An analysis of circulating T lymphocytes among asthmatic children with different sensitized patterns / 中国免疫学杂志

Objective:To investigate the difference in circulating T lymphocyte subsets among asthmatic children with different sensitized patterns.Methods:A total of 374 asthmatic children were enrolled in present study,and the sensitized patters were identified using skin prick testing.The numbers of circulating T cells (CD3+,CD19+),CD4+T cells (CD3+,CD4+),CD8+ T cells (CD3 + CD8 +),Tregs(CD4+ CD25+ FOXP3+),Th1 (CD4+IFN-γ+T),Th2 (CD4+ IL-4+ T)and Th17 cells(CD4+ IL-17+ T)in peripheral blood were measured by flow cytometry.Results:According to positive skin responses detected by SPT,patients with asthma were divided into three groups:un-sensitized asthma group,mono-sensitive asthma group and poly-sensitized asthma group.Compared with healthy controls,there were significant variations in CD4+ T cells and CD8+ T cells and CD4/CD8 ratio,Th1 cells and Th2 cells and Th1/Th2 ratio,Tregs,Th17 cells,Tregs/Th17 ratio (all P ＜ 0.05).A further pairwise comparison indicated that the statistically significant difference in Tregs,Th17 cells and Tregs/Th17 were found among un-sensitized asthma group,mono-sensitive asthma group and poly-sensitized asthma group(all P＜0.05).According to the type of allergens detected by SPT,the asthmatic patients were divided into the dust mite group,mould group,animal dander group,pollen group and other groups.Compared with healthy controls,there were significant variations in CD4+ T cells and CD8+ T cells and CD4/CD8 ratio,Th1 cells and Th2 cells and Th1/Th2 ratio,Tregs,Th17 cells,Tregs/Th17 ratio(all P＜0.05).Similarly,a pairwise comparison indicated that the numbers of Th1 cells,T h2 cells,Th2 cells,Th1/Th2 ratios,Tregs,Th17 cells and Tregs/Th17 ratios were found significant among these 5 groups(all P＜0.05).Conclusion:The finding highlights the importance of paying attention to the differences in the distribution of T lymphocyte subgroups among asthmatic patients with different sensitization patterns.

Quality control for maximal expiratory flow-volume curve as a pulmonary function test in school-age children / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To assess the quality control for the maximal expiratory flow-volume (MEFV) curve in school-age children.</p><p><b>METHODS</b>Eight hundred and sixty-two children who had two or more MEFV manoeuvres were classified into ≥6-year-old (n=379), ≥8-year-old (n=210), ≥10-year-old (n=64), and 12-17-year-old groups (n=109). The parameters of quality control and concordance with quality control criteria for MEFV were compared between the two groups. In addition, patients who were diagnosed with asthma were classified into two groups, one with normal pulmonary function (n=155) and the other with abnormal pulmonary function (n=62), based on the results of spirometry. Differences in the parameters of quality control for spirometry were compared between the two groups.</p><p><b>RESULTS</b>Eight hundred and sixty-two children underwent 2 367 MEFV manoeuvres, 97.8% of which met the start of test criterion for backward extrapolated volume (VBE) of less than 0.15 L, with the highest concordance in the ≥6-year-old group and the lowest concordance in the 12-17-year-old group. Three hundred and eighty-one children (44.2%) met the end of test criterion for forced expiratory time (FET) and the concordance in children over 10 years of age was lower than that in children under 10 years of age (P<0.05). Differences in two best forced expiratory volume in first second (FEV1) and forced vital capacity (FVC) manoeuvres were within 150 mL in 91.9% and 84.8%, respectively, of the children. The parameters of quality control for spirometry were better for asthmatic children with abnormal pulmonary function compared with asthmatic children with normal pulmonary function (P<0.05).</p><p><b>CONCLUSIONS</b>Concordance with the start of test criteria and the manoeuvre repeatability criteria is high, whereas the concordance with the end of test criteria is low. It is suggested that the concordance with the FET criteria should be improved.</p>

A comparision of the effects of subcutaneous and sublingual immunotherapy on immunological responses in children with asthma / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To compare the difference in the effects of subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT) on immunological responses in children with asthma.</p><p><b>METHODS</b>A total of 86 children with asthma caused by dust mites were enrolled and divided into a SLIT group (n=29), a SCIT group (n=13), a group receiving complete SCIT course (complete SCIT group; n=14), and a group receiving conventional medication (control group, n=30). Peripheral blood mononuclear cells were isolated and stimulated with house dust mite extract for 48 hours in vitro, and the percentage of regulatory T cells (Treg%) in CD4+ T cells was measured by flow cytometry. Analysis of variance with repeated measures was applied to compare the changes in humoral immunological indices and therapeutic effects in the SCIT and SLIT groups before treatment and after 6 and 12 months of treatment.</p><p><b>RESULTS</b>Before antigenic stimulation, Treg% in CD4(+) T cells in the SCIT group was significantly higher than that in the SLIT and control groups; after antigenic stimulation was given, Treg% in the four groups decreased significantly. After 6 and 12 months of immunotherapy, the SCIT group had significant changes in serum sIgE and sIgG4 levels, while the SLIT group only showed a significant change in serum sIgE level.</p><p><b>CONCLUSIONS</b>Temporal difference exists in different immunotherapies to cause immunological responses in children with asthma, and immunological responses induced by SCIT may occur earlier.</p>

Related factors for asthmatic children's responses to long-term treatment / 中国当代儿科杂志

<p><b>OBJECTIVE</b>To study the changes in pulmonary function and fractional exhaled nitric oxide in exhaled breath (FeNO) in asthmatic children who have different responses to regular treatment.</p><p><b>METHODS</b>A total of 52 asthmatic children who had a good compliance with regular stepped control treatment were selected as subjects. They were followed up every three months to evaluate the asthma control level, pulmonary ventilation function, and FeNO for 9 months. Besides, medications for asthma control were recorded.</p><p><b>RESULTS</b>At three follow-up points (months 3, 6, and 9), the percentage of asthmatic children who used the first or the second level of control treatment in the stable group (with stable response to the treatment) was significantly higher than in the unstable group (with unstable response to the treatment) (P<0.05), while the percentage of asthmatic children who used the third level of control treatment in the stable group was significantly lower than in the unstable group (P<0.05). At the three follow-up points, the stable group had a significantly higher ratio of forced expiratory volume in 1 second to forced vital capacity (FEV1/FVC) than the unstable group (P<0.05); at the 3-month and 9-month follow-up points, the stable group had a significantly higher percentage of predicted maximum mid-expiratory flow (MMEF%) than the unstable group (P<0.05); at the initial evaluation and 3-month follow-up point, the stable group had a significantly higher FeNO than the unstable group (P<0.05).</p><p><b>CONCLUSIONS</b>Continuously monitoring FEV1/FVC, MMEF% and FeNO is useful in the early evaluation of the responses to treatment in children with asthma.</p>

Effect of house dust mite immunotherapy on interleukin-10-secreting regulatory T cells in asthmatic children / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Subcutaneous specific immunotherapy has been demonstrated to be capable of inducing T-cell regulatory response. Interleukin-10 (IL-10) plays a crucial role in inducing allergen-specific tolerance. However the reports of the changes of IL-10 in house dust mite (HDM)-specific immunotherapy were varied. The aim of this study was to evaluate the function of IL-10-secreting regulatory T cells in asthma children successfully treated with HDM immunotherapy.</p><p><b>METHODS</b>Peripheral blood mononuclear cells (PBMCs) were isolated from 27 patients following 1.5 - 2 years of HDM-specific immunotherapy (SIT, SIT group) and from 27 matched treated asthmatic children allergic to HDM (asthma group). After 48 hours of in vitro stimulation with HDM extracts, IL-10-secreting regulatory T cells were measured by four colour flow cytometry. Sera were tested for allergen-specific IgG(4) and IgE using the Immuno CAP 100 assay.</p><p><b>RESULTS</b>PBMCs from children undergoing immunotherapy following HDM extracts stimuli produced significantly more IL-10 compared with the asthma group. The frequency of iTreg cells and aTreg cells increased in SIT group after HDM stimulation, while it was not affected in the asthma group. Among the iTreg cells and aTreg cells, the frequency of CD4(+)CD25(-)Foxp3(-)IL-10(+) Treg cells increased the most which was 2 times higher than that in unstimulated cultures in SIT group. The levels of HDM-specific IgG(4) of SIT group was significiently higher compared with asthma group, but there was no correlation of the levels of HDM-specific IgG(4) and IL-10 secreting Treg cells.</p><p><b>CONCLUSIONS</b>HDM-specific immunotherapy can successfully upregulate the frequency of IL-10-secreting Treg cells. CD4(+)CD25(-)Foxp3(-)IL-10(+) Treg cells may play a key role in inducing the immune tolerance in HDM-specific immunotherapy.</p>

Clinical, enteroscopic, and pathological characteristics of 796 cases of colorectal polyps / 中南大学学报(医学版)

OBJECTIVE@#To study the age, clinical, enteroscopic and pathological characteristics of colorectal polyps and factors affected polyp-carcinoma.@*METHODS@#We analyzed the clinical, enteroscopic and pathological characteristics of 7276 cases of colorectal polyps.@*RESULTS@#The incidence of colorectal polyps was 10.94%, including 521 men and 275 women. The rate of colorectal polyp was 82.29% in 30-69 year olds. The adenomatous, inflammatory, hyperplastic and juvenile polyps were 43.84%, 42.09%, 11.06% and 1.51%, respectively. Polypoid lesions were located at cecum 3.29%, ascending 11.88%, transverse 4.89%, descending 11.58%, sigmoid 26.05%, and rectum 42.32%. Thirty-five cases (4.4%) were found to have polpous canceration. The canceration rates in villous, mixed and tubular adenomas were 29.73%, 11.11%, and 4.86%. The rate of canceration seemed to depend on its dimensions, being 1.3%, 7.4%, and 25.6% for the 0.6 - 1.0 cm, 1.1 - 1.9 cm, and > or = 2.0 cm in size, respectively. Conclusion The ages between 30-69 tend to suffer from colorectal polyps. The incidence in the male is higher than that in the female. Colorectal polyps are more likely to locate in left colon. The common pathological types were adenomatous and inflammatory polyps. There is a high canceration of polyps in the left colon, villous adenomas and > or = 2.0 cm polyps. The broader the pedicles and the larger the diameters of polyps are, the higher the canceration rate. All of the colon polyps should be excised and undergo the pathological examination. Enteroscopic polypectomy helps prevent colorectal polpous canceration.

Diagnostic significance of combined testing of anti-cyclic citrullinated peptide antibody and hidden rheumatoid factor immunoglobulin M in patients with juvenile rheumatoid arthritis / 实用儿科临床杂志

Objective To explore the early diagnostic significance of anti-cyclic citrullinated peptide(CCP) antibody and hidden rheumatoid factor immunoglobulin M(HRF-IgM) detected by ELISA in patients with juvenile rheumatoid arthritis(JRA). Methods The synthesized CCP was used as the antigen to detect anti-CCP antibody. Anti-CCP antibody and HRF-IgM were detected dynamically in 27 patients with early diagnosed JRA and their specificity and sensitivity were determined for early diagnosed JRA by calculating the positive predicting value (PPV) and negative predicting value (NPV). Results The total positive rate of anti-CCP antibody and HRF-IgM were 58.5 % and 65.0 % respectively in patients with JRA. The sensitivity of HRF-IgM was more predominant than that of anti-CCP antibody. There was a positive correlation between the positive rate of antibodies and the subtype of JRA. The specificity of anti-CCP antibody for predicting early JRA was superior to that of HRF-IgM. When using these two tests in combination, the PPV predicting rate of early JRA was 93.7 % . Conclusions Both anti-CCP antibody and HRF-IgM are elevated in patients with JRA, which show positive correlations with the subtype of the disease. The specificity of anti-CCP antibody testing is considerably higher for diagnosing early JRA, and when it was used together with HRF-IgM testing, the PPV for JRA can be raised further.