ABSTRACT
The risk of early acute rejection after kidney transplantation is relatively high, which severely affects the quality of life of the recipients. In 2009, Kidney Disease: Improving Global Outcomes (KDIGO) recommended that immune inducers should be included in the immune-inducing regime before kidney transplantation, aiming to provide certain strength of immunosuppression during this critical phase and effectively reduce the incidence of acute rejection following kidney transplantation. At present, the selection, efficacy and safety of immune inducers remain controversial among transplantation centers around the world. In this article, clinical efficacy of monoclonal antibodies including interleukin-2 receptor antagonist, alemtuzumab, rituximab and polyclonal antibody antithymocyte globulin in immune induction therapy before kidney transplantation were compared and literature review was performed at home and abroad, aiming to provide reference for promoting the individualized selection of immune inducers for kidney transplantation and improving the quality of life of recipients.
ABSTRACT
El síndrome de activación macrofágica (SAM) presenta criterios clínicos y de laboratorio establecidos. Presentamos el caso de un adolescente varón con debut de Lupus eritematoso generalizado pediátrico grave, donde su manifestación principal fue un SAM y el receptor de interleucina 2 soluble en suero (IL-2rs) o CD25 soluble (CD25s) aumentado resultó clave en la confirmación diagnóstica, en el tratamiento y pronóstico de su enfermedad. Sin embargo, este receptor de citocinas no se mide habitualmente en la práctica clínica.
Macrophage activation syndrome (MAS) presents established clinical and laboratory criteria. We present the case of a male adolescent with the onset of severe pediatric systemic Lupus erythematosus, manifested mainly by MAS and how a laboratory marker, serum soluble interleukin-2 receptor (IL-2rs) or altered soluble CD25(CD25s), played a key role in treatment and prognosis of the disease. However, this cytokine receptor is rarely measured in clinical practice.
Subject(s)
Humans , Male , Child , Lymphohistiocytosis, Hemophagocytic/diagnosis , Lymphohistiocytosis, Hemophagocytic/therapy , Macrophage Activation Syndrome/diagnosis , Macrophage Activation Syndrome/therapy , Thorax/diagnostic imaging , Radiography, Thoracic/methods , Receptors, Interleukin-2 , Macrophage Activation Syndrome/pathology , Lupus Erythematosus, SystemicABSTRACT
Objective::To investigate the effect of Bletillae Rhizoma polysaccharide on the expressions of phosphatidylinositol 3-kinase (PI3K), protein kinase B (Akt) gene protein and its mediated cytokines interleukin-2 receptor (IL-2R) and interleukin-4 (IL-4) in gastric tissue of rats with gastric ulcer (GU). Method::Sixty SPF Wistar rats were randomly divided into blank group and model group.The GU model was replicated by direct acetic acid cauterization in model group.The GU model rats were randomly divided into five groups: model group, positive control group, and large, medium and small-dose Bletillae Rhizoma polysaccharide groups, with 10 rats in each group.Rats in blank group and GU model group were given 10 mL·kg-1·d-1 distilled water by gavage, rats in large, medium and small-dose groups were given 0.5, 0.25, 0.125 g·kg-1·d-1 Bletillae Rhizoma polysaccharide by gavage, while rats in positive control group were given 0.3 g·kg-1·d-1 ranitidine by gavage for 15 days.Serum nitric oxide (NO) content, pepsinase activity and cytokines IL-2R and IL-4 levels in rats of each group were measured by enzyme-linked immunosorbent assay (ELISA), PI3K and Akt mRNA expressions were detected by Real-time fluorescent quantitative polymerase chain reaction (Real-time PCR), and PI3K and Akt protein expressions were detected by Western blot. Result::Compared with the blank group, the contents and gene expressions of cytokines IL-2R and IL-4 in gastric tissue were significantly increased, and the PI3K and Akt genes and protein expressions were significantly increased, with statistical significance (P<0.01). Compared with GU model group, the content and gene expressions of IL-2R and IL-4 in large, medium and small-dose Bletillae Rhizoma polysaccharide groups were decreased significantly, and the PI3K and Akt gene and protein expressions were decreased significantly in large-dose Bletillae Rhizoma polysaccharide group, while those in large and medium-dose Bletillae Rhizoma polysaccharide groups were decreased significantly (P<0.05, P<0.01). Conclusion::Bletillae Rhizoma polysaccharide can protect gastric mucosa by down-regulating PI3K and Akt gene and protein expressions and inhibiting abnormal secretion of cytokines IL-2R and IL-4.
ABSTRACT
Objective To explore the influence of interleukin-2 receptor antagonists(IL-2Ra) on the morbidity and prognosis of new onset diabetes after transplantation(NODAT)in liver transplant recipients. Methods Pre-and post-operative clinical data of 879 nondiabetic patients who underwent a liver transplantation between April 2001 and December 2016 were retrospectively studied. All the enrolled patients were divided into IL-2Ra and non-IL-2Ra groups according to the use of IL-2Ra. Transient-NODAT(T-NODAT)and Persistent-NODAT(P-NODAT)were defined according to whether NODAT would be existed continuously. The impacts of IL-2Ra on the cumulative incidence as well as the risk of NODAT and T-NODAT were analyzed through comparison between patients who used IL-2Ra or not. And influence of IL-2Ra on the long-term survival of NODAT patients was further analyzed. Results Among 879 patients,177(32.24%)from the IL-2Ra group(n=549)developed NODAT and 29.38%(n=52)of the NODAT reversed,while 131(39.70%)from the non-IL-2Ra group(n=330)developed NODAT and 26.72%(n=35)of the NODAT reversed. After adjusting for 18 possible confounding factors,the IL-2Ra group had significantly decreased cumulative incidence of NODAT over the non-IL-2Ra group(adjusted P=0.028). COX regression analyses showed that IL-2Ra was a protective factor against NODAT development(HR 0.774;95% CI 0.616-0.973; P=0.028), while the use of IL-2Ra and the reverse of NODAT did not significantly related. In addition, long-term survival of the NODAT patients were far better in the IL-2Ra group(adjusted P=0.001). Conclusion IL-2Ra significantly reduces the risk of NODAT in liver transplant recipients and is beneficial to the long-term survival of NODAT patients.
ABSTRACT
Objective To investigate the effect of pegylated interferon combined thymopeptideenteric-coated tablets on CXCR3, CCR6 and serum IL-2 and soluble ligand in patients with chronic hepatitis.Methods 125 patients with chronic hepatitis B patients from June 2015 to June 2016 in our hospital were selected and divided into observation group 62 cases and control group 63 cases.The observation group was treated with pegylated interferon combined thymopeptideenteric-coated tablets, and the control group was treated with thymopeptideenteric-coated tablets, the expression of T cells in patients with CXCR3 and CCR6 was detected by flow cytometry, the serum levels of interleukin-2 and soluble interleukin-2 receptorwere measured by enzyme-linked immunosorbent assay, and compared the treatment of two groups of patients.Results After treatment, the levels of IL-2 and sIL-2R in the observation groupwere (16.4 ±5.6), (9.4 ±2.1), significantly lower than that in the control group, while CXCR3 and CCR6 were (5.8 ±0.9), (5.54 ±1.2), significantly higher than the control group, the difference was statistically significant (P<0.05), the levels of HBsAg, HBeAg and HBV-DNA in the observation group were (1.5 ±0.4), (1.6 ±0.9), (1.6 ±0.3), significantly lower than those in the control group, the difference was statistically significant (P<0.05), the levels of ALT, AST, TBIL, IBIL in the observation groupwere (34.5 ±8.7), (31.4 ±6.9), (14.6 ± 6.9), (9.4 ±2.9), significantly lower than those in the control group, the difference was statistically significant (P<0.05).Conclusion Interferon combined thymopeptideenteric-coated tablets therapy for chronic hepatitis B is helpful to improve the level of chemokine receptor and inhibit the degree of inflammatory reaction.It can help to improve liver function and inhibit viral replication in patients with hepatitis B.It is better than the treatment of chronic hepatitis with thymosin alone.
ABSTRACT
Objective To observe the clinical efficacy of acupuncture plus Chinese herbs in treating sensorineural hearing loss.Method Eighty patients with sensorineural hearing loss were randomized into a treatment group and a control group, 40 cases in each group. The control group was intervened by conventional medication, while the treatment group by acupuncture in addition to the intervention given to the control group. The two groups were intervened once a day, 30 days as a treatment course. The serum interleukin (IL)-2, IL-6, soluble interleukin-2 receptor (sIL-2R) levels and pure tone hearing threshold value were observed before and after consecutive 2 treatment courses, and the clinical efficacies in the two groups were compared.Result The serum levels of IL-2, IL-6 and sIL-2R and pure tone hearing threshold value were significantly changed after the treatment in the two groups (P<0.05). There were significant differences in the serum IL-2, IL-6, sIL-2R levels and pure tone hearing threshold value between the two groups after the treatment (P<0.05). The total effective rate was 94.6% in the treatment group versus 84.2% in the control group, and the difference was statistically significant (P<0.05).Conclusion Acupuncture plus Chinese herbs is an effective approach in treating sensorineural hearing loss.
ABSTRACT
Objective To evaluate the value of soluble interleukin 2 receptor (sIL-2R),interleukin (IL)-6,IL-10 and tumor necrosis factor-cα (TNF-α) used in differential diagnosis of systemic juvenile idiopathic arthritis (sJIA) and sepsis in children.Methods Each of 41 children with sJIA and sepsis were enrolled and 41 healthy children were selected as the healthy control group at Children's Hospital of Nanjing Medical University from January 2015 to July 2017.Levels of serum sIL-2R,IL-6,IL-10,TNF-α and peripheral blood levels of white blood cells (WBC),hemoglobin (Hb),platelets (PLT),high sensitivity C-reactive protein (hs-CRP),erythrocyte sedimentation rate (ESR) and procalcitonin (PCT) were compared between the sJIA group and sepsis group before treatment and those of the healthy control group.Results Peripheral blood levels of WBC,Hb,PLT,CRP,ESR and PCT in the healthy control group were (8.43 ± 2.35) × 109/L,(124.46 ± 8.76) g/L,(298.45 ± 100.23) × 109/L,(11.32 ± 5.76) mg/L,(18.32 ± 9.33) mm/1 h,(0.27±0.17) μg/L and the levels of serum sIL-2R,IL-6,IL-10,TNF-α were (483.24 ± 255.33) kU/L,(7.38 ±4.02) ng/L,(5.45 ± 3.06) ng/L,(8.23 ± 3.03) ng/L,respectively.Peripheral blood levels of WBC,Hb,PLT,CRP,ESR and PCT in the sJIA group before treatment were (17.53 ± 7.98) × 109/L,(105.76 ± 13.33) g/L,(389.43 ± 176.34) × 109/L,(88.32 ± 43.21) mg/L,(55.32 ± 34.23) mmn/1 h,(0.53 ±0.24) μg/L and the levels of serum sIL-2R,IL-6,IL-10,TNF-α were (945.35 ±436.75) kU/L,(132.39 ± 58.43) ng/L,(7.02 ± 5.12) ng/L,(14.32 ± 7.95) ng/L.Peripheral blood levels of WBC,Hb,PLT,CRP,ESR and PCT in sepsis group before treatment were (16.88 ± 6.54) × 109/L,(102.95 ± 20.18) g/L,(302.87 ± 124.45) × 109/L,(60.41 ± 33.24) mg/L,(53.75 ± 28.43) mm/1 h,(2.84 ± 1.76) μg/L and the levels of serum sIL-2R,IL-6,IL-10,TNF-α were (2 476.36 ± 1 574.11) kU/L,(39.47 ± 20.32) ng/L,(6.31 ±4.04) ng/L,(15.87 ±6.32) ng/L.Blood levels of WBC,CRP,ESR,PCT,sIL-2R,IL-6 and TNF-α in the sJIA and the sepsis group were significantly higher than those in healthy control group.Serum levels of sIL-2R and PCT in the sJIA group were obviously lower than those in the sepsis group,but the level of IL-6 was higher than that in the sepsis group.Conclusion Combined detection of blood sIL-2R,IL-6 and PCT can provide a reference and reduce mistaken diagnosis of sJIA and sepsis in the earlier clinical stage.
ABSTRACT
Objective To examine the relationship between plasma soluble interleukin 2 receptor(sIL2R), bone metabolism markers, and bone mineral densities in female patients with Graves′ disease(GD), and to explore the role of sIL2R in bone metabolism of GD.Methods This study included 201 female GD patients.FT3, FT4, TSH, PTH, osteocalcin(OCN), C-terminal telopeptides of type Ⅰ collagen (CTX), procollagen type I N-terminal propeptide(PINP), and 25-(OH)-vitamin D(25OHD) were measured using electrochemical luminescence technique.sIL2R was measured using chemiluminescence method.All pations underwent examinations of bone mineral densities at lumbar spine, total hip, and femoral neck(LS-BMD, TH-BMD, and FN-BMD).The associations of sIL2R with bone metabolism markers and bone mineral densities were analyzed.Results OCN,CTX,PINP gradually decreased across the tertile groups of LS-BMD, TH-BMD, FN-BMD(all P<0.05).FT3, sIL2R gradually increased across the tertile groups of OCN, CTX, PINP(all P<0.05).Multiple linear regression analysis showed that sIL2R was independently associated with OCN and CTX(both P<0.05).Conclusion The increase of bone turnover leads to bone loss in female GD patients.The plasma level of sIL2R was positively correlated to bone turnover, which indicated that sIL2R may play an important role in bone metabolism of GD.
ABSTRACT
Objective:To analysis clinical curative effect of laparoscopic radical prostatectomy bladder cancer and influence on serum levels of ferritin (SF),soluble interleukin-2 receptor (SIL-2 R) and rumor specific growth factor (TSGF).Methods:98 cases of bladder cancer who were treated in our hospital from August 2012 to February 2016 were selected and randomly divided into the control group 0=49) and the research group (n=49).The patients in the control group were treated with open radical radical cystectomy,while the patients in the research group were treated with laparoscopic radical cystectomy.Then the operation time,intraoperative blood loss,anal exhaust time,hospitalization,the lymph node cleaning,the serum levels of SF,SIL-2R,TSGF,white blood cells and cortisol,the complications and recurrence rate in the two groups were observed and compared.Results:The operation time of research group was longer than that of the control group,while the intraoperative blood loss,the hospitalization and the anal exhaust time were less than those of the control group,and the differences were statistically significant (P＜0.05).There was no statistically significant difference about the numbers of the lymph node and the recurrence rate between two groups (P＜0.05).After treatment,the serum levels of SF,SIL-2R and TSGF in the two groups decreased,while there was no statistically significant difference between the two groups (P＞0.05);After treatment,the white blood cell count and cortisol rise in the two groups increased,while the research group was lower than that of the control group (P＜0.05).Conclusion:LRC and ORC clinical efficacy similar,both of which can reduce the serum levels of SF,SIL-2R and TSGF of patients with laparoscopic radical prostatectomy bladder cancer.
ABSTRACT
Objective To investigate the application of serum soluble interleukin-2 receptor(sIL-2R)and soluble tumor necrosis factor receptor Ⅱ (sTNFR Ⅱ) in extrapulmonary organ involvement sarcoidosis.Methods Of 28 cases with sarcoidosis which were in active period,12 cases were in extrapulmonary organ involvement subgroup,16 cases were in pure pulmonary lesions subgroup.Serum sIL-2R and sTNFR Ⅱ of the two groups were detected by enzyme linked immunosorbent assay and compared.Results The expression level of sIL-2R in extrapulmonary organ involvement subgroup was (1.60 ± 0.80) μg/L,significantly higher than that of pure pulmonary lesions group,and there was significant difference((1.00±0.29)μg/L,t =2.764,P＜0.05);and the expression level of sTNFR Ⅱ in extrapulmonary organ involvement subgroup was (1.09 ± 0.24) μg/L,significantly higher than that of pure pulmonary lesions group,and the difference between the two groups was statistically significant((0.85±0.29) μg/L,t =2.183,P＜0.05).Conclusion The expression level of peripheral blood serum sIL-2R and sTNFR Ⅱ may serve as the important indexes to judge the extrapulmonary organ involvement sarcoidosis.
ABSTRACT
Background: Vitiligo is a common skin disorder characterized by macular depigmentation of the skin. Although the etiopathogenesis of the disease is still unclear, several studies have shown that within the cascade of pathogenesis of vitiligo, cytokines play an important role. Objectives: The aim of our study was to evaluate serum concentrations of interleukin- IL-2 (IL-2) and interleukin-2 soluble receptor (IL-2 sR) in patients with vitiligo and healthy subjects and also to asses a possible association between these cytokines and duration of the disease. Study Design: Case control study. Place of the Study: The study was carried out in University Clinical Center Sarajevo, Department of Dermatology and Venereology. Patients and Methods: Twenty one patients (11 female and 10 male; age range 15-53 years) with vitiligo and 20 healthy controls (10 female and 10 male; age range 17-52) were enrolled in the study. c The duration of vitiligo ranged from 2 to 252 months. Ten patients (47.62%) had generalized, and eleven patients (52.38%) had localized vitiligo Serum concentrations of cytokines were measured using enzyme-linked immunoassay techniques. Results: Both IL-2 (median 22.600 pg/ml, range 20.900-76.100) and IL-2sR (median 76.100 pg/ml, range 15.700-183.800) in the patient group were significantly higher when compared with that of the normal controls. When the serum cytokine level in vitiligo group were compared to total disease duration (Spearman correlation ρ), serum IL-2 was negatively (ρ= -0.000573, P= 0.9980) and IL-2 sR was positively (ρ=0.241, P= 0.2797) correlated with total disease duration, but it is of borderline significance. Conclusions: Our results showed hight serum levels of IL-2 and IL2 sR among vitiligo patients which may highligth a functional role of these cytokines in the pathogenesis of this disease.
ABSTRACT
Objective To investigate the effects of CD25 siRNA nanoparticles against immune rejection and prolongation of corneal graft survival time after high-risk corneal grafting in rats. Methods Orthotopic corneal transplantation was performed in SD rats with alkali burned corneas to mimic high-risk rat models. Donor cornea (Wistar rats) was grafted into the right cornea of SD recipients on day 14 after alkali burn. The grafted rats were randomly divided into control group (Group A), Entranster™- control CD25siRNA instillation treatment (Group B), Entranster™-CD25siRNA instillation treatment (Group C) and Entranster™- CD25siRNA twice instillation treatment (Group D, first administration at 2-hour post-surgery and second on day 7 post-surgery). The recipient eyes were examined using a slit lamp microscope. Then, the mean survival time and rejection index (RI) were calculated. The morphologies of grafts were microscopically examined with HE staining, and TEM. CD25 expression after operation was determined by quantitative RT-PCR and immunohistochemistry. Results The survival curves of transplanted cornea showed that the mean survival time in rats of groups C and D was significantly longer than that in groups A and B (P<0.05). No significant difference was found in survival time between group A and group B, and the same between group C and group D. The grafts in groups A and B showed obvious edema and thickening, with irregular arrangement of collagen fibers and infiltration of a large amount of inflammatory cells. Immunohistochemical results showed that expression of CD25 was found in the corneal epithelium, stroma and endothelium in all rats, and higher CD25 expression was observed in groups A and B. Transmission electron microscopy revealed that the degree of stromal fibroblast apoptosis and necrosis in corneal graft was obviously lower in groups C and D than that of groups A and B, with a significant statistical difference. The expression of CD25 mRNA in the experimental group was significantly lower at every single time points. Conclusions CD25siRNA gene transfer could successfully down-regulate CD25 expression, inhibit graft rejection and prolong the survival time of allogeneic corneal graft.
ABSTRACT
Aim: The aim of this study was to examine whether a Human herpes virus-6 (HHV-6) infection increases the risk of MS in individuals harboring particular cytokine receptor α- chain gene alleles. Study Design: MS patients and controls were assessed for HHV-6 DNA and for single nucleotide polymorphisms (SNPs) in their IL7RA and IL2RA genes. Place and Duration of Study: The study was carried out at the Department of Experimental Pathology, Microbiology and Immunology, American University of Beirut, between March 2011 and March 2013. Methodology: Blood samples from 100 MS patients and 100 controls were investigated for the presence of HHV-6 by nested PCR. Single nucleotide polymorphisms (SNPs) in the IL7RA and IL2RA genes were examined by restriction fragment length polymorphism. Results: HHV-6 was detected in 58% of MS patients and 32% of controls (OR = 2.935, 95% CI = 1.582-5.463, p=0.000). We did not detect a statistically significant correlation between MS and the studied rs2104286, rs12722489 SNPs in the IL2RA gene and rs6897932 SNP in the IL7RA gene. Concomitant presence of rs2104286 and HHV-6 was detected in 56% of patients and 30% of controls (OR=2.970, 95% CI=1.594-5.53, P=0.000). Similarly, rs6897932 and HHV-6 were observed in 57% of patients and 28% of controls (OR=3.409, 95% CI= 1.815-6.428, P=0.000). Therefore, double positivity moderately increased the risk of MS compared to either factor alone. HHV-6 and rs12722489 double positivity did not increase the risk of MS. Conclusion: HHV-6 infections may enhance the risk of MS in subjects with particular genetic determinants.
ABSTRACT
Objective To investigate effects of azithromycin on expression of interleukin 2 (IL-2) and soluble interleukin-2 re-ceptor (sIL-2R) and interleukin 17 (IL-17) in children with mycoplasma pneumonia .Methods 30 cases uninfected with pneumonia was control group and 23 cases with mycoplasma pneumoniae infection was test group .By enzyme-linked immunosorbent assay (ELISA) was used to detect serum IL-2 ,sIL-2R and IL-17 levels before and after treatment .Results The serum level of IL-2 was (8 .51 ± 0 .23) pg/mL in control group ,and the serum level of IL-2 was(15 .72 ± 0 .58)pg/mL in test group .There was significant difference between the two groups(P<0 .05) .The serum level of sIL-2R was (24 .51 ± 6 .23) pg/mL in control group ,and the ser-um level of sIL-2R was (57 .72 ± 9 .58)pg/mL in test group .There was significant difference between the two groups (P<0 .05) . The serum level of IL-17 was (4 .51 ± 0 .23) pg/mL ,and the serum level of IL-17 was(7 .72 ± 0 .58)pg/mL in test group .There was significant difference between the two groups(P<0 .05) .After treatment ,the serum levels of IL-2 ,sIL-2R and IL-17 were lower in test group (P<0 .05) .Conclusion IL-2 and IL-17 are related to mycoplasma pneumoniae pathogenesis ,and azithromycin can re-duce IL-2 ,sIL-2R and IL-17 levels .
ABSTRACT
Objective To investigate the changes and clinical indications of interleukin-2 receptor, ferritin and fi-brinectin in the cerebrospinal fluid of central nervous system leukemia.Methods ELISA was used to detect the changes of-soluble interleukin-2 receptor, ferritin and fibrinectin in the cerebrospinal fluid of central nervous system leukemia group ( CNSL) and non-CNSL group.Results The concentrations of soluble interleukin-2 receptor, ferritin and fibronectin ince-rebrospinal fluid of the CNSL group were significantly higher than those in non -CNSL group and the control group ( p <0.05).Conclusion The soluble interleukin 2 receptor, ferritin and fibronectin in cerebrospinal fluid are indicative of cen-tral nervous system leukemia.The result suggests that combined detection is important in early diagnosis of central nervous system leukemia.
ABSTRACT
Objective To analyze the characteristics of lymphocyte subsets and interleukin-2 re-ceptor (CD25) in patients with severe fever with thrombocytopenia syndrome (SFTS) in Zhoushan island. Methods Automated blood analyzer , automatic biochemical analyzer and flow cytometry were used to meas-ure hematological parameters , biochemical parameters and lymphocyte subsets in patients with SFTS before and after treatment .The dynamic changes and correlation analysis were statistically analyzed .Results The counts of white blood cells (WBCs), platelets, total T cells and CD4+T cells in patients with SFTS before treatment were significantly lower than those in healthy subjects .The counts of WBCs and platelets were sig-nificantly increased after ten days of treatment , and the level of CD25+cells was higher than that in control group, but the level of total T cells and CD 4+T cells were still lower than those in healthy subjects ( P<0.05).Patients died of SFTS had significantly lower counts of total T cells , CD4+T cells, CD8+T cells and CD25+cells than cured patients (P<0.05).The level of CD25+cells and B cells were positively correlated with WBC level (P<0.05).Platelet level was positively correlated with the percentage of CD 4+T cells (P<0.05).The level of alanine aminotransferase and creatine kinase were positively correlated with the number of CD3+T and CD8+T cells (P<0.05).Conclusion SFTS virus infection affected the percentage of body′s immune cells, especially the level of CD4+T cells.The imbalanced immune system was correlated with the counts of WBCs , platelets and various enzymes in serum and it might be one of the factors causing extensive damage of multiple organs and tissues .
ABSTRACT
[Summary] Interleukin-2 receptor antagonist (IL-2Ra,ie,basiliximab and daclizumab),a new antibody agent,is widely employed in lowering the risk of acute rejection after organ transplantation,but it meanwhile causes increasing concerns on the effect it exerts on glucose metabolism in transplant recipients,and so far the exact effect still remains controversial.New onset diabetes after transplantation (NODAT) is one of the most influential metabolic complications affecting graft survival and patients' long-term outcomes.Some of the current researches indicate that IL2Ra may improve glucose metabolism in the transplant recipients,some show just the opposite,yet others show no effects.Hence further investigations focusing this aspect are needed.
ABSTRACT
BACKGROUND:Daclizumab can be special y combined with the inerleukin-2 receptor on the surface of activated T cells in human body, and this method can reflect the close of interleukin-2 receptor thus inferring the effect of induction therapy. At present, the daclizumab has been widely used in renal transplantation, but there is no consensus on its clinical application in liver transplantation. OBJECTIVE:To investigate the expression of serum CD25+T cells and soluble interleukin-2 receptor in the patients receiving daclizumab for liver transplantation during perioperative period. METHODS:A total of 58 patients received orthotopic liver transplant for the first time were included and then the patients were randomly divided into two groups:control group (n=28) and treatment group (n=30). The patients in the two groups were treated with tacrolimus, mycophenolate mofetil and corticosteroids triple immunosuppressive regimen. The patients in the treatment group received immune induction therapy with daclizumab, and the patients in the control group did not receive daclizumab. RESULTS AND CONCLUSION:Flow cytometry and enzyme-linked immunosorbent assay showed the expression levels of CD25+T cells in the treatment group were significantly lower than those in the control group at different time points after liver transplantation (P<0.01);and the expression levels of soluble interleukin-2 receptor in the treatment group were lower than those in the control group during transplantation and at the first day after transplantation (P<0.05, P<0.01). At 6 months after transplantation, the incidence of acute rejection was decreased in the treatment group (P<0.01). The results indicate that daclizumab can effectively suppress the expression level of CD25+T cells, as wel as the expression level of soluble interleukin-2 receptor in the peripheral blood in the early stage of liver transplantation, thus effectively reducing the rate of acute rejection.
ABSTRACT
ObjectiveTo explore the clinical features,etiological factors,diagnosis and treatments in children with hemophagocytic syndromes (HPS).MethodsA retrospective study was carried out to analyze etiological factors,clinical symptoms and sighs,laboratory findings and outcomes of 32 children with HPS in our hospital.Results( 1 ) Etiological factors:virus infection cases accounted for 75.0％ (24/32),in which Epstein-Barr virus infection cases were predominant,making up to 68.8％ (22/32) ; (2) Main clinical features:included persistent fever,hepatosplenomegaly,lymphadenopathy; ( 3 ) Characteristic laboratory findings:included decrease of three lines or two lines of peripheral blood cells,hyperferrttinemia,abnormal liver function and coagulation function,hypertriglycerdema and decreased fibrinogen,hemophagocytosis in bone marrow,high soluble interleukin-2 receptor level,decreased natural killer cell activity.(4) Treatments and outcomes:twenty-four(24/32) virus infection cases received antivirus and high dose of immunoglobulin treatment.Twenty-two cases were treated with glucocorticoid and cyclophosphamide,resulting in 11 cases improvement,5 cases with complete remission,2 cases giving up and 4 death.The other 10 cases were treated under the guide of HLH-2004 protocol treatmemt with 4 cases improved and 6 cases with complete remission.Conclusion HPS is mainly triggered by infections,especially Epstein-Barr virus infection.Serum ferrifin,interleukin-2 receptor level and natural killer cell activity are biomarkers of the disease,so that they should be monitored during the progress of chemotherapy.HLH-2004 protocol is a good guide for the treatment of this disease.
ABSTRACT
Objective To investigate the role of CD4+ CD25+ regulatory T lymphocyte(Tregs)in the immunological pathogenesis of liver fibrosis.Methods Twenty-six rats were divided into two groups:control group(6 rats)and model group(twenty rats).The rat model of liver fibrosis was induced bv subcutaneous injection of carbon tetrachloride(CCl4).The serums were collected for detection of hepatic function and fibrosis parameters.Hepatic tissue samples were used to observe the histopathological changes.The flow cytometry was used to detect the proportions of Tregs in both peripheral blood and spleen.The data were evaluated by t-test.The relationship between two variables was analyzed using Pearson linear correlation.Results The levels of serum alanine aminotransferase (ALT)and aspartate aminotransferase (AST) were significantly increased,but the level of serum albumin (Alb) was obviously decreased.The concentrations of serum hyaluronic acid (HA),procollagen type Ⅲ(PCⅢ),collagen type Ⅳ(CⅣ)of the model group increased to(177.42±61.25)μg/L,(34.86±7.47)μg/L and(7.32±3.71)μg/L,respectively,which were higher than those in the control group(t=-3.670,-5.661,-3.950,respectively;all P0.05).Conclusion These findings suggest that the reduction of CD4+ CD25+ Tregs probably play an important role in the immunological pathogenesis of liver fibrosis.