To compare the clinical and pathological manifestations of patients with antineutrophil cytoplasmic autoantibodies (ANCA) directed against proteinas e 3 (anti PR3) or myeloperoxidase (anti MPO). Methods. One hundred a...To compare the clinical and pathological manifestations of patients with antineutrophil cytoplasmic autoantibodies (ANCA) directed against proteinas e 3 (anti PR3) or myeloperoxidase (anti MPO). Methods. One hundred and forty patients with ANCA were detected for anti PR3 a nd anti MPO by ELISA. The clinical features at presentation, histopathological characteristics and outcome of all patients who were tested positive for anti P R3 or anti MPO were analysed.Results. In anti PR3 group (n=21), 16 cases (76.2%) had systemic vasculitis , in which Wegener’s granulomatosis prevailed (13 cases, 61.9%). In anti MPO g roup (n=31), 19 cases (61.3%) were diagnosed as systemic vasculitis and 12 case s (38.7%) as microscopic angiitis. For vasculitic patients with anti PR3 and a nti MPO, the disease duration at diagnosis was 9.6±2.0m and 4.4±0.9m respecti vely, P< 0.05;vasculitis activity index (BVAS) and mean number of affected organ were 22.5±2.1, 5.0±0.4 and 25.1±1.7, 4.8±0.4 respectively, P >0.05;upper r espiratory tract, eye and joint involvements were 11(68.8%), 7(43.8%), 11(68.8 %) and 7(36.8%), 2(10.5%), 5(26.3%) respectively, P< 0.05.Although there was no statistical difference in renal involvement between these two groups, patien ts with serum creatine >500 μmol/L were more commonly seen in anti MPO group t han in anti PR3 group, which were 8(42.1%) and 2(12.5%) respectively, P< 0.05 . Ten relapses were seen in anti PR3 group and only 2 in anti MPO group, but t he acute mortality rate in anti MPO group (5/19, 27.4%) was much higher than t hat in anti PR3 group (1/16, 6.3%). Conclusions. Anti PR3 and anti MPO occurred mainly in systemic vasculitis. A large divergence was seen in the disease spectrum between patients with anti PR 3 and those with anti MPO. In particular, upper respiratory tract, eye and join t involvements, granuloma formation and relapse were more prominent in anti PR3 patients. By contrast, the anti MPO patients had a more acute disease onset, m ore rapid progressive renal involvement and a higher acute mortality rate.展开更多
Suppression of excessive inflammation can ameliorate blood brain barrier （BBB） injury, which shows therapeutic potential for clinical treatment of brain injury induced by stroke superimposed on systemic inflammatory...Suppression of excessive inflammation can ameliorate blood brain barrier （BBB） injury, which shows therapeutic potential for clinical treatment of brain injury induced by stroke superimposed on systemic inflammatory diseases. In this study, we investigated whether and how clematichinenoside （AR）, an anti-inflammatory triter- pene saponin, protects brain injury from stroke superimposed on systemic inflammation. Lipopolysaccharide （LPS） was intraperitoneally injected immediately after middle cerebral artery occlusion （MCAO） in rats. Rat microvessel endothelial cells （rBMECs） were exposed to hypoxia/reoxygenation （H/R） coexisting with LPS. The results re- vealed that AR suppressed the excessive inflammation, restored BBB dysfunction, alleviated brain edema, de- lessened neurological dysfunction, and decreased infarct rate. Further study demon- creased neutrophil infiltration, inducible nitric oxide synthase （iNOS） , strated that the expression of nucleus nuclear factor kappa B （NF-KB）, intercellular adhesion molecule-1 （ ICAM-1 ）, tumor necrosis factor-α （TNF-α） and interlukin-1β （ IL-1β） were suppressed by AR via zinc finger protein A20. Besides, AR increased in vitro BBB integrity through A20. In con- clusion, AR alleviated cerebral inflammatory injury through A20-NF-KB signal pathway, offering an alternative medication for stroke associated with systemic inflammatory diseases.展开更多
文摘To compare the clinical and pathological manifestations of patients with antineutrophil cytoplasmic autoantibodies (ANCA) directed against proteinas e 3 (anti PR3) or myeloperoxidase (anti MPO). Methods. One hundred and forty patients with ANCA were detected for anti PR3 a nd anti MPO by ELISA. The clinical features at presentation, histopathological characteristics and outcome of all patients who were tested positive for anti P R3 or anti MPO were analysed.Results. In anti PR3 group (n=21), 16 cases (76.2%) had systemic vasculitis , in which Wegener’s granulomatosis prevailed (13 cases, 61.9%). In anti MPO g roup (n=31), 19 cases (61.3%) were diagnosed as systemic vasculitis and 12 case s (38.7%) as microscopic angiitis. For vasculitic patients with anti PR3 and a nti MPO, the disease duration at diagnosis was 9.6±2.0m and 4.4±0.9m respecti vely, P< 0.05;vasculitis activity index (BVAS) and mean number of affected organ were 22.5±2.1, 5.0±0.4 and 25.1±1.7, 4.8±0.4 respectively, P >0.05;upper r espiratory tract, eye and joint involvements were 11(68.8%), 7(43.8%), 11(68.8 %) and 7(36.8%), 2(10.5%), 5(26.3%) respectively, P< 0.05.Although there was no statistical difference in renal involvement between these two groups, patien ts with serum creatine >500 μmol/L were more commonly seen in anti MPO group t han in anti PR3 group, which were 8(42.1%) and 2(12.5%) respectively, P< 0.05 . Ten relapses were seen in anti PR3 group and only 2 in anti MPO group, but t he acute mortality rate in anti MPO group (5/19, 27.4%) was much higher than t hat in anti PR3 group (1/16, 6.3%). Conclusions. Anti PR3 and anti MPO occurred mainly in systemic vasculitis. A large divergence was seen in the disease spectrum between patients with anti PR 3 and those with anti MPO. In particular, upper respiratory tract, eye and join t involvements, granuloma formation and relapse were more prominent in anti PR3 patients. By contrast, the anti MPO patients had a more acute disease onset, m ore rapid progressive renal involvement and a higher acute mortality rate.
文摘Suppression of excessive inflammation can ameliorate blood brain barrier （BBB） injury, which shows therapeutic potential for clinical treatment of brain injury induced by stroke superimposed on systemic inflammatory diseases. In this study, we investigated whether and how clematichinenoside （AR）, an anti-inflammatory triter- pene saponin, protects brain injury from stroke superimposed on systemic inflammation. Lipopolysaccharide （LPS） was intraperitoneally injected immediately after middle cerebral artery occlusion （MCAO） in rats. Rat microvessel endothelial cells （rBMECs） were exposed to hypoxia/reoxygenation （H/R） coexisting with LPS. The results re- vealed that AR suppressed the excessive inflammation, restored BBB dysfunction, alleviated brain edema, de- lessened neurological dysfunction, and decreased infarct rate. Further study demon- creased neutrophil infiltration, inducible nitric oxide synthase （iNOS） , strated that the expression of nucleus nuclear factor kappa B （NF-KB）, intercellular adhesion molecule-1 （ ICAM-1 ）, tumor necrosis factor-α （TNF-α） and interlukin-1β （ IL-1β） were suppressed by AR via zinc finger protein A20. Besides, AR increased in vitro BBB integrity through A20. In con- clusion, AR alleviated cerebral inflammatory injury through A20-NF-KB signal pathway, offering an alternative medication for stroke associated with systemic inflammatory diseases.
