ABSTRACT
Objective To study the correlation between immune imbalance mediated by Th 17 and Treg cells and impaired lung function in patients with chronic obstructive pulmonary disease ( COPD ) . Methods Ninety-five patients with moderate or severe COPD , thirty-five smokers with normal lung function and thirty-one healthy non-smokers from Yinzhou People′s Hospital from January 2009 to December 2012 were recruited in this study .The percentages of circulating Th 17 and Treg cells in peripheral blood samples were determined by flow cytometry .The concentrations of cytokines in serum samples and supernatants of in-duced sputum samples were measured by enzyme-linked immunosorbent assay (ELISA).The expression of ROR-γt and Foxp3 at mRNA level in peripheral blood mononuclear cells ( PBMC) were determined by quan-titative real-time PCR.The potential association between ratios of Th 17/Treg cells and lung function was evaluated.Results Compared with smokers and healthy subjects , patients with moderate or severe COPD showed high levels of Th17 cells, IL-17A, IL-6 and IL-23, and an up-regulated expression of ROR-γt at transcriptional level .However, the percentage of Treg cells , IL-10 level and the expression of Foxp 3 at mRNA level were down-regulated in patients with COPD .The levels of cytokines in supernatants of induced sputum samples varied in the same way as that of Th 17/Treg in peripheral blood samples .The ratio of Th17 to Treg cells was negatively correlated with the values of forced vital capacity ( FVC) , forced expiratory vol-ume in one second (FEV1), and FEV1/FVC.Conclusion Th17/Treg cells imbalance was closely associ-ated with the deterioration of pulmonary function in patients with moderate or severe COPD .Th17/Treg cells imbalance might be involved in the progression of COPD .
ABSTRACT
ObjectiveTo evaluate the value of serum galactomannan platelia aspergillus kit in the diagnosis and treatment of invasive fungal infection(IFI) patients. MethodsA total of 178 serum samples from 74 high risk patients were collected. ELISA assay was used to detect the level of GM antigen. Refer to domestic IFI diagnostic criteria, 16 patients include the proven cases and probable cases were defined as study group, while 29 patients of improbable cases defined as control group. Fourflod table was founded,by which the sensitivity,specificity,positive predictive value, negative predictive value of this GM test were calculated. Meanwhile, a total of 53 patients received antifungal therapy which divided into GM-positive group(21 patients with I≥0. 5) and GM-negative group(32 patients with I ＜0. 5). The therapeutic effect comparison of two groups was made according to curative effect criterion. ResultsAccording to the certainty level of IFI diagnosis, 1,9,10 and 4 patients were identified as GM positive in proven, probable,possible and improbable IFI groups respectively. The prevalence of GM in these 4 groups was 50％ ,64％ ,34％ and 14％ ,respectively. The sensitivity and specificity of galactomannan ELISA assay were 63％ ,86％ respectively. The positive and negative predictive values were 71％ and 81％ respectively. The diagnose accordance rate was 78％, the Younden index was 0. 49. The efficacy of fluconazole in GM-positive patients was significant lower than in GMnegative patients( x2 =4. 95 ,P ＜0. 05) ,while The efficacy of non-fluconazole drug was superior to that in GM-negative patients( x2 =4. 88,P ＜ 0. 05). After antifungal therapy, the GM value of GM-positive patients decreased significantly( t =2. 13 ,P ＜0. 05). ConclusionThe galactomannan ELISA assay with high specificity, could be helpful in diagnosis and choicing effective anti-fungi drug in clinic.