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Neuromyelitis optica spectrum disorders (NMOSD) is an immune mediated inflammatory demyelinating disease of the central nervous system. Optic neuritis and longitudinally extensive transverse myelitis are the main clinical signs, and the etiology is mainly related to aquaporin 4 (AQP4) antibody. AQP4 is the target antigen of immune attack. NMOSD is characterized by optic neuritis, longitudinally extended transverse myelitis, medulla area postrema syndrome, brainstem syndrome, diencephalic syndrome and cerebral syndrome. In recent years, the etiological mechanism, clinical diagnosis and monoclonal antibodies targeting new mechanisms of NMOSD have made great progress, which promoted the development of clinical neurology.
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Objective:To investigate the effect of autophagy on the Treg/Th17 cell imbalance in mice with acute lung injury (ALI).Methods:Twenty-four male SD mice were randomly divided into the sham operation group (S group), sepsis group (Sep group) and autophagy inhibitor 3-methyladenine group (Sep +3-MA group). ALI model was prepared by LPS tracheal dripping method. The mouse pathological injury score mice were evaluated under light microscopy and the W/D ratio was calculated. The counts of Th17 cells and Treg cells in tracheoalveolar lavage fluid (BALF) of mice and the levels of related cytokines were detected by flow cytometry. The expressions of LC3-Ⅱ, Beclin-1 and p62 in Th17 cells and Treg cells in BALF were determined by Western blot.Results:CCompared with the S group, the lung histopathological score and W/D ratio of the Sep group and Sep+3-MA group increased ( P<0.05). Compared with the Sep group, the count of Th17 cells in BALF of the Sep +3-MA group decreased, while the count of Treg cells increased significantly with the progression of sepsis( P<0.05), and the levels of IL-17, IL-10 and TNF-α were significantly decreased ( P<0.05). TGF-β1 levels increased in the early stages of sepsis, but decreased significantly with the progression of sepsis( P<0.05). Compared with the Sep group, LC3-Ⅱ expression in BALF Th17 cells and Treg cells of the Sep+3-MA group showed a downward trend, but there was no statistical difference, while Beclin-1 expression significantly decreased ( P<0.05), and the expression of p62 significantly increased ( P<0.05). Conclusions:Abnormal activation of autophagy in Th17 cells and Treg cells is involved in the immune imbalance of Th17/Treg cells in ALI with sepsis. Inhibition of autophagy can restore the functions of Th17 cells and Treg cells, and improve the imbalance of Th17/Treg by inhibiting autophagy may become a new idea to control the pathogenesis and progression of immune disorders with sepsis.
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Objective:To evaluate the changes in CD4 + CD25 + regulatory T cells (Treg)/helper cell type 17 (Th17) during intestinal damage in septic rats. Methods:Forty-eight clean-grade Sprague-Dawley rats, aged 3 months, weighing 200-300 g, were divided into control group (group C)and sepsis group(group Sep), with 24 rats in each group.The modified cecal ligation and puncture method was used to establish the model of sepsis in anesthetized rats.Resuscitation was performed with normal saline after operation, and the right jugular vein catheterization was used for treatment of enteral nutrition in two groups.Six rats were sacrificed at 12, 24, 48 and 72 h after surgery (T 1-4), and mesenteric lymph nodes and colon were obtained.The percentage of Treg cells and Thl7 cells in mesenteric lymph nodes was detected by flow cytometry.The contents of interleukin-17 (IL-17), IL-23, transforming growth factor beta (TGF-β) and IL-10 in colon tissues were determined by enzyme-linked immunosorbent assay. Results:Compared with group C, the percentage of Treg cells was significantly decreased at T 1, the percentage of Treg cells at T 3, 4 and Th17 cells at T 2-4 were increased, the contents of IL-17 and IL-23 at T 1-4, TGF-β at T 3-4 and IL-10 at T 2-4 were increased, and TGF-β contents were decreased at T 2 in group Sep ( P<0.05). Conclusion:The mechanism of intestinal damage is related to Treg and Th17 cell imbalance in septic rats.
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Objective To evaluate the effect of thymosin α1 (Tα1) on sepsis in rats.Methods A total of 120 pathogen-free healthy male Sprague-Dawley rats,weighing 250-300 g,aged 7 weeks,were divided into 3 groups using a random number table method:sham operation group (group S,n =24),sepsis group (group CLP,n=48) and Tα1 group (group T,n=48).Sepsis was induced by modified cecal ligation and puncture in anesthetized rats,and vena cava cannula was placed through the right jugular vein to connect the micropump infusion device.In group S,the cecum was only turned without ligation and perforation,and total venous nutrient solution 60 ml was intravenously infused daily for 3 days.After successful establishment of the model,total venous nutrient solution 60 ml was intravenously infused daily for 3 days in group CLP.After successful establishment of the model in group T,Tα1 0.18 mg/kg was subcutaneously injected daily at a fixed time,and total venous nutrient solution 60 ml was intravenously infused daily for 3 days.Twenty-four rats in group CLP and group T were selected,and the survival rate were observed within 3 days after establishing the model.At 12,24,36 and 72 h after establishing the model,6 rats were selected from each group,and blood samples were collected from the jugular vein for determination of the levels of regulatory T cells (Tregs) and T helper cell 17 (Th17) (using flow cytometry) and serum interleukin-10 (IL-10),IL-17 and tumor necrosis factor-alpha (TNF-α) concentrations (by enzymelinked immunosorbent assay),and the IL-10/TNF-cα ratio was calculated.Results Compared with group S,the level of Tregs in peripheral blood was significantly decreased at 24 h after establishing the model and was increased at 36 and 72 h after establishing the model,and the level of Th17 in peripheral blood and serum IL-10,IL-17 and TNF-α concentrations were increased at each time point after establishing the model,and the IL-10/TNF-α ratio was increased at 36 and 72 h after establishing the model in group CLP,and the levels of Tregs and Th17 in peripheral blood were significantly increased at 72 h after establishing the model,the concentrations of serum IL-10 and IL-17 were increased at each time point after establishing the model,serum TNF-α concentrations were increased at 12 and 24 h after establishing the model,and the IL-10/TNF-α ratio was increased at 36 and 72 h after establishing the model in group T (P＜0.05).Compared with group CLP,the levels of Tregs and Th17 in peripheral blood were significantly decreased,the serum IL-10 and IL-17 concentrations and IL-10/TNF-α ratio were decreased at 36 and 72 h after establishing the model,serum TNF-α concentrations were decreased at 72 h after establishing the model,and the survival rate was increased within 3 days after establishing the model in group T (P＜0.05).Conclusion Tα1 can reduce sepsis through improving the cellular immune function in rats.
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Objective To study the effect of compound hypertonic saline solution (HSD) on sepsis.Methods 133 male Wistar rats were divided into four groups,sham operation group (n =15),cecal ligation and puncture (CLP)group (n =45),CLP plus normal saline (NS) group (n =45),and CLP plus HSD group (n =28).A rat model of sepsis was reproduced by CLP,and the rats in sham operation group received celiotomy without ligation and puncture.All rats in four groups received subcutaneous injection of 30 mL/kg 0.9％ sodium chloride after laparotomy.The rats in CLP plus NS group and CLP plus HSD group received infusion of 5 mL/kg 0.9％ sodium chloride or 7.5％ sodium chloride/6％ dextran post CLP via jugular vein for 3 hours,with the infusion rate of 0.4 mL·kg-1·min-1.The survival rate of each group was observed 9 hours and 18 hours after laparotomy.Mean arterial pressure (MAP) at 0,9,18 hours were monitored.Blood specimens were collected from all rats 0,9 and 18 hours after laparotomy,respectively,for measurement of the plasma levels of tumor necrosis factor-α (TNF-α),interleukin-1β (IL-1β),and procalcitonin (PCT).The rats were all sacrificed,and their lung tissues were harvested for the neutrophil count in bronchoalveolar lavage fluid (BALF),myeloperoxidase (MPO) activity in lung tissue,wet/dry weight ratio (W/D) of lung,and pathological changes in lung tissue.Results There was no death in the sham operation group.The survival rates at 9 hours and 18 hours were 62.2％ and 31.1％ in the CLP group,57.8％ and 35.6％ in the CLP plus NS group,85.7％ and 64.3％ in the CLP plus HSD group,and they were all significantly higher compared with those of the CLP group and the CLP plus NS group (P ＜ 0.05 or P ＜ 0.01).MAP levels in the CLP group and the CLP plus NS group were significantly lower than those in sham operation group,and the plasma levels of TNF-α,IL-1β and PCT were significantly higher compared with those of sham operation group,while there was no difference between CLP group and the CLP plus NS group.MAP and the plasma levels of TNF-α,IL-1β and PCT in the CLP plus HSD group were significantly improved compared with those of the CLP plus NS group at 9 hours and 18 hours [MAP (mmHg,1 mmHg =0.133 kPa) at 9 hours:102±5 vs.94±6,18 hours:90±2 vs.72±3; TNF-α (ng/L) at 9 hours:284.19±57.18 vs.329.67±45.79,18 hours:263.46±42.58 vs.349.68±52.40; IL-1β (ng/L) at 9 hours:219.28±39.21 vs.263.47±32.36,18 hours:195.98±39.06 vs.250.10±41.57; PCT (μg/L) at 9 hours:2.32±0.37 vs.4.52±0.75,18 hours:2.89±0.62 vs.5.02±0.84; P ＜ 0.05 or P ＜ 0.01].The ratio of neutrophils in BALF,MPO activity and lung W/D at 18 hours in the CLP group and the CLP plus NS group were significantly higher than those of the sham operation group,while they were all significantly lower in the CLP plus HSD group than those of the CLP group and the CLP plus NS group [ratio of neutrophils in BALF:0.094±0.019 vs.0.148±0.062,0.151 ±0.055; MPO (U/g):1.19±0.45 vs.2.31 ±0.79,2.64±0.69; lung W/D ratio:4.02 ± 0.63 vs.5.14 ± 0.59,5.12 ± 0.83,all P ＜ 0.05].Under light microscope,no pathobiological changes were found in sham operation group.The lung tissues in the CLP group and the CLP plus NS group showed congestion,edema,infiltrating inflammatory changes,while the inflammatory changes in the lung tissue in the CLP plus HSD group were significantly alleviated.Conclusion HSD can obviously ameliorate the circulatory failure in septic rats,alleviate immune disturbance and acute lung injury,and improve the survival rate of rats with sepsis.
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Objective To analyze the clinical characteristics of gastric polyps in different histopathological types. Methods Based on histopathological difference, gastric polyps were categorized into fundic gland polyps, hyperplastic polyps, inflammatory polyps, adenomatous polyps, etc; Different types of polyps in the aspects of distribution, Helicobacter pylori (H. pylori) infection, the relationship between the proton pump inhibitors (PPI) and the occurrence of gastric polyps to provide guidance on treatment Results 365 cases of gastric polyps were diagnosed in 10 197 patients who underwent gastroscopy. The prevalence was 3. 6%. The histopathological type of the polyps were fundic gland polyps (61. 1%), hyperplastic polyps (23. 3%) , inflammatory polyps (12. 3%) , adenomatous polyps (2. 2%). 289 cases showed single polyps, which was the majoriry across all types of gastric polyps. Majority of the gastric polyps were located in gastric body and fundus, followed by gastric antrum and cardia Most of the fundic gland polyps were located in gastric body and fundus; Majority of the hyperplastic polyps and adenomatous polyps were located in gastric antrum; The main locations of inflammatory polyps were cardia and gastric body and fundus. A higher percent (51. 6%) of fundic gland polyps patients used PPI. The difference was statistically significant compared with the hyperplastic polyps(8. 2%)and inflammatory polyps group(8.9%) (x2 = 48. 31,27. 63 ,P <0. 01). The H. pylori infection rate of hyperplastic polyps and inflammatory polyps were 72.4% and 74.4% ,respectively, both of which were higher than that of fundic gland polyps(20. 2%)(x2 =46. 50,35. 04, P < 0. 01) . One year after the H. pylori eradication, the recurrence cases of hyperplastic polyps and inflammatory polyps were 1/41 and 0/19,respectively. Conclusions The main histopathological type of gastric polyps is fundic gland polyps followed by hyperplastic polyps. The main location of the gastric polyps is gastric body and fundus, followed by gastric antrum and cardia. The distribution of different types of gastric polyps has some characteristics. Long-time usage of PPI may increase the risk of fundic gland polyps. The occurrence of hyperplastic polyps and inflammatory polyps may be related to H. pylori infection. The H. pylori eradication helps preventing the recurrence of hyperplastic and inflammatory gastric polyps.
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Objective To summarize the clinical and pathological data of gastric polyps under gastroscope,and to investigate the clinical characteristics of gastric polyps in elderly patients.Methods The 692 cases of gastric polyps diagnosed by gastroscopy and pathology were retrospectively analyzed.The elder group was defined as aged 60 years and over.The young group was defined as aged less than 60 years.The data were analyzed by SPSS software.Results The detected ratios of gastric polyps were 3.9% in the elder group and 2.9% in the young group (χ2 =15.792,P<0.01).The rates of gastric polyps found in fundus,gastric body and gastric antrum were 32.0%,41.3% and 19.8% respectively in the elder group.And the corresponding rates in the young group were 37.5%,45.8% and 11.1% respectively (χ2 = 2.277,1.404,10.289,P = 0.131,0.236,0.001).The pathological types of the gastric polyps were in the order of fundic gland (60.0%),hyperplastic (26.2%),inflammatory (11.3%),adenomatous (1.7%) and others (0.8%).The diagnostic rates of hyperplastic polyps in the elder group and the young group were 31.7% and 21.9% respectively;the corresponding rates of adenomatous polyps were 3.0% and 0.8% respectively (χ2 = 8.525,4.834,P=0.004,0.028).Conclusions The detected ratio of gastric polyps is higher in the elder group than in the young group.In both groups,the polyps in the fundus and the body are more prevalent,followed by those in the antrum.The diagnostic rate of polyps in the antrum is significantly higher in the elder group than in the young group.Although the main pathological type of the gastric polyps is fundic gland in both groups,the diagnostic rates of hyperplastic polyps and adenomatous polyps are both higher in the elder group,the risk of cancer is higher as well.Therefore,in the elderly,the gastric polyps are recommended to be cut off as soon as possible and followed up closely.
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Objective To establish P2 or P0 peptide-induced experimental autoimmune neuritis (EAN)in the Lewis rats and to explore the optimal type and doses of antigen inoculated to induce EAN and the associated cell-mediated immune mechanisms.Methods Lewis rats were classified into EAN and control groups.The EAN rats were immunized by injection into both hind footpads of inoculums containing 100 or 200 ?g of P2_(57-81)peptide or 200?g of P0_(180-199)peptide and Freund's complete adjuvant(FCA),and the control rats were immunized with FCA only.Clinical scores were compared when they were at peak time of paralysis.Lymphocyte proliferation assay,the ratio of CD_4~+ T cells to lymphatic monocytes and percentage of CD_4~+ CD_(25)~+ T cells to CD_4~+ T cells obtained on day 14 post-immunization were examined.Histopathalogical assessment of sciatic nerves was made.Results Peak clinical scores of P2_(57-81)200 ?g group were dramatically higher than those in P2_(57-81)100 ?g group and P0_(180-199)200 ?g group(both P
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We investigated the students of a seven-year medical master in the bilingual teaching program in Neurology with a questionnaire.We found that the bilingual teaching program has the following problems:the students don't have a solid foundation of medical English terminology and the content of the English teaching was higher than the ability of the students.So we think that we need to impress upon the students the importance of the program.We can also raise the overall quality of this program through an improvement of teaching methods,regulation of the proportion of English content in all courses and suitable midterm and final examinations.These alterations will effectively improve the bilingual teaching program.
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<p><b>OBJECTIVE</b>To investigate the way of revascularization of donator's trachea wrapped in united muscle flap.</p><p><b>METHODS</b>Using fiberoptic bronchoscopy, histopathology and microangiography, we evaluated the tracheal mucosal blood flow, the survival rate, the percentage of patency, and the graft viability of autograft tracheas with varying lengths wrapped in one-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap and autograft tracheas with the length of 5 rings without wrapped in muscle flap in 32 dogs.</p><p><b>RESULTS</b>In the tracheal autograft wrapped in the united muscle flap group with a length less than 4 centimeters, the submucosal blood flow of graft could be detected by laser blood flowmetry one week after transplantation, and it reached 60% of the normal, which had no significant difference between the place near the site of anastomosis and the middle part of the graft. Dense vessels could be found to grow from the wrapped muscles into the autografted trachea by microangiography. Histopathological examination demonstrated that the structure of the autograft was the same as what it originally was. the inner surface of the autograft was covered with pseudostratified columnar ciliary epithelia, and no necrotic tracheal cartilages were found. Every autograft could survive over long time. However, at 1 week, most mucous membrane in the middle part of the graft with length over 4 cm was in gray or in pale; hyperemia, edema, and haemorrhage were found near the site of anastomosis. Mucosal blood flow measured by laser blood flowmetry in the middle part of the graft was significantly less than that near the site of anastomosis. Malacia, dissolution or granulation hyperplasia occurred in midportion of the major grafts shortly after transplanatation. As for those autografted trachea without wrapping in muscles flap, mucous membranes turned black one week after the transplantation and all dogs died of graft necrosis later.</p><p><b>CONCLUSION</b>One-sided sternocephalic muscle flap and two-sided sternohyoid-sternothyroid muscle flap can provide blood for the graft and the grafted trachea can survive for a long time.</p>
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Animales , Perros , Femenino , Masculino , Broncoscopía , Cuello , Colgajos Quirúrgicos , Tasa de Supervivencia , Tráquea , Patología , Trasplante , Trasplante AutólogoRESUMEN
Objective The aim of this study was to assess the reliability of a newly developed enzymeimmumoassay, the Helicobacter pylori (H. pylori) stool antigen (HpSA) test, for the detection of H.pylori infection before and after eradication. Methods The H.pylori infected patients referred to our department were included. They were divided into two groups. The 331 patients in group A had intact stomach, and 65 patients in group B had history of subtotal gastrectomy. All patients underwent gastroscopy with biopsies for rapid urease test (RUT) and histology, which was viewed as “gold standard”. H.pylori status was defined as positive or negative with both RUT and histology presenting concordant positive or negative results. The results of these reference tests were compared with those obtained by HpSA test and ()~(13)C-urea breath test (()~(13)C-UBT). In addition, Fifty-six-positive patients in group A, constituting group C, were treated with 1-week triple therapy. At the 28 th day after the end of therapy, the patients underwent another ()~(13)C-UBT which was also defined as “gold standard”. The stool specimens were collected on days 1, 7, 14, 21, and 28 after completion of therapy and were used to detect the antigen of H.pylori by HpSA. Results In group A, 175 patients were defined as H.pylori-positive and 156 as negative by the “gold standard”. The sensitivity and specificity of the HpSA test was (95.4%) and 91.0%, respectively. There was no significant difference between HpSA test and ()~(13)C-UBT. In group B, 30 patients were defined as H.pylori-positive and 35 as negative by the “gold standard”. The sensitivity of the HpSA test and ()~(13)C-UBT was 90.0% and 66.7%, respectively (P
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Objective To assess the reliability of a newly developed enzyme immunoassay for Helicobacter pylori-specific antigen detection in the old patients' stools. Methods The 199 old patients referred to our department for upper gastrointestinal endoscopy were included. Among which, 48 patients suffered from subtotal gastrectomy previously, and 151 patients never had any gastric surgery. All patients underwent gastroscopy with biopsies for rapid urease test (RUT) and histology (Warthin-Starry stain). Used RUT and Warthin-Starry stain as gold standard, Helicobacter pylori (H. pylori) status was defined positive (or negative) if both RUT and Warthin-Starry stain were positive (or negative). A stool specimen was collected for each patient and tested by using a novel enzyme immunoassay for H. pylori detection (HpSA). Every patient was also detected by 13 C-urease breath test ( 13C-UBT). Sensitivity and specificity of these two tests were calculated respectively. Results H. pylori ststus was positive in 81 patients and negative in 70 patients of 151 patients. The sensitivity and specificity of HpSA were 96.3% and 90.0%, and 13 C-UBT were 92.6% and 92.9% respectively; H. pylori infection was confirmed in 23 of 48 patients with gastric surgery, the sensitivity of HpSA test for the diagnosis of H. pylori infection was 91.3% and its specificity 88.0%, and 13 C-UBT were 65.2% and 92.0% respectively, the sensitivity of 13 C-UBT was lower than HpSA in the patients with a history of gastric surgery (P
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Objective To study the prophylactic effects of nasal tolerance with a dual analogue (Lys262-Ala207) on experimental autoimmune myasthenia gravis (EAMG) and observe the underlying mechanisms, the clinical and immunological changes in Lewis rats treated with dual analogue nasally. Methods The effects of the predetermined dosage of a dual analogue Lys262-Ala207 were compared at different time points, and the dual analogues or control peptides were given nasally before (Group A or CA) or on the day (Group B or CB) of immunization with acetylcholine receptor (AChR) in complete Freund's adjuvant for 10 consecutive days. The clinical scores were evaluated for 50 days after immunization. The levels of anti-AChR IgG in serum were tested by RIA. Proliferative responses of lymphocytes to no antigen, Lys262-Ala207, AChR, AChR-?100-116, MBP peptide, or Con A were tested. The numbers of mononuclear cells expressing CD4 and/or CD25 from lymph nodes were enumerated using flow cytometry. Results As compared with the corresponding control groups, Lewis rats in group A or B developed EAMG with reduced severity and loss of AChR within the neuromuscular junction. The levels of anti-AChR IgG (21.96?3.37 and 29.41?4.59) were also decreased. Proliferative responses were suppressed in response to antigen-specific stimulations in rats receiving dual analogue, whereas the numbers of CD4+CD25+ T cells were higher in group A (11.34%?1.62%) and B (8.68%?1.83%) than in their corresponding control groups. Conclusions Nasal administration with a dual analogue Lys262-Ala207, at two different time points before and on the day of immunization ameliorated muscular weakness in EAMG rats associated with decreased levels of anti-AChR IgG in serum, suppressed antigen-specific T cell proliferation and increased numbers of CD4+CD25+ T cells from lymph nodes as compared to rats receiving control peptides. The results of our study suggest that the mucosal tolerance with dual analogue should be served as an alternative maneuver in human MG.
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Objective To study the effect of nasal tolerance with a dual analogue (Lys262 Ala207) on experimental autoimmune myasthenia gravis (EAMG) and the underlying mechanisms, the clinical and immunological changes were observed in Lewis rats treated with dual analogue Methods Different doses of dual analogues were given to Lewis rats immunized with acetylcholine receptor (AChR) in complete Freud's adjuvant (CFA) and the medium dosage was chosen in the following studies As comparing the effects of treatment of the predetermined dosage of dual analogue at different time points, the body weight and clinical symptoms of Lewis rats immunized with AChR in CFA were evaluated The levels of anti AChR IgG in serum were tested by ELISA Proliferative responses of lymphocytes to no antigen, AChR, dual analogue, control MBP peptide, MBP, or Con A were tested Results Lewis rats receiving dual analogue nasally for 10 consecutive days at the time of immunization (Group A) or the first day after complete remission from the acute phase of the disease (Group B) sparsely developed EAMG with reduced severity than the corresponding control groups The subsiding disease was associated with decreased amount of anti AChR IgG in serum expressed as optic density ( A ) at 405 nm On day 35 post immunization, the A values in group B vs control group were 0 95?0 26 and 1 19?0 12, respectively Proliferative responses expressed as stimulation index (SI) were suppressed in response to antigen specific stimulations in rats receiving dual analogue as compared with rats receiving control peptide For instance, the values of SI in response to AChR in group A and control group were 1 71?0 78 and 3 24?1 31, respectively Those values were suppressed to a less extent in group B vs control group (1 97?0 56 vs 3 19? 1 50) Conclusions Nasal administration of a dual analogue Lys262 Ala207, at two different time points post immunization should ameliorate muscular weakness in EAMG rats involved in decreased levels of anti AChR antibodies and antigen specific T cell proliferation