ABSTRACT
Objective To study the clinical feature,treatment,and prognosis of the cytomegalovirus (CMV)pneumonia patients treated with immunosuppressor against kidney disease.Mlethod The patients received immunosuppressor against kidney disease in The First Affiliated Hospital of Sun Yat-sen University from June 1999 to December 2006.CMV antigen of leucocyte in the peripheral blood and/or bronchoalveolar lavage fluid of these patients were detected with immunocytochemical methods,and 21 patients were found suffering from CMV pneumonia.The 21 patients were introvenously injected with ganciclovir 5～10 mg/(kg?d),and the immunosuppressive agent treatment suspended.Their clinical feature and prognosis were retrospectively analyzed. Results The 21 patients received corticosteroids before CMV pneumonia contracted,of them,13 patients had been intensively treated with Methyllprednisolone with mean total dose(3.2?0.6)g.Of them,15 had been treated with cyclophosphamide with mean total dose(3.8?1.3)g.The median time from the beginning of using immunosuppressor to the onset of CMV pneumonia was 25(13～92)days.All patients had fever,cough, shortness of breath and X-ray showed interstitial pneumonia,of them,19 patients developed hypoxemia,and 11 patients' CMV antigen was positive in the leucocyte from bronchial lavage fluid.The result showed 9 patients survived and 12 died.The average duration of treatment with ganciclovir was(26.2?6.3)days. CMV pneumonia is a serious complication in patients who were treated with immunosuppressor against kidney disease.The mortality is high.Ganciclovir is a medicine of choice to treat CMV pneumonia.
ABSTRACT
<p><b>AIM</b>To investigate the significance of the calcineurin (CaN) activation in active lupus nephritis patient.</p><p><b>METHODS</b>Peripheral blood mononuclear cells (PBMCs) were separated from twenty-one active LN patients and 12 healthy controls. Phosphatase activity of CaN was determined using the CaN assay kit by measuring the content of released PO4. Reverse transcription-PCR was used to detect the expression of CD40L mRNA. Flow cytometry analysis was used to detect the expression of CD40L in LN PBMC.</p><p><b>RESULTS</b>(1) Increased activation of CaN in spontaneous cultured PBMC in active LN group was found as compared with control group (46.08 +/- 5.58 vs 8.81 +/- 3.61, P < 0.01). In stimulated by PMA/Ionomycin , activity of CaN in active LN group was also higher than that of control (69.34 +/- 12.59 vs 37.12 +/- 11.57, P < 0.01). (2) Relative content of CD40L in PBMC in active LN groups increased significantly as compared with the control groups under spontaneous and PMA/Ionomycin-induced culture, respectively (P < 0.01). (3) FK506 reduced significantly production of CD40L in spontaneous and PMA/Ionomycin-induced PBMC of LN.</p><p><b>CONCLUSION</b>Elevated activation of CaN in active LN may participate in regulation overexpression of CD40L in PBMC of LN. Through inhibiting CaN activity, FK506 may prevent abnormal activation of CD40-CD40L costimulatory pathway in lupus nephritis.</p>
Subject(s)
Adolescent , Adult , Female , Humans , Male , Middle Aged , Young Adult , CD40 Ligand , Metabolism , Calcineurin , Metabolism , Case-Control Studies , Cells, Cultured , Leukocytes, Mononuclear , Metabolism , Lupus Nephritis , Blood , Metabolism , Tacrolimus , PharmacologyABSTRACT
<p><b>OBJECTIVE</b>To investigate the effect of Lupus Recipe (LR) on IL-6 and IL-10 secretion of splenic cells in vitro in lupoid model mice and on anti-dsDNA antibody.</p><p><b>METHODS</b>Chronic graft-versus-host disease model was used in the experiment. The model mice were divided into four groups, the model group was un-treated and the other three groups treated with LR, prednisone and combined treatment (prednisone + LR) respectively. The serum level of ds-DNA antibody, the ConA induced splenic cell proliferation in mice's splenic cell culture as well as the IL-6, IL-10 level in the supernatant of culture were determined after treatment and compared with those of normal controls.</p><p><b>RESULTS</b>(1) The splenic cell proliferative reaction in the model group splenic cells was obviously higher than that of the normal control (P < 0.05); but that in the three treated groups was different from the control insignificantly (P > 0.05); (2) The serum anti-dsDNA in the model group was higher than that in the normal control, 1.75 +/- 0.25 vs 1.20 +/- 0.21 (P < 0.01), while the difference in comparison of the treated groups with the normal control was insignificant, (P > 0.05); (3) Splenic cell IL-6 and IL-10 secretion in the model group induced by ConA was higher than those in the treated groups and the controls significantly (P < 0.05).</p><p><b>CONCLUSION</b>LR reveals the effect of immunosuppressor, which could inhibit the activation of T- and B-cells, reduce the Th2 cytokine formation and auto-antibody production so as to treat lupus erythematosus effectively.</p>