淋巴细胞功能相关抗原-1基因敲除对实验性自身免疫性脑脊髓炎小鼠引流淋巴结T细胞活性的影响

目的探讨淋巴细胞功能相关抗原-1(lymphocyte function-associated antigen-1,LFA-1)基因敲除对实验性自身免疫性脑脊髓炎(experimental autoimmune encephalomyelitis,EAE)模型小鼠引流淋巴结T细胞活性的影响。方法采用髓鞘少突胶质细胞糖蛋白(myelin oligodendrocyte glycoprotein,MOG)35-55多肽诱导LFA-1a链CD11a基因敲除的C57BL/6小鼠及野生型C57BL/6小鼠,建立EAE小鼠模型,取MOG诱导后21 d EAE模型小鼠脊髓颈段切片,HE染色和LuxolFastBlue染色,观察小鼠脊髓组织学变化;于MOG诱导后7、14、21d处死小鼠,收集腹股沟引流淋巴结CD4+T淋巴细胞,加入终浓度为1μg/ml的MOG35-55多肽刺激48 h后,应用BrdU试剂盒检测细胞增殖情况;于MOG诱导后4、7、10、14、21 d处死小鼠,收集腹股沟引流淋巴结细胞,加入终浓度为1μg/ml的MOG35-55多肽刺激48 h后,进行细胞内细胞因子染色,观察分泌IFNγ和IL-17的T细胞比例。结果 MOG诱导的野生型小鼠脊髓出现明显淋巴细胞浸润及广泛的脱髓鞘变化,而LFA-1基因敲除小鼠无明显变化;在EAE疾病早期(7 d),LFA-1基因敲除可减少淋巴细胞向引流淋巴结聚集,降低MOG体外刺激T细胞增殖能力,分泌IFNγ及IL-17的T细胞比例也较野生型C57BL/6小鼠明显降低(P0.05);而在EAE疾病缓解期(21 d),LFA-1基因敲除小鼠淋巴细胞聚集及T细胞增殖能力与野生型C57BL/6小鼠相比无明显差异(P0.05),分泌IFNγ及IL-17的T细胞比例高于野生型C57BL/6小鼠(P0.05)。结论在EAE疾病发生早期,LFA-1可能起到了关键性的作用,LFA-1有可能成为自身免疫性疾病治疗的重要分子靶点。     

B细胞在MOG_(35-55)诱导的小鼠实验性自身免疫性脑脊髓炎中的作用

目的探讨B细胞参与MOG35-55诱导的实验性自身免疫性脑脊髓炎(Experimental autoimmune encelphalomyelitis,EAE)小鼠模型的可能机制。方法采用MOG35-55肽段免疫C57BL/6小鼠建立EAE模型;采用临床评分检测EAE模型建立情况,HE和快蓝染色观察脊髓炎性细胞浸润和脱髓鞘状况,流式细胞术检测B细胞活化程度,免疫组化法检测脾组织生发中心的形成,ELISA法检测IgG1、IgG2a和IgG2b的分泌水平。结果成功建立了MOG35-55诱导的EAE小鼠模型,EAE组临床评分明显高于弗氏完全佐剂(Complete Freund adjuvant,CFA)组(P<0.001),EAE组小鼠脊髓可见明显的炎性细胞浸润和脱髓鞘斑块;在EAE组发病起始期(免疫后第5天和第8天),外周免疫器官活化B细胞表达水平明显高于CFA组(P<0.01);在发病高峰期(免疫后第15天)EAE组小鼠脾中形成生发中心,而CFA组未见生发中心形成,且外周血抗MOG35-55抗体分泌水平明显高于CFA组(P<0.005)。结论 MOG35-33肽段可以诱导B细胞活化,进而可能通过发挥体液免疫作用介导EAE疾病的发生。     

IL-17对髓鞘碱性蛋白诱导鼻黏膜免疫耐受治疗实验性自身免疫性脑脊髓炎的影响

目的探讨IL-17对髓鞘碱性蛋白(MBP)68-86诱导鼻黏膜免疫耐受治疗实验性自身免疫性脑脊髓炎(EAE)的影响。方法将大鼠分为5组,分别经鼻黏膜滴注PBS、MBP68-86、MBP68-86+IL-17(0.01μg/d)、MBP68-86+IL-17(0.05μg/d)和MBP68-86+IL-17(0.1μg/d)诱导其发生免疫耐受,并在此基础上建立EAE动物模型,观察各组大鼠发病情况;通过3H掺入试验检测特异性抗原MBP68-86多肽诱导T淋巴细胞增殖活性;HE染色观察脊髓淋巴细胞浸润情况,免疫组化方法检测脊髓中单位面积IL-17+细胞数。结果PBS组和IL-170.1μg/d组与MBP组相比,大鼠免疫后出现进食减少、体重减轻、尾瘫、后肢瘫痪等临床症状,IL-170.01μg/d组和0.05μg/d组大鼠临床症状较轻或无症状。淋巴细胞增殖试验结果显示,PBS组和IL-170.1μg/d组与MBP组相比,特异性淋巴细胞增殖反应显著增高,IL-170.01μg/d组和0.05μg/d组与MBP组相比,差异无显著意义,与IL-170.1μg/d组相比差异有显著意义;PBS组、IL-170.1μg/d组与MBP组、IL-170.01μg/d组和0.05μg/d组相比,脊髓切片中淋巴细胞浸润面积较大且细胞数量较多,IL-17+细胞数也显著增多。结论MBP68-86特异性肽段可诱导EAE免疫耐受的形成,预防EAE的发生;鼻黏膜给予IL-17可以打破MBP诱导的特异性免疫耐受,且存在剂量依赖性。     

转化生长因子-β在骨髓间充质干细胞治疗实验性自身免疫性重症肌无力机制中的作用

目的探讨转化生长因子-β(TGF-β)在骨髓间充质干细胞(BMSCs)治疗实验性自身免疫性重症肌无力(EAMG)机制中的作用。方法分离培养健康Lewis大鼠BMSCs,并进行大量体外扩增;以大鼠来源的乙酰胆碱受体(R-AChR)2次免疫Lewis大鼠,建立EAMG模型;第2次免疫的同时,经尾静脉移植BMSCs,1×107个/只,依据Lennon评分标准,进行体重测量和临床体征评定。并通过体外实验进一步探讨TGF-β在治疗EAMG过程中的具体机制。结果BMSCs移植明显缓解了EAMG的临床症状,临床评分及体重变化差异均有统计学意义,表明治疗有效;体外实验结果显示,BMSCs能通过TGF-β的分泌影响AChR特异性Th17/Treg细胞亚群的分布及其相关因子的分泌,以anti-TGF-β抗体封闭后,这种调节作用在一定程度上被抑制。结论BMSCs通过细胞因子TGF-β,能在一定程度上调节AChR特异性Th17/Treg细胞亚群的平衡,从而起到治疗EAMG的作用。     

Th17及IL-17与实验性自身免疫性重症肌无力发病过程的相关性

目的探讨Th17及其相关因子IL-17与实验性自身免疫性重症肌无力(EAMG)发病过程的相关性。方法建立EAMG大鼠模型及CFA对照组,分别于两发病时相(早期发病高峰和晚期发病高峰),采用ELISA法检测血清以及淋巴细胞培养上清中IL-17的含量;流式细胞仪检测CD4+IL-17+淋巴细胞含量;3H增殖试验检测淋巴细胞的增殖能力;B-ELISPOT法检测B细胞的抗体分泌情况。结果与CFA组相比,EAMG组大鼠血清、淋巴细胞培养上清中IL-17的表达以及CD4+IL-17+淋巴细胞含量在早期发病时相差异均无统计学意义;而在晚期发病时相则均明显增多。与非刺激组相比,IL-17的刺激对CFA和EAMG组淋巴细胞的增殖能力及B细胞抗体分泌水平,在早期发病时相均无明显影响;而在晚期发病时相,EAMG组均明显升高。结论Th17及其相关因子IL-17参与大鼠EAMG的晚期发病时相,并促进疾病的发展。     

猪血凝性脑脊髓炎病毒单克隆抗体的制备与鉴定

目的制备猪血凝性脑脊髓炎病毒(HEV)单克隆抗体,并进行鉴定。方法通过差速离心和蔗糖密度梯度离心法对猪HEV进行纯化,免疫BALB/c小鼠后,取其脾细胞与骨髓瘤SP2/0细胞进行融合,经间接ELISA和血凝抑制试验(HI)筛选能稳定分泌抗HEV单克隆抗体的杂交瘤细胞株,并对单抗进行生物学鉴定。结果筛选出4株能稳定分泌抗HEV单抗的杂交瘤细胞株2H2、2A1、1E2、4D4。经鉴定,4株杂交瘤细胞株诱生小鼠腹水抗HEV的ELISA效价可达1∶12800～1∶51200,其中3株HI效价可达1∶24～1∶28,另1株为0。4株杂交瘤细胞分泌的单抗与猪传染性胃肠炎病毒(TGEV)、猪流行性腹泻病毒(PEDV)和猪伪狂犬病病毒(PRV)均不发生交叉反应;杂交瘤细胞染色体数为83～103;除2A1单抗为IgG2b外,其他3株均为IgG1;Westernblot分析表明,2H2、2A1和4D4能识别HEV的血凝素-酯酶蛋白(HE),1E2可识别纤突蛋白(S)。结论已成功制备出抗HEV的单克隆抗体,为HEV快速检测试剂的研制奠定了基础。     

生物发酵骨化二醇相关杂质的制备及结构鉴定

目的 对生物发酵的骨化二醇相关杂质进行分离纯化及结构鉴定。方法 生物发酵维生素D3的发酵液经过粗提后,采用高压制备色谱多次分离得到骨化二醇的相关杂质,使其达到一定纯度后,再通过DAD扫描、质谱和核磁鉴定化合物的结构。结果 纯化后得到纯度97.5%的杂质单品,结构鉴定此杂质化学结构式为(5Z,7E)-9,10-开环胆甾-5,7,10(19)-三烯-3b,24-二醇,也即24-羟基维生素D3,为骨化二醇的同分异构体。结论 本研究结果为生物发酵的骨化二醇原料药的质量标准的建立提供依据,同时为后续实验工作提供杂质对照品.     

猪血凝性脑脊髓炎病毒HE基因的克隆及原核表达

目的构建猪血凝性脑脊髓炎病毒株(67N)血凝素酯酶蛋白(HE蛋白)原核表达系统,为建立特异性免疫学诊断方法提供备选材料。方法克隆猪血凝性脑脊髓炎病毒(67N)HE蛋白抗原表位富集区基因,构建重组表达质粒pET-HE,并在大肠杆菌中诱导表达。经包涵体的初步纯化,金属螯合层析进一步纯化HE蛋白,SDS-PAGE和Western blot进行检测。结果大肠杆菌可高效表达HE蛋白,目的蛋白表达量可占菌体总蛋白的42.2%。纯化后蛋白浓度为0.6 mg/ml,纯度为85.4%。所表达的蛋白可被兔抗猪血凝性脑脊髓炎阳性血清所识别。结论已成功构建猪血凝性脑脊髓炎病毒HE蛋白原核表达载体,重组HE蛋白抗原具有良好的特异性,可作为检测猪血凝性脑脊髓炎病毒血清抗体的候选抗原。     

截瘫后骨化性肌炎的综合治疗

目的探讨截瘫后骨化性肌炎的治疗。方法采用综合治疗:针灸、推拿、脉冲、红光。结果9例住院病人综合治疗6～11个月,总有效率达89.1%。结论针灸、推拿、脉冲、红光等综合治疗是截瘫后骨化性肌炎的一种有效治疗方法,疗效满意。     

Adhesion Molecule Profile and the Effect of Anti-VLA-4 mAb Treatment in Experimental Autoimmune Encephalomyelitis,a Mouse Model of Multiple Sclerosis

In the course of multiple sclerosis (MS) and its animal model, experimental autoimmune encephalomyelitis (EAE), the infiltration of lymphocytes and other inflammatory cells across the blood–brain barrier is associated with interactions between adhesion molecules expressed by infiltrating cells and vascular endothelium. Monoclonal antibodies (mAb) against the α4 subunit of α4-β1 integrin (VLA-4) show beneficial effects in both MS and EAE. (1) Background: The aim of this study was to examine the expression of selected adhesion molecules: VLA-4, VCAM-1, LFA-1, ICAM-1 and PECAM-1 in the successive phases of EAE and the effect of anti-VLA-4 mAb treatment on that expression. (2) Methods: EAE was induced in C57BL/6 mice by immunization with MOG_35–55 peptide. The animals were killed in three successive phases of the disease: onset (day 13), peak (day 18) and chronic (day 28). Frozen sections of the lumbar spinal cord were examined by quantitative immunofluorescence microscopy. The expression of the studied molecules was quantified as the percentage of the cross-sectioned spinal cord lesion area occupied by immunopositive structures. (3) Results: The expression of the studied molecules showed two temporal patterns: (1) an increase in the onset phase, a maximum in the peak phase and a decrease in the chronic phase, which corresponded to the temporal pattern of the clinical score, the number of lesions and the inflammation level (ICAM-1, LFA-1 and PECAM-1), and (2) an increase in the peak phase and no significant change or further increase in the chronic phase (VCAM-1, VLA-4). Among the molecules studied, ICAM-1 and LFA-1 exhibited the highest expression levels in the peak phase of EAE. Anti-VLA-4 mAb inhibited the expression of not only VLA-4 but also other adhesion molecules. (4) Conclusions: The interactions of adhesion molecules governing the migration of leukocytes across the blood–brain barrier change in the successive phases of EAE. The therapeutic mechanism of anti-VLA-4 mAb treatment seems to include a complex influence on a variety of adhesion molecules expressed by infiltrating cells and vascular endothelium.     

The Immunomodulatory and Neuroprotective Effects of Mesenchymal Stem Cells (MSCs) in Experimental Autoimmune Encephalomyelitis (EAE): A Model of Multiple Sclerosis (MS)

Mesenchymal stem cells (MSCs) are multipotent cells that differentiate into the mesenchymal lineages of adipocytes, osteocytes and chondrocytes. MSCs can also transdifferentiate and thereby cross lineage barriers, differentiating for example into neurons under certain experimental conditions. MSCs have anti-proliferative, anti-inflammatory and anti-apoptotic effects on neurons. Therefore, MSCs were tested in experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis (MS), for their effectiveness in modulating the pathogenic process in EAE to develop effective therapies for MS. The data in the literature have shown that MSCs can inhibit the functions of autoreactive T cells in EAE and that this immunomodulation can be neuroprotective. In addition, MSCs can rescue neural cells via a mechanism that is mediated by soluble factors, which provide a suitable environment for neuron regeneration, remyelination and cerebral blood flow improvement. In this review, we discuss the effectiveness of MSCs in modulating the immunopathogenic process and in providing neuroprotection in EAE.     

Hedgehog Signalling Modulates Immune Response and Protects against Experimental Autoimmune Encephalomyelitis

The Hedgehog (Hh) pathway is essential for the embryonic development and homeostatic maintenance of many adult tissues and organs. It has also been associated with some functions of the innate and adaptive immune system. However, its involvement in the immune response has not been well determined. Here we study the role of Hh signalling in the modulation of the immune response by using the Ptch-1-LacZ^+/− mouse model (hereinafter referred to as ptch^+/−), in which the hemizygous inactivation of Patched-1, the Hh receptor gene, causes the constitutive activation of Hh response genes. The in vitro TCR stimulation of spleen and lymph node (LN) T cells showed increased levels of Th2 cytokines (IL-4 and IL-10) in ptch^+/−cells compared to control cells from wild-type (wt) littermates, suggesting that the Th2 phenotype is favoured by Hh pathway activation. In addition, CD4⁺ cells secreted less IL-17, and the establishment of the Th1 phenotype was impaired in ptch^+/− mice. Consistently, in response to an inflammatory challenge by the induction of experimental autoimmune encephalomyelitis (EAE), ptch^+/− mice showed milder clinical scores and more minor spinal cord damage than wt mice. These results demonstrate a role for the Hh/ptch pathway in immune response modulation and highlight the usefulness of the ptch^+/− mouse model for the study of T-cell-mediated diseases and for the search for new therapeutic strategies in inflammatory diseases.     

Alemtuzumab in Multiple Sclerosis: Mechanism of Action and Beyond

Alemtuzumab is a humanized monoclonal antibody against CD52 (cluster of differentiation 52) and is approved for the therapy of relapsing-remitting multiple sclerosis. The application of alemtuzumab leads to a rapid, but long-lasting depletion predominantly of CD52-bearing B and T cells with reprogramming effects on immune cell composition resulting in the restoration of tolerogenic networks. Alemtuzumab has proven high efficacy in clinical phase II and III trials, where interferon β-1a was used as active comparator. However, alemtuzumab is associated with frequent and considerable risks. Most importantly secondary autoimmune disease affects 30%–40% of patients, predominantly impairing thyroid function. Extensive monitoring and early intervention allow for an appropriate risk management. However, new and reliable biomarkers for individual risk stratification and treatment response to improve patient selection and therapy guidance are a significant unmet need. Only a deeper understanding of the underlying mechanisms of action (MOA) will reveal such markers, maximizing the best potential risk-benefit ratio for the individual patient. This review provides and analyses the current knowledge on the MOA of alemtuzumab. Most recent data on efficacy and safety of alemtuzumab are presented and future research opportunities are discussed.     

Prenatal Vitamin D Deficiency Induces an Early and More Severe Experimental Autoimmune Encephalomyelitis in the Second Generation

In a previous study, we demonstrated that mouse adult F₁ offspring, exposed to a vitamin D deficiency during pregnancy, developed a less severe and delayed Experimental Autoimmune Encephalomyelitis (EAE), when compared with control offspring. We then wondered whether a similar response was observed in the subsequent generation. To answer this question, we assessed F₂ females whose F₁ parents (males or females) were vitamin D-deprived when developing in the uterus of F₀ females. Unexpectedly, we observed that the vitamin D deficiency affecting the F₀ pregnant mice induced a precocious and more severe EAE in the F₂ generation. This paradoxical finding led us to assess its implications for the epidemiology of Multiple Sclerosis (MS) in humans. Using the REFGENSEP database for MS trios (the patient and his/her parents), we collected the parents’ dates of birth and assessed a potential season of birth effect that could potentially be indicative of the vitamin D status of the pregnant grandmothers. A trend for a reduced number of births in the Fall for the parents of MS patients was observed but statistical significance was not reached. Further well powered studies are warranted to validate the latter finding.     

自身免疫性溶血性贫血患者成分输血的疗效观察

目的探讨自身免疫性溶血性贫血(AHIA)患者成分输血的临床疗效。方法对15例输注洗涤红细胞的AHIA患者(A组)和15例输注红细胞悬液的AHIA患者(B组)的临床资料进行回顾性对比分析。结果 A、B两组患者输血24h后,血红蛋白(Hb)、红细胞(RBC)数量和血细胞比容(Hct)均升高;同组内输血前后比较,差异均有统计学意义;两组间输血前后差异均无统计学意义。A组中5例患者输注洗涤红细胞联合血浆置换治疗AHIA,临床症状明显改善。结论输注洗涤红细胞与红细胞悬液治疗AHIA,其临床效果差异无统计学意义;输注洗涤红细胞联合血浆置换治疗AHIA效果显著。