Impact of fish oil enriched total parenteral nutrition on elderly patients after colorectal cancer surgery

BACKGROUND

Polyunsaturated omega-3 fatty acids may beneficially influence healing processes and patient outcomes. The aim of this research was to study the clinical efficacy of fish oil enriched total parenteral nutrition in elderly patients after colorectal cancer surgery.

METHODS

Fifty-seven elderly patients with colorectal cancer were enrolled in this prospective, randomized, double-blind, controlled clinical trial. All patients received isocaloric and isonitrogenous total parenteral nutrition by continuous infusion (20 - 24 hours per day) for seven days after surgery. The control group (n = 28) received 1.2 g/kg soybean oil per day, whereas the treatment group (n = 29) received 0.2 g/kg fish oil and 1.0 g/kg soybean oil per day. Blood samples were taken pre-operatively, and at days one and eight after the operation. The plasma levels of CD4, CD8, CD4/CD8, interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were measured. Clinical outcomes were then analysed.

RESULTS

Patient characteristics were comparable between the two groups. At day eight post-surgery, IL-6, TNF-α and CD8 titres were lower in the treatment group when compared to the control group; these results reached statistical significance. In the treatment group, there were fewer infectious complications and incidences of systemic inflammatory response syndrome (SIRS), and shorter lengths of hospital stay were observed. The total cost of medical care was comparable for the two groups. No serious adverse events occurred in either group.

CONCLUSIONS

Fish oil 0.2 g/kg per day administrated to elderly patients after colorectal surgery was safe and may shorten the length of hospital stay and improve clinical outcomes.

[Evaluation of CD4+CD161+CD196+ and CD4+IL-17+ Th17 cells in the peripheral blood of young patients with Hashimoto's thyroiditis and Graves' disease]

INTRODUCTION

Up till now, altered balance of Th1 and Th2 immune cells has been postulated to play an important role in the pathogenesis of autoimmune thyroid diseases (AITD). However, recent studies on thyroid diseases suggest a new role for Th17 (T helper 17) cells that have been classified as a new lineage, distinct from Th1, Th2 and Treg cells. Despite wide interest, the role of Th17 cells in the pathogenesis of inflammatory and autoimmune diseases is still being debated. Th17 cells are involved in immune responses against extracellular pathogens and have the ability to secrete cytokines: IL-17, IL-17F, IL-22 and IL-21. Th17 cells can be characterized by several surface markers, i.e. CCR6 (CD196), IL-23R, IL-12Rbeta2 and CD161.

AIM OF THE STUDY

Was to estimate the frequencies of circulating CD4+CD161+CD196+ and CD4+IL-17+ Th17 cells in patients with Graves' disease (GD, n=20, mean age ± SEM 14.9 ± 6 years), Hashimoto's thyroiditis (HT, n=20, mean age ± SEM 15.2±3 yrs) and in healthy controls (C, n=20, mean age ± SEM 15.4 ± 2 yrs).

MATERIAL AND METHODS

Polychromatic flow cytometry and several fluorochrome-conjugated monoclonal antibodies were applied to delineate Th17 cells with either CD4+CD161+CD196+ or CD4+IL-17+ phenotype using apparatus FACSCalibur (BD Biosciences). Thyroid anti-TSH receptor immunoglobulins (TRAK), anti-thyroperoxidase (anti-TPO) and anti-thyroglobulin (anti-TG) antibodies were measured in all the samples using electrochemiluminescence "ECLIA" with Modular Analytics E170 analyzer (Roche Diagnostics, Poland).

RESULTS

In untreated HT children we observed an increased percentage of CD4+CD161+CD196+ (7.1 ± 3.5 vs. 3.7 ± 1.8; p <0.04) and CD4+IL-17+ (3.7 ± 2.7 vs. 1.4±0.4; p <0.01) Th17 lymphocytes in comparison to the healthy controls. In untreated and treated GD children we did not reveal such abnormalities in the population of these cells compared to the controls. In cases with HT, a positive correlation between the percentage of CD4+IL-17+ and CD4+CD161+CD196+ T cells and serum level of anti-TPO antibodies (r=0.48; p <0.025; r=0.65; p <0.01; respectively) was detected.

CONCLUSIONS

We conclude that the increased percentage of Th17 cells in children with untreated Hashimoto's thyroiditis can suggest their role in initiation and development of immune and inflammatory processes in this endocrinopathy.

Elevated Th22 cells correlated with Th17 cells in patients with rheumatoid arthritis

BACKGROUND

T-helper (Th) 22 and Th17 cells are implicated in the pathogenesis of autoimmune diseases. The roles of Th22 cells in the pathophysiology of rheumatoid arthritis (RA) remain unsettled.

MATERIALS AND METHODS

CD4(+)IFNγ(-)IL17(-)IL-22(+) T cells (Th22 cells), CD4(+)IFNγ(-)IL-22(-)IL17(+) T cells (pure Th17 cells), CD4(+)IL17(+) T cells (Th17 cells), and CD4(+)IFNγ(+) T cells (Th1 cells) in RA, osteoarthritis patients, and healthy controls were examined by flow cytometry. Plasma IL-22 and IL-17 levels were examined by enzyme-linked immunosorbent assay.

RESULTS

Th22 cells, pure Th17 cells, Th17 cells, and interleukin-22 were significantly elevated in RA patients compared with osteoarthritis and healthy controls, but there were no significant differences regarding Th1 cells and interleukin-17. Th22 cells showed a positive correlation with interleukin-22 as well as pure Th17 cells or Th17 cells in RA patients. Additionally, the percentages of Th22 cells, pure Th17 cells as well as Th17 cells correlated positively with both C-reactive protein levels and 28-joints disease activity score.

CONCLUSION

Together, our results indicated a possible role of Th22 pure Th17 cells and Th17 cells in RA, and blockade of the interleukin-22 may be a reasonable therapeutic strategy for RA.

[Analysis of frequency of peripheral blood CD4+; CD25(high);Tregs and CD4+; CD25(low);T cells and expression of PD-1 in SLE and RA patients]

AIM

To explore the frequencies of peripheral blood CD4(+);CD25(high);Treg and CD4(+);CD25(low);T cells and the expression of the co-stimulatory molecule PD-1 on these two group cells surface in SLE and RA patients, and to explore their roles in cell immunity disorder of SLE and RA.

METHODS

Flow cytometry (FCM) was used to determine the frequencies of peripheral blood CD4(+);CD25(high);Treg and CD4(+);CD25(low);T cells, and the expression percentage of PD-1.

RESULTS

Compared with healthy control, the frequencies of peripheral blood CD4(+);CD25(high);Treg from both SLE and RA patients groups decreased significantly(P<0.05). Compared between two disease groups, the frequency of peripheral blood CD4(+);CD25(high);Treg in SLE patients was significantly lower(P<0.05). The expression percentage of PD-1 on CD4(+);CD25(high);Treg surface in RA group was obviously lower than that in both healthy control and SLE patients groups(P<0.05), while the percentage had no significant difference between SLE patients and healthy control(P>0.05). There was no significant difference in both the frequency of CD4(+);CD25(low);T cells and the expression percentage of PD-1 on this subset cells among three groups.

CONCLUSION

The weakened ability of peripheral blood CD4(+);CD25(high);Treg to suppress effector T cells resulted from their production deficiency is the common characteristic of SLE and RA patients. Decreased expression of PD-1 is the primary cause leading to the suppressive function of peripheral blood CD4(+);CD25(high);Treg weakened in RA patients. However, PD-1 does not play major role in weakening the suppression activity of CD4(+);CD25(high);Treg from SLE patients.

Predicting virologic failure among HIV-1-infected children receiving antiretroviral therapy in Tanzania: a cross-sectional study

BACKGROUND

Many HIV care and treatment programs in resource-limited settings rely on clinical and immunologic monitoring of antiretroviral therapy (ART), but accuracy of this strategy to detect virologic failure (VF) among children has not been evaluated.

METHODS

A cross-sectional sample of HIV-infected children aged 1-16 years on ART >or=6 months receiving care at a Tanzanian referral center underwent clinical staging, CD4 lymphocyte measurement, plasma HIV-1 RNA level, and complete blood count. Associations with VF (HIV-1 RNA >or=400 copies/mL) were determined utilizing bivariable and multivariate analyses; accuracy of current clinical and immunologic guidelines in identifying children with VF was assessed.

FINDINGS

Of 206 children (median age 8.7 years, ART duration 2.4 years), 65 (31.6%) demonstrated VF at enrollment. Clinical and immunological criteria identified 2 (3.5%) of 57 children with VF on first-line therapy, exhibiting 3.5% sensitivity and 100% specificity. VF was associated with younger age, receipt of nevirapine vs. efavirenz-based regimen, CD4% < 25%, and physician documentation of maladherence (P < 0.05 on bivariable analysis); the latter 2 factors remained significant on multivariate logistic regression.

INTERPRETATION

This study demonstrates poor performance of clinical and immunologic criteria in identifying children with virologic failure. Affordable techniques for measuring HIV-1 RNA level applicable in resource-limited settings are urgently needed.

Altered expression of CD4(+)CD25(+) regulatory T cells and its 5-HT(1a) receptor in patients with major depression disorder

BACKGROUND

There is growing interest in immune imbalance observed in major depression, but the mechanism of this imbalance is still not well understood. CD4(+)CD25(+) regulatory T (Treg) cells are known to play an important role in immune regulation. However, their role in major depression has rarely been explored. The aims of this study are to determine the immune imbalance status in patients when first diagnosed with major depression, and to explore possible indications of Treg cell involvement in immune imbalance of major depression.

METHODS

27 patients with major depression and 27 healthy individuals were recruited in the study. The immune imbalance was observed by the analysis of Th cell cytokines and CD4(+)CD25(+) Treg cell level. The 5-HT in peripheral serum was measured with HPLC, and changes of Foxp3 and 5-HT(1a) receptor were observed by RT-PCR and double-immunofluorescence.

RESULTS

Despite the similar total lymphocyte count between patients and healthy individuals, the Th1/Th2 ratio increased and the CD4(+)CD25(+) Treg cells decreased in patients' peripheral blood. Moreover, we found that the level of 5-HT was decreased in peripheral serum, and the expression of 5-HT(1a) receptor was also decreased in peripheral lymphocytes of major depression patients, notably in the CD4(+)CD25(+) Treg cells rather than CD4(+)CD25(-) T cells.

LIMITATIONS

The details of interaction between 5-HT(1a) receptors and Treg cells in major depression need further exploration.

CONCLUSION

CD4(+)CD25(+) Treg cells may contribute to the immune imbalance in patients with major depression, which could involve its interaction with 5-HT system.

Neurocognitive correlates of alexithymia in asymptomatic individuals with HIV

Alexithymia, an impairment of affective and cognitive emotional processing, is often associated with human immunodeficiency virus (HIV) and may reflect effects of the virus on brain areas that are also important for multiple cognitive functions, such as the prefrontal and anterior cingulate cortices. We hypothesized that there would be a correlation between extent of alexithymia and cognitive performance associated with these brain areas, including attention, executive function, and visuospatial processing. Thirty-four asymptomatic HIV+ participants and 34 matched healthy HIV- volunteers were administered the Toronto Alexithymia Scale, a series of neuropsychological tests, and measures of apathy, depression, and quality of life (QoL). The HIV+ participants had significantly higher levels of alexithymia, depression and apathy than the HIV- group. The extent of alexithymia and two of its processing components (Difficulty Describing Feelings [DDF] and Externally Oriented Thinking), but not depression, correlated with performance on measures of executive and visuospatial abilities, consistent with dysfunction of the frontostriatal circuits and their cortical projections. Apathy was related to alexithymia and two processing components (Difficulty Identifying Feelings and DDF) but to only one cognitive measure. The higher rate of alexithymia, as well as cognitive dysfunction, in HIV may be a consequence of the infection on the frontostriatal system and its cortical connections. Our findings also demonstrated a dissociation of apathy and alexithymia in HIV, pointing to overlapping but distinct neural substrates within frontostriatal circuits. Alexithymia correlated strongly with QoL ratings, underscoring the importance of assessment and treatment of HIV-associated emotional and cognitive processing deficits.

Percentage of regulatory T cells CD4+CD25+CD127- in HIV-infected patients is not reduced after cryopreservation

Interest in regulatory T cells (Treg) has been continuously growing over the last 10years. In particular, a role for Treg has been recently reported in HIV. It is crucial to investigate their conservation over time, once sampled and purified. The objective of the present study was to investigate whether cryopreservation may modify recognition and measurement of relative frequency of Treg (CD4(+)CD25(+)CD127(-)) among PBMCs purified from 17 HIV-infected patients. Ours results indicate that cryopreservation does not affect this specific T lymphocyte subset.

[The use of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency associated with acute poisoning with neurotropic poisons]

Examination and treatment of 262 patients with severe acute intoxication by neurotropic poisons and unaffected oxygen delivery system showed that inclusion of cytoflavin in combined neurometabolic therapy of acute cerebral insufficiency significantly reduced severity of metabolic disorders. Specifically, tissue hypoxy, endotoxicosis, lipid peroxidation activity, and immunosuppression decreased while antioxidative protection and clinical picture were improved. Duration of comatose state and artificial lung ventilation was reduced from 64.5 +/- 15.1 to 28.8 +/- 10.2 hours and that of critical condition from 117.2 +/- 17.2 to 63.7 +/- 9.2 hours. Overall lethality dropped from 16 to 9.9%.

[Comparison of selected elements of neonate immunological system with relation to indications for cesarean section and time of delivery]

AIM OF STUDY

To define to what degree time and the way of delivery cause changes in CD3+ lymphocytes and their subpopulations CD4+, CD8+, CD25+ and CD19+ lymphocytes and their subpopulations CD5+, CD23+.

MATERIAL AND METHODS

49 healthy neonates born in the years 1998-2003 in the Clinical Ward of Perinatology and Gynecology of Silesian Medical University in Zabrze were examined. Taking into account the time of pregnancy and the way of delivery the children were divided into the following groups: Group Ib--23 full-term neonates born by Cesarean section, including 15 neonates with elective indications (Ibe), 8 with emergency indications (Ibn). Group IIb--26 pre-term neonates born by Cesarean section, including 18 with elective indications (IIbe) and 8 with emergency indications (IIbn). Our study applied a method of umbilical blood sampling with the following red blood cells lysis.

RESULTS

Statistically significant lower mean number of B CD5+ lymphocytes was found in full-term neonates born by Cesarean section in comparison to pre-term neonates born by the same method. Similar differences concern full-term and pre-term neonates born by elective Cesarean section. Statistically significant lower mean number of CD3+, CD4+ and CD25+ lymphocytes was found in pre-term neonates born by elective Cesarean section in comparison to pre-term neonates by emergency Cesarean section.

CONCLUSIONS

Time of pregnancy termination in a mother by Cesarean section can be related to the occurrence of statistically significant changes in B CD5+ lymphocytes quantities in her neonate. Emergency Cesarean section in a mother can be related to the increased quantity of T lymphocytes, helper T lymphocytes, activated T lymphocytes in her pre-term born neonate. No statistically significant differences were found in mean values of other immunological parameters among study groups.

Upregulation of CD4+CD25+T lymphocyte by adenovirus-mediated gene transfer of CTLA4Ig fusion protein in experimental autoimmune myocarditis

OBJECTIVE

To explore the effects of adenovirus vector-mediated gene transfer of CTLA4Ig fusion protein on CD4+CD25+ T cells in experimental autoimmune myocarditis (EAM).

METHODS

EAM was induced by porcine cardiac myosin as previously described. Adenovirus vector-mediated CTLA4Ig gene was administrated intravenously in EAM rats on days 1, 4 and 7, with EGFP as control. On day 21, myocardium histopathology was examined and CD4+CD25+ T cells were isolated. Proliferation and suppression assays were used to evaluate the suppressive capacity of CD4+CD25+ T cells in vitro. Relative mRNA level of Foxp3 and TGF-beta was determined by quantitative real-time RT-PCR; expression of CTLA-4, B7-1 and B7-2 protein was compared with Western blot in CD4+CD25+ Tregs.

RESULTS

Severe inflammatory lesions were observed in the hearts of EGFP-treated EAM rats and the untreated ones, while Ad-CMV-CTLA4Ig alleviated the myocarditis histologically. Adenovirus vector-mediated CTLA4Ig gene transfer up-regulated the proportion of CD4+CD25+ Tregs significantly. T cell proliferation was greatly inhibited in the CTLA4Ig group compared with the untreated and EGFP-treated groups in vitro. CTLA-4 and B7-2 proteins were down-regulated in the CTLA4Ig group, Foxp3 and TGF-beta mRNA was up-regulated significantly by CTLA4Ig treatment.

CONCLUSIONS

Adenovirus vector-mediated CTLA4Ig gene transfer alleviated inflammation in EAM, one of the potential mechanisms is up-regulation of CD4+CD25+ Tregs.

Determination of intracellular cytokines IFN-gamma and IL-4 in canine T lymphocytes by flow cytometry following whole-blood culture

This report describes a whole-blood flow cytometric method for the determination of intracellular cytokines IFN-gamma and IL-4 in canine T lymphocyte subpopulations. Conjugated anti-cytokine antibodies and commercially available reagents for cell fixation and permeabilization were used. Canine peripheral blood was cultured with a combination of phorbol-12-myristate-13-acetate (PMA) and ionomycin to promote cytokine synthesis in each cell, along with monensin to increase the sensitivity of the method by retaining IFN-gamma and IL-4 within the cell to detectable levels. The optimum concentrations of PMA and ionomycin were determined. Maximum IFN-gamma expression from both CD4+ and CD8+ T lymphocytes was detected after 6 h of incubation of cell culture, while maximum IL-4 production took 6 h from CD4+ cells and 4 h from CD8+ cells. This method is a simple immunologic technique for measuring intracellular cytokines which could be of value in the investigation of canine immunological response mainly in various intracellular and extracellular infections, since IFN-gamma and IL-4 are considered key cytokines activating the cellular and humoral immunity, respectively.

[Galavit-induced change of immunologic parameters in patients with non-small lung cancer]

Administration of an immunomodulator, galavit, for stage II-III non-small lung cancer along with standard therapy was followed by immunological vigor improvement by the end of the course. CD3, CD4, IgA, IgM and IgG indices were normal in more than 80% of the study group by day 51 after surgery; CD8, CD20 and HLA-DR--in more than 50%; CD16--in 45.2%. In control, by day 51, normal IgG and HLA-DR levels were reported in 60%. The remaining indices were normal in less than 50%. Our results point to immunological vigor improvement due to use of galavit. The drug is well tolerated, has neither side effects nor toxicity.

[Evaluation of CD4+ CD25+ regulatory T cells in the peripheral blood of recurrent spontaneous abortion patients]

OBJECTIVE

To explore the role of CD4+ CD25+ regulatory T cells (CD4+ CD25+ Tr) in the pathogenesis of recurrent spontaneous abortion.

METHODS

Peripheral blood samples were collected from 29 women with unexplainable recurrent spontaneous abortion (the URSA group) and another 20 with normal pregnancy (the control group). The percentage of CD4+ CD25+ Tr in the peripheral blood was measured by flow cytometry.

RESULTS

The rate of CD4+ CD25bright Tr in the URSA patients ([1.98 +/- 0.96]%) was significantly lower than that in the control group ([3.21 +/- 1.25]%, P < 0.05), while the percentages of CD4+ CD25+ and CD4+ CD25dim and the ratio of CD4+ CD25bright/CD4+ were not significantly different between the two groups (P > 0.05).

CONCLUSION

URSA might be associated with the decreased percentage of CD4+ CD25bright Tr, which plays an important role in fetomaternal immunologic tolerance.

CD4+CD25+ regulatory cells from human peripheral blood express very high levels of CD25 ex vivo

Selective isolation of only those CD4+ T cells that display the highest levels of CD25 by FACS results in a highly homogeneous regulatory population as defined by functional activity and the expression of multiple surface antigens. Thus greater than 98% of CD4+CD25high cells express CD45RO in the absence of CD45RA expression. Upon TCR stimulation CD4+CD25high cells are both anergic and tolerogenic as they inhibit proliferation and cytokine secretion by activated CD4+CD25- responder T cells in a contact-dependent manner. In contrast, CD4+ cells that express lower levels of CD25 are more heterogeneous in their levels of expression of CD45RO, HLA-DR and CD122, and do not exhibit anergic or suppressive characteristics. Providing either CD28 co-stimulation or IL2 to a maximal anti-CD3 stimulus results in a modest induction of proliferation and the loss of observable suppression by CD4+CD25high regulatory cells. Unlike CTLA4 blockade, blocking the interaction of PD-1 with its ligand PD-L1 affects the level of suppression. However, since this reduction in suppression by alphaPD-L1 can be overcome by increasing the number of CD4+CD25high T cells in the co-culture assay, the mechanism of CD4-CD25high regulation can proceed in the absence of PD-1/PD-L1 interactions, although it is not as efficient.

Correlation between CD4 counts of HIV patients and enteric protozoan in different seasons - an experience of a tertiary care hospital in Varanasi (India)

BACKGROUND

Protozoan infections are the most serious among all the superimposed infections in HIV patients and claim a number of lives every year. The line of treatment being different for diverse parasites necessitates a definitive diagnosis of the etiological agents to avoid empirical treatment. Thus, the present study has been aimed to elucidate the associations between diarrhoea and CD4 counts and to study the effect of HAART along with management of diarrhoea in HIV positive patients. This study is the first of its kind in this area where an attempt was made to correlate seasonal variation and intestinal protozoan infestations.

METHODS

The study period was from January 2006 to October 2007 wherein stool samples were collected from 366 HIV positive patients with diarrhea attending the ART centre, inpatient department and ICTC of S.S. hospital, I.M.S., B.H.U., Varanasi. Simultaneously, CD4 counts were recorded to assess the status of HIV infection vis-à-vis parasitic infection. The identification of pathogens was done on the basis of direct microscopy and different staining techniques.

RESULTS

Of the 366 patients, 112 had acute and 254 had chronic diarrhea. The percentages of intestinal protozoa detected were 78.5% in acute and 50.7% in chronic cases respectively. Immune restoration was observed in 36.6% patients after treatment on the basis of clinical observation and CD4 counts. In 39.8% of HIV positive cases Cryptosporidium spp. was detected followed by Microsporidia spp. (26.7%). The highest incidence of intestinal infection was in the rainy season. However, infection with Cyclospora spp. was at its peak in the summer. Patients with chronic diarrhea had lower CD4 cell counts. The maximum parasitic isolation was in the patients whose CD4 cell counts were below 200 cells/microl.

CONCLUSION

There was an inverse relation between the CD4 counts and duration of diarrhea. Cryptosporidium spp. was isolated maximum among all the parasites in the HIV patients. The highest incidence of infection was seen in the rainy season.

[Changes in proportion of decidua and peripheral blood CD(4)(+)CD(25)(+) regulatory T cells in unexplained recurrent spontaneous abortion patients]

OBJECTIVE

To study the changes in the percentage of CD(4)(+)CD(25)(+) regulatory T (Tr) cells in peripheral blood and deciduas in unexplained recurrent spontaneous abortion (URSA) patients, normal non-pregnant and pregnant women respectively.

METHODS

The percentage of CD(4)(+)CD(25)(+) Tr cells in deciduas and peripheral blood from 25 URSA patients, 22 normal non-pregnant (NNP) women, and 34 normal early pregnant (NP) women were measured by double-staining followed by flow cytometric analysis.

RESULTS

(1) The percentage of CD(4)(+)CD(25)(bright) T cells in peripheral blood in both URSA and NP [(1.55 +/- 0.77)%, (2.65 +/- 1.10)%, respectively] women were increased significantly than that in NNP women [(0.39 +/- 0.14)%, P < 0.05]. The percentage of CD(4)(+)CD(25)(bright) T cells in peripheral blood in URSA women was significantly lower than that in NP women (P < 0.05). (2) The percentage of CD(4)(+)CD(25)(bright) T cells in decidua in URSA women was significantly lower than that in NP women [(0.59 +/- 0.23)%, (1.24 +/- 0.55)%, respectively, P < 0.01]. There was no significant difference in the percentage of CD(4)(+)CD(25)(dim) T cells in decidua between URSA women and NP women [(4.23 +/- 1.52)%, (3.75 +/- 1.88)%, respectively, P > 0.05]. (3) The proportion of CD(4)(+)CD(25)(bright)/CD(4)(+) cells in deciduas was significantly higher than that in peripheral blood in NP women [(13.10 +/- 10.25)%, (5.59 +/- 2.62)%, respectively, P < 0.05]. However, a significant difference in the proportion of CD(4)(+)CD(25)(bright)/CD(4)(+) between decidua and peripheral blood was not found in URSA patients [(5.16 +/- 2.83)%, (4.64 +/- 2.07)%, respectively, P > 0.05)].

CONCLUSIONS

The number of CD(4)(+)CD(25)(+) Tr cells is increased in normal pregnancy and decreased in URSA. Therefore, CD(4)(+)CD(25)(+) Tr cells may play an important role in maintaining maternal-fetal tolerance and may be involved in the pathogenesis of URSA.

[Effect of laparoscopic surgery on the immune function of patients with endometriosis]

OBJECTIVE

To investigate the effect of laparoscopic surgery on the immune function of patients with endometriosis.

METHOD

Blood samples were obtained from 36 patients undergoing laparoscopy for endometriosis before and 1 day and 3 days after the operation. Peripheral blood T-cell subsets CD3, CD4, and CD8 were determined with flow cytometry, the levels of IgM, IgG, IgA, Complement (C)3, C4, C-reactive protein and (CRP) were detected with turbidimetry, and the levels of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were measured with enzyme linked immunosorbent assay (ELISA).

RESULTS

No significant variation were found in the T-cell subsets, IgM, IgA, C4 after the operation (P>0.05). The levels of IgG and C3 1 day after the operation were significantly lower than the preoperative levels (P<0.05) and nearly recovered the preoperative level 3 days after operation. Serum concentration of IL-6, TNF-alpha, and CRP 1 day after the operation were significantly higher than the preoperative levels (P<0.01) and decreased 3 days after the operation.

CONCLUSIONS

The immune function of patients with endometriosis is mildly affected by laparoscopic surgery and recover rapidly, which may be one of the reasons for quick recovery of patients after laparoscopy for endometriosis.

[The prophylactic effect of thymosin alpha 1 on the acute exacerbation of chronic obstructive pulmonary disease]

OBJECTIVES

To investigate the prophylactic effect of thymosin alpha 1 and its mechanism on patients with chronic obstructive pulmonary disease.

METHODS

Eighty patients with chronic obstructive pulmonary disease were divided into two groups. In the treatment group, 42 patients received thymosin alpha 1 1.6 mg hypodermic injection, quague die alterna, for 10 times. All patients were followed for 6 months, and were assessed the number and days of patients with acute exacerbation at 3 and 6 months. In two groups, before treatment and 3 and 6 months after treatment, the pulmonary function tests were measured, and the blood samples were collected for the measurement of the blood IgA, IgG, IgM, CD3, CD4 and CD8 levels.

RESULTS

In the treatment group, the number and days of patients with acute exacerbation were significantly lower in comparison with those of the control group. After treatment of thymosin alpha 1, blood CD4 and CD4/CD8 levels were significantly increased.

CONCLUSION

Thymosin alpha 1 has a good protection for the acute exacerbation of chronic obstructive pulmonary disease, by incresing body cellular immune activity.

[Identification of correlations between numbers of CD4+ CD25+ Treg cells, levels of sera anti-AChR antibodies and transfer growth factor-beta in patients with myasthenia gravis]

OBJECTIVE

The purpose of the current study is to demonstrate possible involvement of CD4+ CD25+ Treg cells and TGF-beta in immune activation in patients with myasthenia gravis (MG). If so, how does CD4+ CD25+ Treg cells and TGF-beta, collaborate to impact on the production of pathogenic anti-AChR antibodies (Ab)?

METHODS

40 MG in-patients with recent onset or deterioration and age and gender-matched 38 healthy subjects were consecutively enrolled. Flow cytometry was employed to detect circulating CD4+ CD25+ Treg cells. Levels of AChR-Abs and TGF-beta1 in serum were detected by radioimmunoassay and enzyme-linked immunoabsorbance assay respectively.

RESULTS

Numbers of CD4+ CD25+ Treg cells were significantly decreased in MG patients (3.0% +/- 2.5%) compared with healthy controls(4.6% +/- 3.7% , P = 0.03). Decreased production of CD4+ CD25+ Treg cells was associated with late-onset, longer-duration, positive-MG sera for AChR-Abs, normal or atrophic thymus, and non-thymectomy treatment et al, respectively. Although CD4+ CD25+ Treg cells were not linear-correlated with serum anti-AChR Ab titers, but were conversely correlated with each other in MG patients without thymoma (non-MGT) (r = -0.37, P = 0.02). Likewise, levels of TGF-beta1 in 31 non-MGT patients (112 ng/L +/- 83 ng/L) were decreased compared with those of healthy subjects (215 ng/L +/- 134 ng/L, P = 0.00), and was conversely correlated with titers of anti-AChR Abs (r = -0.37, P = 0.02). The titer of anti-AChR Abs were correlated with Osserman classification and MGFA grade (r = 0.34, P = 0.03).

CONCLUSION

Numbers of CD4+ CD25+ Treg cells and levels of TGF-beta1 in MG patients were significantly decreased compared with healthy controls, and may thus contribute to the pathogenesis of MG. Numbers of CD4+ CD25+ Treg cells were conversely correlated with levels of anti-AChR Abs in non-MGT patients.

Skewed distribution of proinflammatory CD4+CD28null T cells in rheumatoid arthritis

Expanded populations of CD4+ T cells lacking the co-stimulatory molecule CD28 (CD4+CD28null T cells) have been reported in several inflammatory disorders. In rheumatoid arthritis, increased frequencies of CD4+CD28null T cells in peripheral blood have previously been associated with extra-articular manifestations and human cytomegalovirus (HCMV) infection, but their presence in and contribution to joint manifestations is not clear. In the present article we investigated the distribution of CD4+CD28null T cells in the synovial membrane, synovial fluid and peripheral blood of RA patients, and analysed the association with erosive disease and anti-citrullinated protein antibodies. CD4+CD28null T cells were infrequent in the synovial membrane and synovial fluid, despite significant frequencies in the circulation. Strikingly, the dominant TCR-Vbeta subsets of CD4+CD28null T cells in peripheral blood were often absent in synovial fluid. CD4+CD28null T cells in blood and synovial fluid showed specificity for HCMV antigens, and their presence was clearly associated with HCMV seropositivity but not with anti-citrullinated protein antibodies in the serum or synovial fluid, nor with erosive disease. Together these data imply a primary role for CD4+CD28null T cells in manifestations elsewhere than in the joints of patients with HCMV-seropositive rheumatoid arthritis.