Reseach progress for ECDI-modified autoantigen peptides being used in autoimmune disease / 中国免疫学杂志

Ethylene carbodiimide (ECDI) is a chemical coupling agent,more and more studies have focused on the immune tolerance induced by administration of ethylene carbodiimide (ECDI)-fixed syngeneic splenocytes (Ag-SPs) coupled to peptides or to whole myelin proteins,in order to establish a novel and effective tolerance therapy for autoimmune diseases.The mechanisms and applications of immune tolerance induced by Ag-SPs in several kinds of common autoimmune diseases were summarized,and were compared with their counterparts in the traditional treatment.

Clinical observation on long-term surviving patients after combined abdominal organ transplantation / 中华外科杂志

<p><b>OBJECTIVE</b>To summarize the treatment experience of long-term surviving patients after combined abdominal organ transplantation.</p><p><b>METHODS</b>From October 2001 to January 2005, 19 patients received combined abdominal organ transplantation in Nanfang Hospital, including 6 with simultaneous kidney-pancreas transplantation (SKPT), 12 with combined liver-kidney transplantation (CLKT), and 1 with simultaneous liver-pancreas transplantation (SLPT). The periods of follow up were from 6 months to 3 years and 8 months. Summarize primary diseases of the patients, factors which impacted on patients long-term survival rate, and immunological characteristics of combined abdominal organ transplantation.</p><p><b>RESULTS</b>All of 19 transplant cases were performed successfully. Among then, 18 were followed up; 16 survived till now; 2 patients undergoing liver-kidney transplantation were dead, one of which died from myocardial infarction in the 18 months after operation, and one died from cytomegalovirus in infection of lung in 13 months; 1 liver-kidney transplantation patient and 2 pancreas-liver transplantation patients experienced acute rejection once; 2 patients were found nephrotoxicity. Among the 18 patients, 4 patients' survival time were over 3 years, 7 over 2 years, 6 over 1 year, 1 over 10 months.</p><p><b>CONCLUSIONS</b>Combined abdominal organ transplantation is effective for treatment of two abdominal organ failure diseases. Factors which impact on patients long-term surviving include choosing suitable recipient, high quality of donated organ, avoidance of surgical complication, the history of myocardial infarction before operation, immunosuppressive regime and virus infection late after transplantation. Combined abdominal organ transplantation has some different immunological characteristics from single organ transplantation.</p>

Three- and two-color flow cytometry for immunologic surveillance of toll-like receptor 4 after renal transplantation / 南方医科大学学报

<p><b>OBJECTIVE</b>To compare the characteristics of three- and two-color flow cytometry for immunologic surveillance of toll-like receptor 4 (TLR-4) after renal transplantation.</p><p><b>METHOD</b>The expressions of CD14, TLR4 and CD80 in peripheral blood monocytes were measured in 10 patients after renal transplantation by three- and two-color fluorescent staining flow cytometry, respectively. The percentages of TLR4 and CD80 in CD14-positive monocytes were calculated, and the characteristics of two methods of flow cytometry were compared.</p><p><b>RESULTS</b>The two detection methods did not significantly differ in their detection of TLR4 (P=0.198) and CD80 (P=0.872) expressions in CD14-positive monocytes, and the measurements of the two methods for the same sample showed positive correlation (r=1, P=0.000 for TLR4 and r=0.999, P=0.000 for CD80). Three-color flow cytometry was also capable of detecting monocytes positive for both TLR4 and CD80. Compared with two-color flow cytometry, three-color flow cytometry provided more information and required less blood sample and monoclonal antibody.</p><p><b>CONCLUSIONS</b>Three- and two-color flow cytometry have almost the same accuracy in immunologic surveillance of TLR4 after renal transplantation. The former method also provides information of the simultaneous expression of TLR4 and its down stream molecule CD80, which could be critical for imploring the mechanisms by which TLR4 takes part in alloimmunity through modulating CD80 expression, and requires less blood sample and monoclonal antibody.</p>

The determination of serum soluble CD14 in patients early after renal transplantation / 中华泌尿外科杂志

Objective To investigate the levels of serum soluble CDI4(sCD14)in patients early after renal transplantation and the relationship between sCD14 and allograft rejection.Methods This se- ries included 51 consecutive patients undergoing renal transplantation.We prospectively determined levels of serum sCD14 at 1 h before transplantation(d 0)and the first 10 d after transplantation(d 1-10).The ser- um creatinine(Cr)levels were recorded at the same time.The patients were divided into 2 groups(rejection and non-rejection groups)according to whether they experienced acute rejection or not during the first 14 d after transplantation.The levels of serum sCD14 and Cr between the 2 groups were compared.Results Of 51 cases,13 experienced acute rejection,and the mean time from postoperation to rejection start was 7 d;38 cases had no rejection.On d 0,the Cr levels of rejection group[(789?221)?mol/L]and non-rejection group[(742?234)?mol/L]had no significant difference(P＞0.05).The Cr level was higher in rejection group than in non-rejection group on d 1-10.In the 2 groups,the Cr levels of d 3 and d 5 to d 10 were (237?104)vs(160?70),(176?85)vs(117?46),(174?81)vs(112?40),(173?81)vs(112?39),(209?53)vs(112?38),(203?73)vs(103?35),(181?50)vs(102?31)?mol/L,respective- ly,with significant difference between them(P＜0.05).The serum sCD14 levels on d 0 in rejection group [(9.55?5.71)mg/L]and non-rejection group[(8.99?3.89)mg/L]had no significant difference.The sCD14 levels were higher in rejection group than in non-rejection group on d 1-5[(15.52?6.60)vs (9.85?4.11),(15.48?5.85)vs(7.53?3.79),(12.15?4.45)vs(5.88?3.95),(10.84?4.11) vs(4.88?3.17),(7.61?5.37)vs(4.66?1.91)mg/L,respectively]with significant difference(P＜0.05).The sCD14 levels in the 2 groups on d 1 were elevated compared with those on d 0,then decreased gradually.Conclusions It is suggest that the increase in serum sCD14 levels occurs earlier than clinically acute rejection.The serum sCD14 levels on d 1-5 after transplantation can serve as important predictors for acute renal graft rejection.

Clinical observation on long-term survival in patients after simultaneous kidney-pancreas transplantation(report of 6 cases) / 中华泌尿外科杂志

Objective To summarize the experience of long-term survival in patients after simulta- neous kidney-pancreas transplantation(SKPT)with modified enteric drainage(ED).Methods From October 2001 to July 2004,6 patients with end-stage renal disease due to Type 1 diabetes underwent SKPT with modified ED,ie,side-to-side anastomosis between the duodenum of donors and jejunum of recipients. The medication regimen included:mycophenolic acid 500 mg and tacrolimus 2 mg before operation;methyl- prednisolone(MP)1.0 during operation;and 2-dose anti-IL-2 receptor monoclonal antibody(2 cases)or antihuman thymocyte globulin(ATG)(4 cases)for immune induction therapy;MP was used on the first 3 d after transplantation,triple immunosuppressive therapy(tacrotimus,mycophenolic acid and prednisone)was used on the second d after transplantation.Anticoagulants such as low molecular heparin or alprostadil were used for 7-10 d to prevent thrombosis in pancreas graft.Somatostatin was used as prophylaxis for graft pan- creatitis.Ganciclovir was used to prevent cytomegalovirus infection when renal graft gradually recovered 3 to 5 d after transplantation.The follow-up was from 1 year and 3 months to 4 years and 1 month.Results Transplantation was successful in all 6 cases.The blood sugar levels were 6-16 mmol/L.Low-dose insulin was used for 5-10 d,then the blood sugar levels returned to normal range.One of 6 patients experienced nephrotoxicity because of high tacrolimus blood concentration at 7 d after operation;after 3 dialyses and re- duction of tacrolimus dose,the renal allograft regained normal function.Three cases experienced alimentary tract hemorrhage at 14,20 and 22 d,respectively,after operation;the bleeding was stopped after treatment. There were no complications such as pancreatic fistula,intestinal fistula and thrombosis early after operation. All the patients are now alive,specifically,1 survived over 4 years,3 over 3 years,1 over 2 years,and 1 over 1 year.All had normal blood sugar free of insulin use.Five cases had normal renal graft function,with normal sCr,and 1 had sCr＞400?mol/L. Two cases were admitted to hospital due to upper respiratory infection and furuncles in the skin of head 6 months and 2 years,respectively,after operation.They were both cured.No complications such as urinary infection,metabolic acidosis and dehydration occurred.Conclusions SKPT is effective for the treatment of end-stage renal disease due to Type 1 diabetes.SKPT with modified ED are relatively simple with physiological compatibility and fewer complications.High quality of donated organs, HLA matching,pancreatic drainage pattern,rational periopcrative medications and infection late after trans- plantation are important factors affecting the long-term survival of the patients.