Imbalance of Circulating Follicular Regulatory and Follicular Helper T Cell Subpopulations Is Associated with Disease Progression and Serum CYFRA 21-1 Levels in Patients with Non-small Cell Lung Cancer

Objective This study aimed to investigate the changes of follicular helper T(TFH)and follicular regulatory T(TFR)cell subpopulations in patients with non-small cell lung cancer(NSCLC)and their significance.Methods Peripheral blood was collected from 58 NSCLC patients at different stages and 38 healthy controls.Flow cytometry was used to detect TFH cell subpopulation based on programmed death 1(PD-1)and inducible co-stimulator(ICOS),and TFR cell subpopulation based on cluster determinant 45RA(CD45RA)and forkhead box protein P3(FoxP3).The levels of interleukin-10(IL-10),interleukin-17a(IL-17a),interleukin-21(IL-21),and transforming growth factor-β(TGF-β)in the plasma were measured,and changes in circulating B cell subsets and plasma IgG levels were also analyzed.The correlation between serum cytokeratin fragment antigen 21-1(CYFRA 21-1)levels and TFH,TFR,or B cell subpopulations was further explored.Results The TFR/TFH ratio increased significantly in NSCLC patients.The CD45RA^(+)FoxP3^(int) TFR subsets were increased,with their proportions increasing in stages Ⅱ to Ⅲ and decreasing in stage IV.PD-1^(+)ICOS+TFH cells showed a downward trend with increasing stages.Plasma IL-21 and TGF-β concentrations were increased in NSCLC patients compared with healthy controls.Plasmablasts,plasma IgG levels,and CD45RA^(+)FoxP3^(int) TFR cells showed similar trends.TFH numbers and plasmablasts were positively correlated with CYFRA 21-1 in stages Ⅰ-Ⅲ and negatively correlated with CYFRA 21-1 in stage IV.Conclusion Circulating TFH and TFR cell subpopulations and plasmablasts dynamically change in different stages of NSCLC,which is associated with serum CYFRA 21-1 levels and reflects disease progression.

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.

Transforming growth factor-β and peripheral regulatory cells are negatively correlated with the overall survival of hepatocellular carcinoma

AIM To understand the cellular and molecular changes inperipheral blood that can lead to the development of hepatocellular carcinoma(HCC) and provide new methods for its diagnosis and treatment.METHODS Peripheral blood mononuclear cells were isolated from the peripheral blood of HCC patients and normal controls and then analyzed by flow cytometry. The percentage of transforming growth factor-β(TGF-β)+ regulatory cells(Tregs) in the peripheral blood was measured, and the expression of TGF-β was also determined. Then, the relationship between the changes and the 5-year survival of patients was analyzed. In addition, recombinant human TGF-β(rh TGF-β) and recombinant human interleukin-6 were added to stimulate the cultured cells, and their effects on HCC were evaluated.RESULTS The expression of TGF-β and the percentage of TGF-β+ Tregs in the peripheral blood of HCC patients increased significantly compared with normal controls. Compared with the low TGF-β expression group, the high TGF-β expression group had a significantly lower 5-year survival rate, and the same result was found in the two TGF-β+ Treg groups, suggesting that TGF-β and TGF-β+ Tregs were negatively correlated with the overall survival of the patients. In addition, rh TGF-β promoted the growth of tumor cells and induced high expression levels of IL-6, which further promoted tumor proliferation.CONCLUSION The results showed that TGF-β may promote tumor growth and proliferation by inducing the production of IL-6, and TGF-β and TGF-β+ Tregs may serve as new markers for predicting a poor prognosis in HCC.

T-regulatory lymphocytes in peripheral blood of gastric and colorectal cancer patients

AIM: To assess the absolute number of T-regulatory cells (Tregs; CD4+CD25+Foxp3+) in the peripheral blood of gastric and colorectal cancer patients. METHODS: We enrolled 70 cancer patients (33 gastric cancer, 37 colorectal cancer) and 17 healthy volunteers. The CD3+CD4+ lymphocytes and CD4+CD25+Foxp3+ Tregs in the peripheral blood were analyzed with flow cytometry. The absolute numbers of Tregs were calculated based on the CD4+CD25+Foxp3+ cells percent-age of CD3+CD4+ cells and the absolute numbers of CD3+CD4+ cells per microliter. RESULTS: The mean number of CD4+CD25+Foxp3+ cells per microliter in colorectal cancer patients was 15.7 (SD: 21.8), for gastric cancer patients 12.2 (SD: 14.3), and for controls 17.5 (SD: 11.4). The absolute number of Tregs was significantly lower in gastric cancer patients than in controls (P = 0.026). There was no statistically significant difference for gastric vs colorectal cancer or colorectal cancer vs controls. The absolute number of Tregs was also significantly depressed in N+ vs Ncancer patients [22.0 (27.7) vs 10.1 (9.0), P = 0.013], and in the subgroup of gastric cancer patients [30.3 (27.6) vs 9.6 (8.0), P = 0.003]. No statistical difference was observed in the proportion of Tregs in the CD4+ population between the groups. CONCLUSION: The absolute number of Tregs in peripheral blood of gastric cancer but not colorectal cancer patients was significantly decreased in comparison with that in healthy controls.

Autologous Peripheral Blood Stem Cells and <i>γ</i>/<i>δ</i>T Cells May Improve Immunity in Treating Secondary Bacteremic Infection in HIV Infected Patient

Opportunistic bacteremia in adult HIV-infected patients is a normal co-infectious condition caused by Gram-negative bacilli. Respiratory infections, including cough, shortness of breath, and chest pain and skin infection with eruptions, pustules and itchiness, are common complaints in the setting of late HIV infection. The variety of infections ranges from mild, self-limited viral, bacteremia and fungal infections to severe, life-threatening demanding urgent care and hospitalization. Varicella pneumonia, for instance, is the most severe complication of chickenpox in HIV infected adults, potentially refractory, fulminant respiratory failure can ensue. Patients with impaired immune status and chronic lung disease are at an increased risk. In the United States as well as in Vietnam, bacterial/viral pneumonia and skin infection are the two most common HIV-associated conditions. While globally the incidence of opportunistic infection has decreased since the introduction of highly active antiretroviral therapy during the last 3 decades, HIV-associated diseases remain a significant source of mortality, thus any manifestation must be taken seriously. This study will present the most common HIV-related pulmonary and skin infections and provide an overview of the epidemiology, characteristic clinical and chest radiograph findings, diagnosis, treatment, and prevention globally as well in Vietnam. Though the extensive efforts of the Vietnamese Government during last decade contributed to a valuable decrease, yet epidemic in Vietnam still remains high, ranking Vietnam 5th in the South-East region. The second part of the study focuses on a unique and severe HIV case report of a 35-year-old man, with a rare form of pneumonia caused by Acitenobacter spp. concomitant with a prolonged and disseminating skin infection. The case has been treated with a combination of conventional anti-retroviral medication and autologous peripheral blood stem cells, the results showed that within 5 months there was an impressive amelioration of HIV viral activity together with a total recovery from pneumonia and skin infection.

Rapamycin increased development of CD4^+ CD25~h ighFoxp3^+ T cells of peripheral blood in liver transplant recipients

Objective To investigate the possible influence of immunosuppressive therapy,including sirolimus ( SRL) and calcineurin inhibitors ( CNI,tacrolimus) ,on level of Treg in liver allo - graft recipients. Methods Forty - seven liver transplant recipients with stable liver function were assessed for at least 2 years,and divided into

急性缺血性脑卒中患者颅内血栓成分及调节性T细胞表达与患者临床结局的相关性

目的:分析急性缺血性脑卒中取栓患者的血栓成分及调节性T细胞表达与临床结局的关系。方法:连续纳入中国医科大学绍兴医院神经内科2021年6月至2022年10月接受颅内动脉取栓治疗的急性缺血性脑卒中患者。收集患者临床相关资料,对取栓术中改良脑梗死溶栓(mTICI)分级和发病3个月改良Rankin量表(mRS)评分等临床结局进行评价。所有血栓标本均进行苏木精-伊红染色、免疫组织化学染色,血栓红细胞、纤维蛋白/血小板以及调节性T细胞行半定量分析。结果:共纳入具有完整血栓数据的44例患者,其中红细胞型15例、混合型11例、纤维蛋白/血小板型18例,三组间ORG 10172急性脑卒中治疗分类试验(TOAST)病因分型差异具有统计学意义(P<0.01),而其余一般临床资料、手术相关资料无明显差异(均P>0.05)。按TOAST病因分型分为大动脉粥样硬化型28例和心源性栓塞型16例。大动脉粥样硬化型患者血栓的红细胞比例明显高于心源性栓塞型[分别为58.0%(44.2%,72.5%)和24.5%(12.7%,48.0%),P<0.01],而心源性栓塞型患者血栓的纤维蛋白/血小板比例明显高于大动脉粥样硬化型[分别为73.0%(49.2%,84.5%)和40.0%(25.2%,54.5%),P<0.01]。44例患者中,神经功能结局良好者19例,神经功能结局不良者25例,对患者相关资料进行单因素二元logistic回归分析,发现年龄、手术时间、CD4^(+)CD25^(+)T细胞数与患者的神经功能结局相关(均P<0.05),而其余临床相关资料及手术相关资料与患者神经功能结局无关(均P>0.05)。采用多因素二元logistic回归分析,纳入年龄、手术时间、CD4^(+)CD25^(+)T细胞数等变量,发现血栓CD4^(+)CD25^(+)T细胞数是患者神经功能结局的独立影响因素(OR=1.369,95%CI:1.101~1.701,P<0.01)。结论:血栓中红细胞、纤维蛋白/血小板成分与患者功能结局无明显相关性,但调节性T细胞表达增高与缺血性脑卒中患者神经功能结局良好相关。

急性髓系白血病患者外周血中Tfh和Tfr细胞及相关因子变化特点的初步研究

目的探讨滤泡辅助性T细胞(Tfh)和滤泡调节性T细胞(Tfr)在急性髓系白血病(AML)患者外周血中的表达及意义。方法选取60例初诊AML患者及40例健康体检者,流式细胞仪检测Tfh和Tfr细胞比例,ELISA检测血清细胞因子白介素-10(IL-10)、转化生长因子-β1(TGF-β1)及白介素-21(IL-21)表达水平;WB检测Tfh和Tfr细胞转录因子B细胞淋巴瘤6(BCL-6)和B淋巴细胞诱导的成熟蛋白1(Blimp-1)的表达水平;比较两组细胞比例、转录因子及相关细胞因子的表达差异;分析AML患者Tfr、Tfh/Tfr比值和细胞因子IL-10、TGF-β1水平与AML患者不良预后之间的关联。结果与对照组相比,AML组Tfr细胞比例、血清IL-10和TGF-β1水平增高,Tfh/Tfr比值和Blimp-1水平降低(P均<0.05),而Tfh细胞比例、BCL-6和血清IL-21水平略增高,无明显统计学差异(P>0.05)。与预后中等组和预后良好组相比,预后不良组Tfr细胞比例、IL-10和TGF-β1明显增高,Tfh/Tfr比值明显降低(P均<0.05);与预后良好组相比,预后中等组Tfr细胞比例、IL-10和TGF-β1水平升高(P均<0.05),Tfh/Tfr比值明显降低(P<0.05)。Pearson相关性分析结果显示,Tfr细胞比例与血清IL-10、TGF-β1水平呈正相关(r=0.706、0.619,P均<0.0001),Tfh/Tfr比值与IL-10、TGF-β1水平呈负相关(r=-0.454,-0.446,P均<0.001)。结论Tfr细胞及其相关细胞因子在AML患者中异常高表达,存在Tfh/Tfr比值失衡,且该现象在预后不良组AML中更明显。

Tfh/Tfr细胞免疫平衡在血液恶性肿瘤中的研究进展

滤泡辅助性T细胞(Tfh)和滤泡调节性T细胞(Tfr)是新发现的具有相互拮抗作用的CD4^(+)T细胞亚群。在淋巴结生发中心发挥功能和体液免疫形成过程中,Tfh细胞辅助浆细胞的抗体生成,而Tfr细胞具有抑制Tfh细胞和B细胞功能。Tfh/Tfr细胞免疫平衡对维持生发中心的形成、诱导B细胞成熟及抗体的产生等具有十分重要的意义。Tfh/Tfr细胞平衡与自身免疫疾病、实体肿瘤及部分血液系统疾病的进展密切相关,而其在血液恶性肿瘤中的作用尚不清楚。该文就Tfh/Tfr细胞的免疫平衡紊乱在血液恶性肿瘤中的最新研究进展进行综述,为恶性血液肿瘤的发病机制和免疫治疗指明新的方向。

肺癌患者外周血和胸腔积液T细胞受体组库特征分析

目的 比较肺癌患者外周血和胸腔积液的T细胞受体(TCR)组库的免疫学特征。方法 收集2020年7月至2021年1月在复旦大学附属中山医院就诊的5例合并恶性胸腔积液肺癌患者的外周血和胸腔积液,分离外周血单个核细胞(PBMC)和胸腔积液单个核细胞(PEMC),提取基因组DNA,采用Illumina MiSeq平台对TCR进行高通量测序,分析TCR组库的多样性等特征。结果 PBMC和PEMC中的TCR克隆型、VJ pairs和互补决定区3(CDR3)序列的多样性和相关性差异均无统计学意义。PBMC中检测到的TCR克隆数量高于PEMC(P<0.05),VJ pairs和CDR3数量与PEMC差异无统计学意义。PBMC和PEMC配对样本的共有VJ pairs数量占总VJ pairs的比例高于共有克隆型和CDR3序列的数量比例(P<0.05),后两者差异无统计学意义。PEMC中高扩增克隆(HEC)数量和占比均高于PBMC。同时鉴定了36个在PBMC和PEMC中差异表达的VJ pairs,其中25个在PEMC中表达升高、9个在PEMC中表达降低。结论 肺癌患者外周血和胸腔积液的TCR组库表现出不同的特征性变化,可能为肺癌重要的免疫病理学特征。

Expression characteristics of peripheral lymphocyte programmed death 1 and FoxP3+ Tregs in gastric cancer during surgery and chemotherapy

BACKGROUND Programmed death 1(PD-1)and CD4^(+)CD25^(+)FoxP3^(+)expression in peripheral blood T-cells has been previously reported in various types of cancer.However,the specific variation tendency during surgery and chemotherapy,as well as their relationship in gastric cancer patients,still remain unclear.Understanding this aspect may provide some novel insights for future studies on tumor recurrence and tumor immune escape,and also serve as a reference for determining the optimal timing and dose of clinical anti-PD-1 antibodies.AIM To observe and analyze the expression characteristics of peripheral lymphocyte PD-1 and FoxP3^(+)regulatory T cells(FoxP3^(+)Tregs)before and after surgery or chemotherapy in gastric cancer patients.METHODS Twenty-nine stomach cancer patients undergoing chemotherapy after a D2 gastrectomy provided 10 mL peripheral blood samples at each phase of the perioperative period and during chemotherapy.This study also included 29 agematched healthy donors as a control group.PD-1 expression was detected on lymphocytes,including CD4^(+)CD8^(+)CD45RO^(+),CD4^(+)CD45RO^(+),and CD8^(+)CD45RO^(+)lymphocytes as well as regulatory T cells.RESULTS We observed a significant increase of PD-1 expression on immune subsets and a larger number of FoxP3^(+)Tregs in gastric cancer patients(P<0.05).Following D2 gastrectomy,peripheral lymphocytes PD-1 expression and the number of FoxP3^(+)Tregs notably decrease(P<0.05).However,during postoperative chemotherapy,we only observed a decrease in PD-1 expression on lymphocytes in the CD8^(+)CD45RO^(+)and CD8^(+)CD45RO^(+)populations.Additionally,linear correlation analysis indicated a positive correlation between PD-1 expression and the number of CD4^(+)CD45RO^(+)FoxP3high activated Tregs(aTregs)on the total peripheral lymphocytes(r=0.5622,P<0.0001).CONCLUSION The observed alterations in PD-1 expression and the activation of regulatory T cells during gastric cancer treatment may offer novel insights for future investigations into tumor immune evasion and the clinical application of anti-PD-1 antibodies in gastric cancer.

血管活性肠肽调控滤泡辅助性T细胞/滤泡调节性T细胞平衡治疗溃疡性结肠炎的研究进展

溃疡性结肠炎(UC)是以结肠黏膜屏障持续损伤为病理基础的自身免疫性疾病。滤泡辅助性T(Tfh)细胞和滤泡调节性T(Tfr)细胞的异常表达与UC的发生发展密切相关,Tfh细胞具有分泌促炎因子、辅助B细胞产生抗体等作用,能够促进UC的发展,Tfr细胞则具有抑制Tfh细胞活性、分泌抗炎因子等作用,如何调节两者平衡已成为UC的潜在治疗靶点之一。血管活性肠肽(VIP)对UC具有防治作用,其机制与调控Tfh/Tfr细胞平衡密切相关,可对UC的治疗提供思路。

滤泡辅助性T淋巴细胞在自身免疫性肝炎中的作用机制

自身免疫性肝炎(AIH)是由自身免疫系统攻击肝细胞导致的慢性肝炎,随着病程的延长,可逐渐发展为肝硬化,甚至肝癌。尽管目前对于AIH的认识和治疗已取得很大进展,但其病因和发病机制仍不明确。T淋巴细胞在AIH的发生、发展过程中发挥至关重要的作用,本文聚焦于滤泡辅助性T淋巴细胞,阐述其在AIH机制中的研究进展,以期为AIH的临床治疗提供新的思路和策略。

Establishment of a humanized mouse model using steady-state peripheral blood-derived hematopoietic stem and progenitor cells facilitates screening of cancer-targeted T-cell repertoires

Background:Cancer-targeted T-cell receptor T(TCR-T)cells hold promise in treating cancers such as hematological malignancies and breast cancers.However,approaches to obtain cancer-reactive TCR-T cells have been unsuccessful.Methods:Here,we developed a novel strategy to screen for cancer-targeted TCR-T cells using a special humanized mouse model with person-specific immune fingerprints.Rare steady-state circulating hematopoietic stem and progenitor cells were expanded via three-dimensional culture of steady-state peripheral blood mononuclear cells,and then the expanded cells were applied to establish humanized mice.The human immune system was evaluated according to the kinetics of dendritic cells,monocytes,T-cell subsets,and cytokines.To fully stimulate the immune response and to obtain B-cell precursor NAML-6-and triple-negative breast cancer MDA-MB-231-targeted TCR-T cells,we used the inactivated cells above to treat humanized mice twice a day every 7 days.Then,human T cells were processed for TCRβ-chain(TRB)sequencing analysis.After the repertoires had been constructed,features such as the fraction,diversity,and immune signature were investigated.Results:The results demonstrated an increase in diversity and clonality of T cells after treatment.The preferential usage and features of TRBV,TRBJ,and the V–J combination were also changed.The stress also induced highly clonal Science and Technology,Grant/Award Number:2021C03010;Zhejiang Provincial Natural Science Foundation of China,Grant/Award Numbers:LTGY24H080003,LY21H080004 expansion.Tumor burden and survival analysis demonstrated that stress induction could significantly inhibit the growth of subsequently transfused live tumor cells and prolong the survival of the humanized mice.Conclusions:We constructed a personalized humanized mouse model to screen cancer-targeted TCR-T pools.Our platform provides an effective source of cancer-targeted TCR-T cells and allows for the design of patient-specific engineered T cells.It therefore has the potential to greatly benefit cancer treatment.

Th17/Treg细胞与高血压相关性的研究现状

高血压作为一种常见的慢性疾病,其发病率在全球范围内逐年上升,且病理机制复杂,涉及遗传、环境、生活方式等多种因素。近年来,免疫-炎症机制在高血压发病中的作用逐渐受到关注。特别是辅助性T细胞17(Th17)和调节性T细胞(Treg),作为免疫系统中的重要组成部分,其平衡状态对高血压的影响成为研究热点。本文将对Th17/Treg与高血压相关性的研究进展进行综述,为高血压的免疫治疗和预防提供新的思路和方法。

调节性T细胞在肝细胞癌患者外周血中的表达及临床意义

目的探讨在不同病理分期肝细胞癌(hepatocellular carcinoma,HCC)患者外周血中CD4^(+)CD25^(+)CD127^(LOW)Treg的含量变化及临床意义。方法收集60例HCC患者的外周抗凝血作为HCC试验组并进行Edmondson-steiner病理分期,20名健康体检者的外周抗凝血作为健康对照组,检测两组CD4^(+)CD25^(+)CD127^(LOW)Treg水平。结果HCC患者外周血中Treg占CD4^(+)T细胞的百分率显著高于健康对照组(P<0.01);且在HCC不同分期中,Ⅲ、Ⅳ期患者外周血中Treg占CD4^(+)T细胞的百分率显著高于Ⅰ、Ⅱ期患者(P<0.05)。结论在HCC患者外周血中,Treg随着疾病的发生发展而逐渐增多,且在Ⅲ、Ⅳ期快速增殖,其可能与肿瘤细胞免疫逃逸密切相关。

滤泡调节性T细胞、滤泡辅助性T细胞及其比值在梅毒血清固定患者外周血中的表达及预测价值

目的分析梅毒血清固定患者外周血滤泡调节性T细胞(Tfr细胞)、滤泡辅助性T细胞(Tfh细胞)及其比值的表达水平,探讨其与梅毒血清固定的相关性及预测价值。方法选取2020年1月至2022年12月浙江省皮肤病医院收治的30例梅毒血清固定患者(梅毒血清固定组)、30例梅毒血清转阴患者(梅毒血清转阴组)作为研究对象。另选取同期30例健康体检者设为健康对照组。利用流式细胞术检测三组外周血Tfh、Tfr细胞水平及Tfr细胞/Tfh细胞比值,分析Tfh、Tfr细胞水平变化与血清甲基胺红不加热血清试验(TRUST)滴度的相关性,绘制受试者工作特征(ROC)曲线评估Tfr细胞水平、Tfr细胞/Tfh细胞比值对梅毒血清固定的预测价值。结果三组Tfh细胞水平比较,差异无统计学意义(P>0.05);梅毒血清固定组Tfr细胞水平、Tfr细胞/Tfh细胞比值均高于梅毒血清转阴组和健康对照组,差异具有统计学意义(P<0.05)。Tfh、Tfr细胞水平与TRUST滴度无显著相关性(r=0.217、0.225,P>0.05)。ROC曲线结果显示,Tfr细胞水平、Tfr细胞/Tfh细胞比值的曲线下面积(AUC)分别为0.707、0.692(P<0.05)。结论梅毒血清固定患者存在Tfh、Tfr细胞的平衡失调,Tfr细胞水平、Tfr细胞/Tfh细胞比值可作为梅毒血清固定的预测指标。

成人乙型肝炎疫苗接种后无应答的影响因素及与外周血滤泡T细胞的关联研究

目的分析成人乙型肝炎(乙肝)疫苗接种后无应答的影响因素,及与外周滤泡T细胞的关联。方法回顾性分析2022年1月至2022年12月至信阳市平桥区疾病预防控制中心接受乙肝疫苗接种的129例患者的临床资料,依据接种后乙型肝炎病毒表面抗体(HBsAb)水平,将接种后HBsAb≥10 mIU/mL的100例患者列为应答组,将接种后HBsAb<10 mIU/mL的29例患者列为无应答组。收集、对比两组患者的一般资料及临床资料,经统计学单因素分析、Logistic多因素回归分析归纳可导致成人乙肝疫苗接种后无应答的影响因素。比较两组患者外周血滤泡T细胞间的差异,经Spearman相关性系数检验外周血滤泡T细胞与乙肝疫苗接种后无应答的关联。结果统计学单因素分析结果显示,无应答组内男性、年龄≥60岁、体重指数(BMI)≥24 kg/m^(2)、有吸烟饮酒史、肌肉注射、按10μg 0-1-6月程序接种、有造血干细胞移植治疗史、合并人类免疫缺陷病毒(HIV)感染、Toll样受体(TLRs)高表达、外周血滤泡辅助性T细胞(Tfh)低表达、白细胞介素-12(IL-12)低表达、外周血滤泡调节性T细胞(Tfr)高表达、趋化因子受体5(CXCR5)高表达占比均高于应答组(P<0.05)。Logistic多因素回归分析结果显示,肌肉注射、按10μg 0-1-6月程序接种、Tfh低表达、IL-12低表达、Tfr高表达、CXCR5高表达为成人乙肝疫苗接种后无应答的主要影响因素。无应答组的Tfh、IL-12分别为(17.44±3.25)%、(70.33±10.21)ng/mL,均低于应答组[(19.25±3.16)%、(75.45±10.23)ng/mL];Tfr、CXCR5分别为(7.32±1.41)%、(33.49±5.18)ng/mL,均高于应答组[(6.65±1.24)%、(30.23±5.22)ng/mL],P<0.05。经Spearman相关性系数检验,Tfh、IL-12与HBsAb应答水平呈正相关,Tfr、CXCR5与HBsAb应答水平呈负相关。结论乙肝疫苗接种方式、程序不当以及个人免疫功能紊乱均是导致成人乙肝疫苗接种后无应答或应答低的重要因素。Tfh、IL-12与HBsAb应答水平呈正相关,Tfr、CXCR5与HBsAb应答水平呈负相关。

乙型肝炎患者体内滤泡辅助性T细胞的功能特点及临床意义研究

目的 通过分析HBV感染者体内滤泡辅助性T细胞(follicular helper T cell,Tfh)的频率和功能,探讨其在HBV感染中的临床意义。方法 本研究入组HBV感染者36例,包括6例急性恢复期(acute recovery,AR)患者和30例慢性HBV感染者,其中慢性HBV感染者又包括免疫耐受期(immune tolerance,IT)患者10例、免疫活化期(immune activation,IA)患者20例。另外纳入8例健康对照(health control,HC)。通过流式细胞术和多色免疫组化技术比较HC组和HBV感染者外周血和肝内Tfh的表达差异,以及通过单细胞分泌蛋白组芯片检测Tfh的功能特点,并对HBV感染者Tfh的频率与HBV相关临床指标(HBV表面抗原、HBV载量、ALT、AST)的相关性进行分析。结果 IA组外周血中Tfh频率显著高于HC组(1.487%vs.0.876%,t=2.126,P=0.043)和IT组(1.487%vs.0.737%,t=3.144,P=0.004);与外周血一致,肝内Tfh也在IA组患者中富集。外周血中Tfh的频率与肝脏炎症指标ALT、AST水平呈正相关(ALT:r=0.488,P=0.000;AST:r=0.498,P=0.000)。单细胞分泌蛋白组芯片检测Tfh的多功能强度指数(polyfunctional strength index,PSI)在AR组患者中最高(AR组>IA组>IT组>HC组),其中AR组患者分泌TNF-、IL-2和IFN-能力较高、IA组分泌IL-10和IL-17A能力较高、IT期分泌粒细胞-巨噬细胞集落刺激因子和IFN-较高,HC组分泌IL-4较高。结论 肝内与外周血结果一致,Tfh在IA组CHB患者中增多,这可能提示Tfh与肝脏炎症的免疫状态密切相关。进一步功能分析表明Tfh在HBV感染不同阶段分泌的细胞因子不同,其可能倾向于不同的分化表型,其中IA期Tfh倾向于cTfh17类表型,而IT期和AR期Tfh倾向于cTfh1类表型,表明Tfh在HBV感染不同阶段表现出不同的CD4^(+)T细胞极化特征。

痤疮患者外周血IL-17、TNF-α及Th22细胞水平与痤疮严重程度的相关性研究

目的探究痤疮患者外周血白介素-17(IL-17)、肿瘤坏死因子α(TNF-α)及外周血辅助性T细胞22(Th22)细胞水平与痤疮严重程度的相关性。方法选择2020年5月至2022年1月门诊进行治疗的痤疮患者78例作为观察组,同一阶段体检的健康体检者47例作为对照组,比较2组外周血IL-17、TNF-α、IL-22、Th22细胞水平。按Pillsbury法将78例痤疮患者分为轻度(Ⅰ级)组19例,中度(Ⅱ~Ⅲ级)组39例,重度(Ⅳ级)组20例,比较3组血清外周血IL-17、TNF-α、IL-22、Th22细胞水平。并进一步分析外周血IL-17、TNF-α及Th22细胞水平与痤疮严重程度的相关性。结果相较于对照组,观察组IL-17、TNF-α、IL-22及Th22细胞水平均明显上调(P<0.05)。相较于轻度组,中、重度组IL-17、TNF-α、IL-22、Th22细胞水平均明显上调(P<0.05);相较于中度组,重度组IL-17、TNF-α、IL-22、Th22细胞水平均明显上调(P<0.05)。IL-17、TNF-α、Th22预测痤疮严重程度的曲线下面积(AUC)分别为0.736、0.750、0.849,灵敏度分别为94.74%、95.53%、100.00%,特异度分别为51.28%、61.54%、71.79%。IL-17、TNF-α、Th22细胞水平与痤疮患者严重程度均呈正相关(r=0.544,0.443,0.691,P=0.032,0.040,0.021)。结论痤疮患者外周血中IL-17、TNF-α、Th22细胞水平均明显上调,与病情严重程度相关,随病情严重程度增加而上调,在预测痤疮严重程度方面具有重要价值。