GENE ENGINEERING EB VIRUS MEMBRANE ANTIGEN IN DETECTION OF MA-IgA ANTIBODY(COMPARISON WITH VCA-IgA AND EA-IgA ANTIBODIES)

With gene engineering EB virus membrane antigen as the diagnostic antigen, indirect immunofluo-rescence (IF) assay was used to detect IgA antibody against EB virus membrane antigen (MA-IgA) in sera from 202 nasopharyngeal carcinoma (NPC) patients and 315 controls (normal and patients with other tumors). MA-IgA antibody was positive in 96.8% of the pretreatment NPC patients with a GMT of 1:36.3. MA-IgA detection by this method was more sensitive than EA-IgA detection by IE. In contrast, patients with tumors other than NPC were negative for MA-IgA antibody. 9.1% of VCA-IgA positive persons were MA-IgA positive with a GMT of less than 1:5. No MA-IgA positive was found in VCA-IgA negatives. The results indicated that this method was relatively specific. In the treatment group, the positive rate and GMT of MA-IgA antibody declined with increase in survival time and the decline was faster than VCA-IgA. When recurrence or distant metastasis developed, similar to VCA-IgA and EA-IgA antibodies, the positive rate and GMT of MA-IgA antibody increased to its pretreatment level. Therefore, MA-IgA detection might be valuable in the early diagnosis and monitor of NPC.

Analysis of Sperm Membrane Protein Relevant to Antisperm Antibody by Two-Dimensional Gel Electrophoresis and Western Blotting

Objective To identify the sperm membrane proteins that are associated with antisperm antibody Methods Using antisperm antibody positive serum through unidimensional polyacrylamide gel electrophoresis and 2-dimensional gel electrophoresis followed by Western blot analysis to determine the molecular weights (MW) and isoelectric points (pI) of sperm membrane proteins that are associated with antisperm antibody. Results Eight kinds of MW with more than ten sperm membrane proteins can be recognized by antisperm antibody positive serum, of which the MWs and pI were 23 kD, 31 kD, 32 kD, 34 kD, 41 kD, 51 kD, 60 kD, 78 kD and 5.3, 5.5,5.7, 5.0, 5.3, 5.8, 6.0, 5.5～6.2, 4.6,5.1,5.5～5.8 respectively. The identification ratios of the sperm membrane proteins on 78 kD (60.7%), 60 kD (71.4%), 51 kD (14.9%) and 23 kD (14.29%) were higher. Conclusion The sperm membrane proteins with MW of 78 kD, 60 kD, 51 kD and 23 kD were associated with antisperm antibody and immunological infertility. Two- dimensional gel electrophoresis and Western blotting can precisely identify the sperm membrane proteins that are associated with antisperm antibody.

Effects of Monoclonal Antibody Against Adipocyte-Specific Membrane Protein on Lipid Metabolism in Pigs

This study was to investigate the regulation of monoclonal antibodies against adipocyte membrane proteins （McAb） on lipid metabolism in pigs. Forty Landrace x Saba pigs were randomly divided into eight groups; the control group was given 10 mL saline and the treat groups were given monoclonal antibody against adipocyte-specific membrane protein with 0.1, 0.5, and 1.0 mg kg-I body weight at 15 and 60 kg body weight, respectively, by intraperitoneal injection. The results showed that McAb could increase, significantly, serum lipoprotein lipase activity and reduce serum nonesterified fatty acid （NEFA） content. Meanwhile, McAb increased content of serum lipid, triglyceride （TG）, cholesterol （CHO）, high density lipoprotein （HDL）, and low density lipoprotein （LDL） both at 15 and 60 kg body weight. However, McAb affected more significantly the lipid metabolism at 15 kg body weight than at 60 kg body weight. Moreover, this effect of McAb on lipid metabolism exhibited dose-dependent effect. These results suggested that this monoclonal antibody increased lipase activity, promoted lipolysis, and utilization of lipid so that McAb could be applied to restrain excessive fat deposition in porcine production through the regulation of fat metabolism.

Generation and Identification of Monoclonal Antibody Against Porcine Adipocyte Plasma Membrane Proteins

Production of monoclonal antibody against porcine adipocyte plasma membrane proteins to explore a new way of controlling body fat deposition and improving carcass quality is discussed in this article. Membrane proteins of pig adipocyte plasma membrane proteins were extracted with the help of sucrose density gradient centrifugation, and two kinds of proteins were obtained. The monoclonal antibody （designated 3B2 and 3F3） of IgG1 and IgG2b subclass against adipocyte membrane proteins were produced by immunization, with adipocyte membrane proteins as an antigen, and its titer was 1：105 detected by enzyme-linked immunoadsorbent assay （ELISA）. The cell strains were identified by analyzing the number of chromosomes, the heat stability, the acid and alkali, the types and subtypes of immnoglobulin, and its peculiarities and affinities. Through identification, the chromosome number of hybridoma cell strains was from 80 to 100 and the strains formed good hybridomas colonies. The strains＇ affinity constants were 4.63 × 10^9 and 3.75 × 10^9 （mol L^-1）-1, respectively. At the same time, the McAb secreted was stable to environmental factors, such as, temperature, acid, alkali and so on. The monoclonal antibodies had been obtained and their specificity to porcine adipocyte plasma membrane proteins had been identified.

Antibody Therapies Targeting Complex Membrane Proteins

In analyses of protein families that may serve as drug targets,membrane-associated G-protein-coupled receptors(GPCRs)dominate,followed by ion channels,transporters,and—to a lesser extent—membrane-bound enzymes.However,various challenges put such membrane proteins among key groups of underutilized opportunities for the application of therapeutic antibodies.Antibodies hold the promise of exquisite specificity,as they are able to target even specific conformations of a particular membrane protein,as well as adaptability through engineering into various antibody formats.However,the ease of raising and isolating specific,effective antibodies targeting membrane proteins depends on many factors.In particular,the generation of specific antibodies is easier when targeting larger,simpler,extracellular domains with greater uniqueness of amino acid sequence.The rareness of such ideal conditions is illustrated by the limited number of approved biologics for targeting GPCRs and other complex membrane proteins.Challenges in developing antibodies to complex membrane proteins such as GPCRs,ion channels,transporters,and membrane-bound enzymes can be addressed by the design of the antigen,antibody-generation strategies,lead optimization technologies,and antibody modalities.A better understanding of the membrane proteins being targeted would facilitate mechanism-based drug discovery.This review describes the advantages and challenges of targeting complex membrane proteins with antibodies and discusses the preparation of membrane protein antigens and antibody generation,illustrated by select examples of success.

Relationship Between the Efficacy of Low-Dose Glucocorticoids Combined with Tacrolimus in the Treatment of Adult Idiopathic Membranous Nephropathy and the Level of Serum Anti-PLA2R Antibodies

Objective:To further evaluate the efficacy and safety of low-dose glucocorticoids combined with tacrolimus in the treatment of adult idiopathic membranous nephropathy(IMN)in a clinical setting.Methods:We carried out a single-center prospective study of 88 patients with IMN who were admitted into the Affiliated Hospital of Hebei University from January 2019 to December 2021,and the participants were divided into two groups based on their serum anti-PLA2R antibody levels:the negative group and the positive group.46 patients were positive for anti-PLA2R antibodies and 42 were negative.Results:After 6 months of treatment,the serum albumin,cholesterol,and 24h urine protein quantification in the anti-PLA2R negative group improved more significantly compared to the positive group(P<0.05);after 6 months of treatment,the remission rate of the positive group was significantly lower than that of the negative group,and(P<0.05);Conclusion:After treatment with tacrolimus combined with low-dose glucocorticoids,patients with idiopathic membranous nephropathy who were tested positive for anti-PLA2R antibodies had a higher overall remission rate compared those who were tested negative for serum anti-PLA2R antibodies.

Analysis of sperm membrane antigens relevant to antisperm antibody using Western blot

To identify the sperm membrane antigens associated with antisperm antibody. Methods: The antisperm antibody in serum was tested by ELISA. Antisperm antibody positive sera from 18 infertile men and 15 infertile women were used. The molecular weight (MW) of sperm membrane antigens associated with the antisperm antibody was analyzed with antisperm antibody positive serum using Western blot. Results: Eight kinds of MW of sperm membrane antigens were identified. The ratio of identification on the 78 KD(60.7 %), 60KD (71.4 %), 51 KD (14.9 %) and 23 KD (14.29 %) sperm antigen was higher than others. Conclusion: Sperm membrane antigens with MW of 78 KD, 60 KD, 51 KD and 23 KD were associated with antisperm antibody and immunological infertility. (Chin J Andro12002; 16: 345)

Effects of Monoclonal Antibody Against Porcine 40-kDa Adipocyte-Specific Membrane Protein on Endocrine Secretion in Pigs

The present study was to investigate the effect of monoclonal antibody against porcine 40-kDa adipocyte-specific membrane protein on endocrine secretion in pigs, in order to provide the evidence for application of this antibody to reduce excessive fat deposition in pig production. 40 Landrace×Saba pigs were randomly divided into 8 groups： 2 control groups were given saline with 10 mL, respectively, and the 6 treatment groups were given monoclonal antibody against porcine 40-kDa adipocyte-specific membrane protein with 0.1, 0.5, and 1.0 mg ·kg^-1 body weight at 15 or 60 kg body weight, respectively, all treatments were performed by intraperitoneal injection. The results showed that this monoclonal antibody could significantly reduce serum insulin level and increase levels of serum growth hormone （GH）, insulin-like growth factor-1（IGF-1）, triiodothyronine （T3）, and tetraiodothyronine （T4） either at 15 or 60 kg body weight injection. However, more marked effect was observed at 15 kg body weight treatment. Moreover, the dose-dependent effect of this monoclonal antibody on endocrine secretion was also observed. This result revealed that this monoclonal antibody increased secretion of hormones regulating fat lysis and reduced secretion of hormones regulating fat synthesis, suggests the reduction of porcine excessive fat deposition by this monoclonal antibody was carried out through affecting hormones regulating fat metabolism.

Anti-VDAC3 recombinant antibody decreased human sperm motility and membrane integrity: A potential spermicide for contraception

Objective:To express recombinant protein that comprises an important fragment of human sperm specific voltage dependent anion channel 3 (VDAC3) protein as a potential molecule for generation of antibody, which can affect sperm function, aiming at spermicide development. Methods: The produce of VDAC3 recombinant protein encoded by cDNA sequence of human VDAC3 exon 5-8, based on experimental design of VDAC3 knock-out mice study. And after the purification of various human sperm VDAC3 recombinant proteins, epitope has been predicted in our recombinant protein determined by ElliPro program. Polyclonal antibody was produced for 14 wk. Then anti-VDAC3-exon 5-8 recombinant antiserum was inoculated to human sperm. After the process, antibody VDAC3 protein in human sperm was incubation with anti-VDAC3 recombinant antibody. Finally evaluation the effect of VDAC3 antiserum to human sperm motility and plasma membrane integrity was proceeded.Results: Human VDAC3 recombinant protein was successfully over-expressed in Escherichia coli and purified by affinity chromatography method. Purified human sperm VDAC3 recombinant protein could stimulate immune response in rabbit producing an antibody against VDAC3. Anti-VDAC3 recombinant antibody recognized VDAC3 antigen in human sperm could decrease human sperm motility and membrane integrity significantly.Conclusions:Anti-VDAC3 recombinant polyclonal antibody that we produced in rabbit by ourselves could decrease sperm motility and sperm membrane integrity. The authors suggest this polyclonal antibody could be used as a candidate agent for male contraception in the future. Furthermore, the authors intend to explore the effect of this antibody into sperm function aiming at male contraceptive vaccine development.

Development and Evaluation of a MAb-Based ELISA for Detection of Chlamy- dophila pneumoniae Infection with Variable Domain 2 and 3 of the Major Outer Membrane protein

Objective This paper aims to develop a monoclonal antibodies （MAbs）- based ELISA for detecting Chlamydophila pneumoniae （C. pneumonioe） antigens in humans with the variable domains （VD） 2 and 3 of the major outer membrane protein （MOMPvD2-VD~） and to assess its sensitivity and specificity by comparing with a widely used MAb that is able to recognize the elementary bodies of C. pneumoniae. Methods MOMPvo2-vo3were overexpressed in Escherichia coil and purified by affinity chromatography. Mice were immunized with the recombinant antigen, and hybridomas secreting MAbs were screened. Three stable hybridomas clones were selected and named 5D6, 7G3, and 8C9. The MAbs-based ELISA was scrutinized for species-specific recognition with a number of human throat swab samples from Group I （156 patients with typical respiratory illness clinically confirmed before） and Group II （57 healthy donors）. Results In Group I, 55 positive cases were detected by anti-EB MAb-based ELISA, 51 cases were positive by MAbs 5D6-based ELISA, and 33 and 38 cases were positive by MAb 8C9 and 7G3-based ELISA respectively. Of the 57 samples from Group II ＂healthy donors＂, 5 were positive and 52 were negative with both anti-EB and 5D6-based tests, while 2 and 3 positive cases were identified by the other two MAb-based ELISAs respectively. Conclusion The novel MOMPvD2.VD3 MAb-based assay may have higher specificity than the anti-EB MAb, which may possibly be used as an alternative tool for the diagnosis of C. pneumoniae infection.

Management of an Adult with Goodpasture’s Syndrome Following Brain Trauma with Extracorporeal Membrane Oxygenation: A Case Report

A 22-year-old man suffered from acute pulmonary hemorrhage and deteriorated renal function occurred within 3 days after traumatic brain injury.Mechanical ventilation cannot correct his severe hypoxemia,therefore,venoarterial extracorporeal membrane oxygenation(VA-ECMO)support was initiated and finally resolved his hypoxemia.Concomitantly,continuous renal replacement therapy was performed to improve his kidney function.Although no anti-glomerular basement membrane(anti-GBM)antibody was detected in serum,Goodpasture’s syndrome was considered.After treated with methylprednisolone pulse therapy and plasmapheresis,his renal function was significantly improved.ECMO was eventually discontinued after 60 hours of treatment and extubated on day 10.He was discharged home with normal pulmonary and renal functions.

原发与继发免疫性血小板减少症患者血小板膜糖蛋白特异性抗体及其与出血评分关系的研究

目的探讨原发与继发免疫性血小板减少症(ITP)患者抗GPⅡb/Ⅲa及GPΙb/Ⅸ抗体的表达、抗体阳性表达与出血评分的关系,以及不同抗体类型出血评分的差异,为原发与继发ITP患者的诊治和出血严重程度提供临床依据。方法选取2013年10月—2020年8月在新疆医科大学第一附属医院诊断为原发ITP患者(42例)及继发ITP患者(42例)为研究对象,所有患者入院时采用ITP出血评分量表行出血评分。应用改良MAIPA法检测患者抗GPⅡb/Ⅲa和抗GPΙb/Ⅸ抗体。结果原发与继发组患者抗GPⅡb/Ⅲa抗体、抗GPΙb/Ⅸ抗体阳性率比较,差异无统计学意义(P>0.05),原发组患者抗体表达以抗GPⅡb/Ⅲa抗体为主,继发组抗体表达以抗GPΙb/Ⅸ抗体为主,两者抗体阳性构成比较,差异有统计学意义(P<0.05)。继发组患者整体出血程度较原发组重(P<0.05)。抗体阳性表达与出血程度的关系:(1)抗GPⅡb/Ⅲa抗体阳性患者出血程度较抗体阴性患者重(P<0.05)。(2)抗GPΙb/Ⅸ抗体阳性患者出血程度较抗体阴性患者重(P<0.05),双抗体阳性患者出血程度较抗体阴性患者重(P<0.05)。结论抗GPⅡb/Ⅲa抗体、抗GPΙb/Ⅸ抗体阳性表达对原发与继发ITP无鉴别意义,但原发ITP患者抗体表达以抗GPⅡb/Ⅲa抗体为主,继发ITP患者抗体表达以抗GPΙb/Ⅸ抗体为主。继发ITP患者临床出血程度较原发ITP患者重。抗GPⅡb/Ⅲa抗体、抗GPΙb/Ⅸ抗体及抗体双阳性患者出血程度较抗体阴性患者重。

双重膜滤过式血浆置换联合脱敏治疗单倍体相合造血干细胞移植供者特异性抗体的临床研究

目的探讨分析双重膜滤过式血浆置换(double filtration plasmapheresis,DFPP)联合脱敏治疗单倍体相合造血干细胞移植供者特异性抗体(donor specific antibody,DSA)的疗效。方法采用DFPP联合丙种免疫球蛋白(intravenous immunoglobulin,IVIG)、利妥昔单抗脱敏治疗DSA阳性患者,检测移植前后DSA水平,主要评估分析其植入情况。结果8例DSA性患者7例获得供者细胞稳定植入,嵌合率均为100%,1例血小板植入不良。经过DFPP、IVIG、利妥昔单抗脱敏处理后为平均荧光强度(mean fluorescence intensity,MFI)(3911±2499),均明显降低,差异均有统计学意义(t=2.101,P<0.001),8例患者中有3例转为弱阳性。干细胞回输第3天复测MFI(907士997),较干细胞回输前再次减低,差异均有统计学意义(t=2.145,P=0.002)。8例患者仅1例发生重度急性移植物抗宿主病。结论双重膜滤过式血浆置换脱敏联合大剂量IVIG和利妥昔单抗,尽量输注高剂量的干细胞,可以降低DSA水平促进供者干细胞植入。

儿童原发性免疫性血小板减少症回顾性临床分析

目的提高对儿童原发性免疫性血小板减少症(ITP)临床特点及预后的再认识,为儿童ITP诊疗提供依据。方法回顾性分析泰安市中心医院2019年10月至2021年6月收治的150例初诊为ITP的患儿,并随访至发病后6个月。根据血小板计数分为两组:非重型ITP为单用糖皮质激素(GCs)组,重型ITP为GCs联合静脉注射免疫球蛋白(IVIG)组。对年龄、性别、初诊血小板膜蛋白特异性抗体、初诊骨髓巨核细胞数目、治疗反应、预后等数据进行分析。结果150例初诊ITP患儿发病年龄为[4.50(0.25,13.00)]岁,其中男82例(54.67%),女68例(45.33%)。血小板膜蛋白特异性抗GPⅠb抗体阳性32例(21.33%),抗GPⅨ抗体阳性15例(10.00%),抗GPⅡb抗体阳性86例(57.33%),抗GPⅢa抗体阳性76例(50.67%),抗GMP-140抗体阳性23例(15.33%),血小板膜蛋白特异性抗体阴性42例(28.00%);完全反应(CR)+反应(R)组初诊巨核细胞数为[476.00(259.00,684.00)]个/骨髓片,无效(NR)组初诊巨核细胞数为[58.00(47.00,89.00)]个/骨髓片。住院时间为[5.00(4.00,12.00)]d;单用GCs组反应时间为[4.00(3.00,10.00)]d,GCs联合IVIG组反应时间为[3.00(2.00,8.00)]d。随访至6个月,CR 86例(57.33%),R 58例(38.67%),NR 6例(4.00%)。单用GCs组及GCs联合IVIG组比较,GCs联合IVIG组反应时间明显较短,差异有统计学意义(P<0.05);随访至6个月,两组患儿疗效差异无统计学意义(P>0.05)。巨核细胞数较多者,预后较好,差异有统计学意义(P<0.05)。结论ITP患儿以学龄前儿童更为常见,男孩多于女孩。GCs联合IVIG比单用GCs治疗反应时间短,预后无明显差异。初诊时骨髓巨核细胞数目低,提示预后不良。不同血小板膜蛋白特异性抗体阳性预后有差异,其中GPⅡb/GPⅢa阳性预后较好,GPⅠb/GPⅨ阳性预后欠佳。

小剂量利妥昔单抗改善早期中高风险膜性肾病疾病进展:一项探索性研究

膜性肾病(membranous nephropathy,MN)是成人原发性肾病综合征(nephrotic syndrome,NS)最常见的病因,近年来研究发现PLA2R是MN的关键致病靶抗原,且其发现给利妥昔单抗(rituximab,RTX)等靶向B细胞的治疗提供了理论基础,然而针对抗体的早期干预是否能有效地阻止MN的进展仍有待进一步探索。我们系统分析了2019年10月至2023年3月在我中心接受RTX治疗的13例PLA2R抗体相关早期中高危MN患者的临床特征和随访。早期中高危MN定义为基线或入院时抗PLA2R抗体滴度超过50 RU/mL,但尚未出现NS状态。患者在基线评估中位时间4.1个月(IQR 1-7.7)启动RTX治疗,此后中位随访时间为27个月(IQR 23-45),期间均未发展至NS,12例(92.3%)在随访2年或末次随访时评估为完全或部分缓解。随访期间未发生死亡、严重感染或其他严重不良反应。RTX对早期中高危MN患者具有良好的疗效和安全性,适时启动抗体清除治疗可能有利于长期疾病控制和远期肾脏预后。

猪流行性腹泻病毒S蛋白和M蛋白截短表达及多克隆抗体制备

为制备猪流行性腹泻病毒(PEDV)S蛋白和M蛋白的多克隆抗体,用蛋白结构分析软件对S和M基因序列进行分析,截取2个基因的相关抗原片段,依据大肠埃希氏菌偏好密码子进行密码子优化、序列合成。将合成的片段克隆至pET-32a(+),转化入大肠埃希氏菌BL21(DE3),IPTG诱导表达后进行SDS-PAGE检测。大量表达重组蛋白,免疫昆明小鼠制备多克隆抗体。结果表明,成功表达大小约为38ku和32ku的重组蛋白Sm和Mm,免疫小鼠后制备的抗Sm多克隆抗体效价超过1:25600,抗Mm多克隆抗体效价超过1:51200,且Westernblot表明多克隆抗体特异性良好。研究制备的多克隆抗体可以为建立PEDV检测方法和开发亚单位疫苗提供材料。

A tumor cell membrane-coated self-amplified nanosystem as a nanovaccine to boost the therapeutic effect of anti-PD-L1 antibody

To improve the response rate of immune checkpoint inhibitors such as anti-PD-L1 antibody in immunosup-pressive cancers like triple-negative breast cancer(TNBC),induction of immunogenic cell death(ICD)at tumor sites can increase the antigenicity and adjuvanticity to activate the immune microenvironment so that tumors become sensitive to the intervention of immune checkpoint inhibitors.Herein,a self-amplified biomimetic nanosystem,mEHGZ,was constructed by encapsulation of epirubicin(EPI),glucose oxidase(Gox)and hemin in ZIF-8 nanoparticles and coating of the nanoparticles with calreticulin(CRT)over-expressed tumor cell mem-brane.EPI acts as an ICD inducer,Gox and hemin medicate the cascade generation of reactive oxygen species(ROS)to strengthen the ICD effect,and CRT-rich membrane as“eat me”signal promote presentation of the released antigens by dendritic cells(DCs)to invoke the tumor-immunity cycle.The biomimetic delivery system displays an amplified ICD effect via Gox oxidation,hydroxyl radical generation and glutathione(GSH)depletion.The induced potent ICD effect promotes DCs maturation and cytotoxic T lymphocytes(CTLs)infiltration,reversing an immunosuppressive tumor microenvironment to an immunoresponsive one.Treatment with the nanosystem in combination with anti-PD-L1 antibody results in distinctive inhibition of tumor growth and lung metastasis,supporting that a potent ICD effect can significantly boost the therapeutic efficacy of the anti-PD-L1 antibody.This self-amplified biomimetic nanoplatform offers a promising means of raising the response rate of immune checkpoint inhibitors.

益气温阳活血利水法在膜性肾病中的疗效及对相关抗体、凝血纤溶系统的影响

目的:探究益气温阳活血利水法在膜性肾病(MN)中的疗效及对相关抗体、凝血纤溶系统的影响。方法:选择2020年6月-2022年6月北京市昌平区中医医院收治的83例MN患者,根据随机数表法分为对照组(n=41)和观察组(n=42)。对照组进行常规MN治疗,观察组则在对照组的基础上加用益气温阳活血利水法进行治疗。比较两组的MN治疗总有效率、治疗前后的症状体征积分(颜面肢体水肿、神疲乏力及畏寒肢冷)、相关抗体指标[血清抗磷脂酶A2受体抗体(PLA2R-Ab)及磷脂酶A2-ⅠB(PLA2-ⅠB)]及凝血纤溶指标[组织纤维溶酶原激活物(t-PA)、纤溶酶原激活抑制剂(PAI-Ⅰ)及活化部分凝血活酶时间(APTT)、凝血酶时间(TT)]。结果:观察组治疗总有效率显著高于对照组,差异有统计学意义(P<0.05)。治疗前,两组症状体征积分、相关抗体指标及凝血纤溶指标比较,差异无统计学意义(P>0.05);治疗1个疗程及2个疗程后,观察组各项症状体征积分均低于对照组,差异有统计学意义(P<0.05)。治疗1个疗程及2个疗程后,观察组PLA2R-Ab、PLA2-ⅠB及PAI-Ⅰ显著低于对照组,t-PA高于对照组,APTT、TT长于对照组,差异有统计学意义(P<0.05)。结论:益气温阳活血利水法应用于MN中的疗效较好,且可有效改善患者相关抗体及凝血纤溶状态。

利妥昔单抗联合环磷酰胺、泼尼松对特发性膜性肾病患者肾功能及血清抗M型磷脂酶A2受体抗体水平的影响

目的:探讨利妥昔单抗联合环磷酰胺、泼尼松对特发性膜性肾病(IMN)患者肾功能、血清抗M型磷脂酶A2受体(PLA2R)抗体水平等的影响。方法:选取2020年6月~2022年12月期间某院诊治的64例IMN患者作为研究对象,采用随机数字表法分为对照组和观察组,每组32例。所有患者均接受控制血压、调脂、抗凝等常规治疗,对照组患者在常规治疗基础上加用醋酸泼尼松片、注射用环磷酰胺,观察组患者在对照组治疗基础上加用利妥昔单抗注射液。比较两组患者血清白蛋白、血脂指标[总胆固醇(TC)和甘油三酯(TG)]、血清抗PLA2R抗体水平、肾功能指标[血清肌酐(Scr)、血尿素氮(BUN)]、24h尿蛋白定量(24hpro)及不良反应发生情况。结果:治疗后,两组患者血清白蛋白水平均升高(P<0.05),且观察组高于对照组(P<0.05);TC、TG水平均降低(P<0.05),且观察组低于对照组(P<0.05);血清抗PLA2R抗体水平均降低(P<0.05),且观察组低于对照组(P<0.05);Scr和BUN水平均降低(P<0.05),且观察组低于对照组(P<0.05);24hpro均降低(P<0.05),且观察组低于对照组(P<0.05)。两组患者不良反应发生率比较无统计学差异(P>0.05)。结论:利妥昔单抗联合环磷酰胺、泼尼松治疗可提高患者血清白蛋白水平,调节血清抗PLA2R抗体及血脂水平,改善患者肾功能,且不会增加不良反应的发生风险。

Removal of anti-phospholipase A2 receptor autoantibodies in primary membranous nephropathy by recombinant phospholipase A2 receptor tandem epitope immunosorbent

Objective To investigate the role of recombinant phospholipase A2 receptor (PLA2R) tandem dominant epitopes (PLA2RTD) in the removal of anti-PLA2R autoantibodies (anti-PLA2R) from primary membranous nephropathy (PMN).Methods The recombinant protein PLA2RTD (cysteine-rich domain,C-type lectin like domain 1 and C-type lectin like domain 7) was expressed in bacmid-insect cell expression system.