。