[Effect of Xuebijing injection on T helper 17 and CD4+ CD25+ regulatory T cells in patients with sepsis].

OBJECTIVE: To study the level and significance of T helper 17 (Th17) and CD4(+) CD25(+) regulatory T cells (Treg) in peripheral blood of patients with sepsis and to evaluate the effects of Xuebijing injection on them. METHODS: ¹ Sixty-four patients with sepsis in intensive care unit (ICU) of Anhui Provincial Hospital were divided into three groups: sepsis group (n=26), severe sepsis group (n=21), and septic shock group (n=17). Eighteen healthy individuals served as controls. The comparison in the expression of Th17 and CD4(+)CD25(+) Treg within groups and the correlation between their levels and the severity of sepsis was made. ² Sixty-four patients were also randomly divided into two groups: routine group (n=25, received routine bundle treatment) and Xuebijing treatment group (n=39, received bundle treatment + Xuebijing treatment). Patients in Xuebijing treated group were given 50 ml Xuebijing injection two times per day in addition to routine bundle treatment. Seven days constituted one course of treatment. The expressions of Th17 and CD4(+) CD25(+) Treg of 64 patients on the 1 day and 7 days after treatment were detected by flow cytometry. The effects of Xuebijing injection on the patients were evaluated. RESULTS: ¹ The expression rate of Th17 and CD4(+)CD25(+) Treg was (0.84 ± 0.29)% and (0.43 ± 0.20)% respectively in control group, and they were lower than that of patients with sepsis (P<0.05). The expression rate of Th17 was higher in severe sepsis group [(3.18 ± 0.84)%] than that of other two groups (P <0.05). Moreover , The expression rate of CD4(+)CD25(+) Treg was highest [(3.28 ± 0.76)%] in septic shock group (P<0.05) , and it was positive correlated with acute physiology and chronic health evaluation II (APACHEII) score and blood lactate (r(1)=0.519, r(2)=0.451, both P =0.01) in all 64 patients. ² Compared with routine group, our study indicated that Xuebijing injection could reduce the abnormal expression of Th17 [(1.72 ± 0.69)% vs. (2.35 ± 0.81)%,P<0.05] and CD4(+)CD25(+) Treg [(1.78 ± 1.00)% vs. (2.30 ± 0.85)%,P<0.05] and decrease length of stay in ICU [(4.7 ± 2.6) days vs. (7.5 ± 4.3) days,P=0.002]. It also lowered 28-day mortality of patients with sepsis, but the difference between two groups was not significant (20.5% vs. 28.0%,P>0.05). CONCLUSION: The expression of Th17 and CD4(+)CD25(+) Treg was increased in sepsis patients and was positively correlated with severity of sepsis, suggesting that they may play an important role in pathogenesis of sepsis. Xuebijing injection could decrease the abnormal expression of Th17 and CD4(+) CD25(+) Treg and tend to decrease the fatality rate of sepsis.

[Effects of hyperbaric oxygen on T lymphocyte subpopulation and its electron microscopic changes in rats with acute pancreatitis].

OBJECTIVE: To investigate the effect of hyperbaric oxygen (HBO) therapy on T lymphocyte subpopulations in rats with acute pancreatitis (AP). METHODS: According to random number table, 56 Sprague Dawley (SD) rats were divided into three groups: the sham group, model group, and HBO therapy group. The rats of model and HBO groups underwent pancreatic duct ligation to induce pancreatitis, then they were divided into three subgroups of 8 rats each. The HBO group was treated with a daily exposure to HBO [2.5 atm (1 atm=101.325 kPa)]. The rats in each subgroup were euthanased on days 1, 3, 7, and the subpopulations of T lymphocytes in peripheral blood were detected respectively using flow cytometry. The nuclei, mitochondrion, rough and smooth endoplasmic reticulum of the pancreatic cells were examined using electron microscopy. RESULTS: The serum level of amylase on day 1 in model and HBO groups was significantly lower than that in sham group. In the model group the CD4(+)CD8(+) cells and the CD4(+)/CD8(+) ratio in AP rats was significantly decreased, indicating the presence of immune suppression. After 7 days of HBO therapy, compared with the model group, the CD4(+) lymphocytes in the HBO group were markedly increased on day 3 and day 7 [(27.92±2.10)% vs. (20.79±2.80)%, (26.58±4.50)% vs. (17.76±4.40)%]. The number of CD8(+) lymphocytes were also increased to a certain extent on day 7 [(25.32±3.70)% vs. (22.46±3.10)%]. The CD4(+)/CD8(+) ratio was obviously increased on day 3 and day 7 (1.07±0.14 vs. 0.86±0.15, 1.04±0.11 vs. 0.79±0.12, P<0.05 or P <0.01). Also beneficial effects as evaluated on the nuclei, mitochondrion, rough and smooth endoplasmic reticulum were found in the HBO group (10.8±1.6 vs. 17.9±1.7, 22.1±1.6 vs. 27.5±1.3, 16.8±1.0 vs. 29.3±0.8, 21.2±1.4 vs. 28.7±1.2, all P <0.01). CONCLUSION: This study shows that 7-day HBO therapy can promote a more balanced profile of T lymphocyte subpopulations, resulting in improvement of cellular immune function, and it can ameliorate pathological changes as shown by electron microscopic examination.

[Effects of hyperbaric oxygen on the acute lung injury induced by oleic acid in rats].

OBJECTIVE: To explore the effect of hyperbaric oxygen (HBO) on acute lung injury (ALI) induced by oleic acid (OA) in rats. METHODS: Eighty healthy Sprague-Dawley (SD) rats were randomly divided into four groups. In OA group (n=30), ALI was produced by injection of OA 0.15 ml/kg through tail vein. Ten rats were randomly selected and sacrificed after injection of OA at the time of 4 hours, 3 days, and 7 days, respectively. In OA plus HBO group (n=20), rats received HBO intervention in a special box with oxygen of 2.5 atm (1 atm=101.325 kPa) for 90 minutes. Ten rats were randomly respectively sacrificed at 3 days and 7 days. In simple HBO group, 20 rats were sacrificed at 3 days and 7 days of HBO intervention, respectively. Other 10 rats were assigned as control group. Blood, lung specimens were collected after sacrifice. Serum contents of tumor necrosis factor-alpha (TNF-alpha), interleukin-1 beta (IL-1 beta) and IL-6 were measured. Gross changes and pathological findings of the left lung were recorded. The wet to the dry weigh (W/D) of the right lung was determined. RESULTS: Partial pressure of oxygen in arterial blood (PaO2, mm Hg, 1 mm Hg=0.133 kPa) fell from 107.70+/-5.37 to 57.40+/-2.63 in OA group. Congestion, bleeding and edema could be seen grossly. They could also be found under microscope with disappearance of normal structure, and accumulation of fluid in interstitium with inflammatory cell infiltration and hyaline membrane formation were also found. Lung W/D ratio was increased as compared with the control group (6.94+/-0.44 vs. 4.59+/-0.44, P<0.05). A marked increase was found in serum TNF-alpha, IL-1 beta, IL-6 levels [TNF-alpha (microg/L): 18.52+/-1.20 vs. 5.27+/-0.61, IL-1 beta (microg/L): 13.73+/-1.37 vs. 6.13+/-1.51, IL-6 (microg/L): 14.51+/-1.21 vs. 11.14+/-0.89]. After HBO therapy for 3 days and 7 days, PaO2 (mm Hg, 3 days: 79.20+/-1.68 vs. 59.00+/-2.70, 7 days: 94.30+/-3.77 vs. 74.00+/-3.85) and lung W/D (3 day: 7.43+/-0.73 vs. 9.82+/-0.99, 7 days : 6.75+/-1.14 vs. 8.77+/-1.60) of HBO group were ameliorated to varying degrees compared with OA model group (P<0.05 or P<0.01). HBO therapy for 3 days could lower levels of IL-1 beta (microg/L) in the serum (6.46+/-1.99 vs. 9.09+/-1.09, P<0.05). CONCLUSION: It is suggested that HBO treatment for ALI in rats had effects of improving arterial blood gases and the lung water transport, and inhibiting inflammatory mediators production.