Effect of extracorporeal photochemotherapy on the regulatory T cells in mice with skin allograft Wei / 器官移植

Objective To investigate the effect of infusion of spleen lymphocytes treated by extracorporeal photochemotherapy on the regulatory T cell (Treg)and survival time of skin allograft in mice. Methods The skin allograft model in mice was established with C57BL/6 mice as donors and BALB/c mice as recipients. The spleen lymphocytes (CSP,BSP)in mice C57BL/6 and BALB/c were isolated,and the mice spleen lymphocytes (PUVA-SP) treated with 8-methoxypsoralen plus ultraviolet (PUVA)were prepared. The experimental animals were randomly divided into 5 groups according to the compositions infused into the recipients through vein:PUVA-BSP,PUVA-CSP,BSP,CSP and phosphate buffer solution (PBS)control groups (n=12 in each group). All recipients of each group were injected with PUVA-BSP,PUVA-CSP,BSP,CSP or PBS on day 7 before the operation,on the operation day and day 7 after the operation through the tail vein,respectively. The survival time of graft in the recipients was observed,and the expression of CD4 +CD25 +Foxp3 +Treg in peripheral blood was detected. Results After skin allograft,the rate of CD4 +CD25 +Foxp3 +Treg in peripheral blood of the recipients in PUVA-BSP group and PUVA-CSP group was significantly higher than those of BSP, CSP and PBS control groups. The rate of CD4 +CD25 +Foxp3 +Treg in PUVA-CSP group was higher than that of PUVA-BSP group,while BSP and CSP groups were lower than that of PBS control group. The survival time of skin graft in the recipients in PUVA-BSP group and PUVA-CSP group was significantly longer than that of BSP,CSP and PBS control groups (all P<0.05 ). Conclusions Sufficient infusion of PUVA-SP can induce more CD4 +CD25 +Foxp3 +Treg in the recipients and prolong survival time of skin graft significantly.

Effect of regulatory dendritic cells on IL-10-producing regulatory B cells of skin allograft in mice / 解放军医学杂志

Objective To investigate the effect of recipient immature dendritic cells (imDCs) loaded with PUVA-treated donor apoptotic splenic lymphocytes (PUVA-SP DC) on IL-10+CD19+regulatory B cells (Breg) and the survival duration of skin allograft in mice. Methods Bone marrow-derived DCs of C57BL/6 mice were obtained from bone marrow cells by co-culturing with recombinant mouse IL-4 and GM-CSF. Spleen lymphocytes (SP) of BALB/c mice were isolated and prepared as PUVA- SP by treating the cells with 8-methoxypsoralen plus ultraviolet A irradiation. The bone marrow-derived imDCs of C57BL/6 mice were co-cultured with PUVA-SP of BALB/c mice to obtain PUVA-SP DCs. The skin allograft model was then established. Animals were randomly grouped according to different pretreatments as follows: the control group was iv. introduction of PBS (0.2ml) alone 7 days before skin transplantation, the PUVA-SP DC group received an iv. injection of PUVA-SP DCs, the maDC (mature DC) group received recipient maDCs, and the imDC group was given recipient imDCs. Mice were monitored daily from day 6 after transplantation for signs of rejection of skin graft. The recipients' peripheral blood serum samples were then collected and the level of cytokines were measured by using ELISA kits. The survival time of skin allograft was evaluated every day. The expression of IL-10+CD19+regulatory B cells was analyzed by flow cytometry. Results After transplantation, the proportion of IL-10+CD19+Breg in the peripheral blood of PUVA-SP DC group was 7.48%, which was obviously higher than that of imDC group (4.12%), maDC group (3.01%) and control group (2.37%). The serum level of cytokine IL-10 in PUVA-SP DC group was 58.2±0.9ng/ml, and it was significantly higher than that in maDC group (20.1±1.6ng/ml), imDC group (26.2±1.3ng/ml) and control group (19.0±0.6ng/ ml, P<0.01). The survival time of allograft in PUVA-SP DC group was 62.3±2.6d, and it was markedly longer than that in maDC group (20.7±1.9d), imDC group (12.1±1.0d) and control group (11.0±1.3d, P<0.01). Conclusions Administration of PUVASP DCs, in the absence of an immunosuppressant, may significantly delay allograft rejection. This effect is associated with upregulation of circulating regulatory B cells with preferential IL-10 secretion.

HLA-G expression in the peripheral blood of live kidney transplant recipients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The human leukocyte antigen-G (HLA-G) has been considered to be an important tolerogeneic molecule playing an essential role in maternal-fetal tolerance, upregulated in the context of transplantation, malignancy, and inflammation, and has been correlated with various clinical outcomes. The aim of this study was to investigate the clinical relevance of the expression of membrane HLA-G (mHLA-G), intracellular HLA-G (iHLA-G), and soluble HLA-G (sHLA-G) in the peripheral blood of live kidney transplant recipients.</p><p><b>METHODS</b>We compared the expression of the three HLA-G isoforms in three groups, healthy donors (n=20), recipients with acute rejection (n=19), and functioning transplants (n=30). Flow cytometry was used to detect the expression of mHLA-G and iHLA-G in the T lymphocytes of peripheral blood from subjects in the three groups. Enzyme-linked immunosorbent assays were used to detect sHLA-G in the plasma from the three groups.</p><p><b>RESULTS</b>There were no significant differences in mHLA-G and intracellular HLA-G among the three groups, but the sHLA-G plasma level was higher in the functioning group than in the acute rejection or healthy group. We found a subset of CD4(+)HLA-G(+) and CD8(+)HLA-G(+) T lymphocytes with low rates of mHLA-G expression in the peripheral blood of kidney transplantation recipients. Intracellular expression of HLA-G was detected in T lymphocytes. However, there was no correlation between acute rejection and the mHLA-G or intracellular HLA-G expression.</p><p><b>CONCLUSION</b>sHLA-G was the major isoform in the peripheral blood of live kidney transplant recipients and high sHLA-G levels were associated with allograft acceptance.</p>

Immune regulation effect of rat dendritic cells phagocytosing photochemotherapy-treated allogeneic cells on syngeneic T cells / 中国实验血液学杂志

The aim of this study was to investigate the immune regulatory effect of dendritic cells phagocytosing photochemotherapy-treated allogeneic spleen lymphocytes on syngeneic T cells. DA rat spleen lymphocytes were treated with 8-methoxypsoralen plus UVA irradiation (PUVA). LEW rat bone marrow-derived DCs were co-cultured with PUVA-treated DA spleen lymphocytes (PUVA-SP), and the surface markers (MHC-II, CD86 and CD40) of treated DC were detected by flow cytometry. CFSE-labeled PUVA SP were incubated with LEW DCs and the phagocytosis of DCs on PUVA-SP was observed by using fluorescent microscope. The ability of DC phagocytosing allogeneic PUVA-SP (PUVA-SP DC) to stimulate the proliferation of LEW T cells was analyzed by mixed leukocyte reactions (MLR). The production of IL-4, IL-10, IL-2, IFN-gamma in MLR culture supernatant was determined by luminex method. The results indicated that the PUVA treatment effectively induced early apoptosis of DA rat spleen lymphocytes. After co-culture, DC efficiently phagocytosed allogeneic PUVA-SP and still maintained an immature phenotype with low levels of MHC II, CD40 and CD86. PUVA-SP DC induced LEW T cell hyporesponsiveness to DA rat antigen, and led to skewing of T cell cytokine expression toward Th2 (IL-10 and IL-4). It is concluded that the PUVA-SP DC effectively down-regulate T cell response to alloantigen and induce Th2 immune deviation in vitro.

The relationship between hemostatic changes in liver cirrhosis patients with different degrees of liver lesions in reference to Child-Pugh scores / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the relationship between hemostatic changes in liver cirrhosis patients with different degrees of their liver lesions.</p><p><b>METHODS</b>Forty-three patients (35 men, 8 women; age: 25 to 71 yr) with liver cirrhosis were divided into three subgroups (A, B, and C) on the basis of Child-Pugh classification. Among the patients, 13 were classified as Child-Pugh class A, 15 were class B, 15 were class C. 16 healthy individuals served as controls. A series of hemostatic tests and parameters including prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen (Fib), factors II, V, VII, VIII, IX, X, vWF assay, antithrombin-III (AT-III), protein C (PC), D-dimer, tissue plasminogen activator antigen (t-PA), plasminogen activator inhibitor activity (PAI) were performed on 43 patients and the 16 healthy controls.</p><p><b>RESULTS</b>PT and APTT were progressively prolonged from A to B and then to C. In comparison to the controls there was a significant difference. Fibrinolytic activity and the activities of factors II, V, VII, IX, X were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference . AT-III and PC activity were progressively decreased from A to B and then to C. In comparison to the controls there was a significant difference. D-dimer and t-PA-antigen were progressively increased from A to B and then to C. In comparison to the controls there was significant difference. PAI activity did not display significant changes in the four groups.</p><p><b>CONCLUSION</b>We found that there is a close relationship between the severity of cirrhosis and the hemostatic changes. Because the deterioration of the coagulation function and increasing fibrinolytic activity parallel the severity of liver cirrhosis, adequate treatment for cirrhotic bleeding should not only correct the coagulation defects, but also lower the increased fibrinolytic activity.</p>

A discussion of standardization for prothrombin time in patients with advanced liver diseases / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine which expression mode of prothrombin time (PT) might achieve PT standardization in patients with advanced liver diseases.</p><p><b>METHODS</b>PT was measured with six thromboplastins with different ISI values in 16 severe chronic hepatitis patients, 50 decompensated liver cirrhosis patients and 30 patients on oral anticoagulation therapy. The results were expressed in PT (second), PTA (%), PTR and INR.</p><p><b>RESULTS</b>In chronic hepatitis patients, the means of the six group's PTAs ranged from 24% to 34%, while their upper limits ranged from 47% to 61%. The means of the INRs ranged from 2.55 to 5.13, while their upper limits ranged from 4.65 to 12.77. Through one-way ANOVA of repeated measures, PPTA (0.489) was > PINR (0.120). In patients with liver cirrhosis, the means of the PTA in six groups ranged from 50% to 59%, while their upper limits ranged from 82% to 90%. The means of the INR ranged from 1.40 to 1.80, while their upper limits ranged from 1.97 to 3.69. Through one-way ANOVA of repeated measures, PPTA (0.102) was > PINR (0.01). In patients on oral coagulation therapy, the means of PTA ranged from 26% to 37%, while their upper limits ranged from 39% to 49%. The means of INR ranged from 2.35 to 2.66, while their upper limits ranged from 3.16 to 4.26. Through one-way ANOVA of repeated measures, PPTA (0.01) was less than PINR (0.102). The correlation between the results detected by Neoplastine and by other reagents were analyzed. They correlated well with each other when PTA was used as the expression mode of PT in patients with advanced liver disease. But in patients on oral anticoagulation therapy, when only the INR was used as the expression mode of PT, the correlation was well with each other.</p><p><b>CONCLUSION</b>The use of INR provides inadequate standardization. Only when the PT is expressed in PTA, then it may provide a standardization mode in patients with advanced liver diseases.</p>

The contrast study of Pre-S1 protein, HBV-DNA and HBeAg in diagnosing viral replication in patients with chronic hepatitis B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the role of Pre-S1 protein in diagnosing viral replication in patients with chronic hepatitis B.</p><p><b>METHODS</b>104 consecutive patients with chronic hepatitis B were included in the study, liver biopsy were performed in all patients. Serial serum samples were studied with the quantitative determination of HBV-DNA by a quantitative PCR assay, determination of Pre-S1 protein by ELISA.</p><p><b>RESULTS</b>The positive rates of HBV-DNA and Pre-S1 protein in patients with HBsAg HBeAg anti-HBc (+) both were 96.5%. The positive rates of HBV-DNA and Pre-S1 protein in patients with HBsAg anti-HBe anti-HBc (+) were 81.5%, 72.3%, respectively. The positive rates of HBV-DNA and Pre-S1 protein in patients with HBsAg anti-HBc (+) were 87.5%, 75.0%, respectively. It represented some patients with HBeAg (-) anti-HBe (+/-) still had viral replication. HBV-DNA>10(3) copy/ml as positive criteria for diagnosing viral replication, the positive rate of HBeAg, Pre-S1 were 31.5% (28/89), 80.9% (72/89) in patients with HBV-DNA>10(3) copy/ml, respectively. The concordance rates of HBeAg, Pre-S1 with HBV-DNA were 40.0% (42/104), 82.0% (85/104), respectively.</p><p><b>CONCLUSION</b>It showed that Pre-S1 was more sensitive than HBeAg in diagnosing viral replication in patients with chronic hepatitis B.</p>

The relationship among the counts of platelet, thrombopoietin and spleen index in patients with liver cirrhosis / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To determine the reason of thrombocytopenia in patients with liver cirrhosis, we studied the relationship among platelet counts, serum thrombopoietin (TPO) level and spleen index.</p><p><b>METHODS</b>Serum TPO, platelet counts and spleen index were measured in 71 cirrhotic patients. TPO was measured with ELISA method, spleen index were measured on ultrasonography by the same doctor.</p><p><b>RESULTS</b>Platelet counts in patients with cirrhosis were lower than that of healthy group [(109.20+/-53.39) vs (169.63+/-26.60) x 10(12)/L, P<0.05]. Serum thrombopoietin level in patients with cirrhosis was similar to that of healthy group [(436.42+/-258.97) vs (412.63+/-132.80) pg/ml, P>0.05]. However, serum thrombopoietin level decreased as liver disease aggravated, [(526.13+/-317.44) pg/ml in Child-Pugh grade A, (445.22+/-214.90) pg/ml in grade B and (311.45+/-182.66) pg/ml in grade C, grade A vs. Grade C, P<0.05]. However, decline in platelet counts was accompanied with incline in spleen index coordinately. 35 of 71 cirrhotic patients had normal platelet counts whereas 36 of them had thrombocytopenia. Thrombopoietin levels were higher in non-thrombocytopenia group than in thrombocytopenia group [(529.43+/-282.64) vs. (351.27+/-228.25)pg/ml, P<0.01]; but spleen index of two groups showed no difference [(29.65+/-12.00) vs. (36.35+/-12.68) cm2, P>0.05]. Correlation was found between thrombopoietin level and platelet counts (r=0.252, P=0.025); no correlation was found between spleen index and platelet counts (r=-0.238, P=0.062).</p><p><b>CONCLUSION</b>The decline serum TPO levels might play an important role for thrombocytopenia in patients with liver cirrhosis.</p>