Bumper ball

diagnosis of invasive aspergillosis by tracking aspergillus -specific t cells in hematologic patients with pulmonary infiltrates

by:Powerful Toys     2019-12-26
Use the invasive mold provided (IA)
Is the main cause of infection.
Related mortality rate in patients with Hematology, the mortality rate is between 50-90%.
The reason for this extremely bad result is due to the difficulty of timely and undoubtedly diagnosis, which still depends on a very high level of doubt.
Current diagnostic tools are limited by invasive, slow, relatively insensitive, lack of standardized and unpredictable dynamics.
The most extensive research experiment, Galctomannan antigenemia (GM)
, Proved highly variable in performance, sensitivity between 29 and 100%, and influenced by several factors associated with fungi or hosts.
In addition, DNA was detected by PCR (PCR)
In addition to technical barriers, difficulties in understanding fungal DNA release and dynamics still hold us back.
For all of these reasons, establishing an early diagnosis of IA remains a challenge.
Recent studies have shown that adaptive immunity contributes to host defense species.
In a mouse model of IA, a high level of T helper1 (T1)
Cytokines, while mice with high levels of T helper2 (T2)
Cytokines are associated with disease progression.
In a human clinical setting, a study measured interferon-(IFN-)or interleukin-10 (IL-10)
In the culture medium of peripheral blood single nuclear cells (PBMCs)
Stimulated with antigen showing patients with high interferon/IL-
10 to survive IA.
In addition, the transfer-specific IFN--producing T-cells (IFN--T1)
According to reports, the treatment of IA by bone marrow transplant (alloBMT)patients.
To evaluate whether to enumerate-specific IFN--T1 and -specific IL-10-producing T-cells (IL-10-T2)
Through an enzyme
Immune spots (ELISPOT)
Detection can improve the diagnosis and clinical management of IA, and we report the first clinical application of ELISPOT in 10 patients with blood system with reduced plasma cell line and lung infiltration, including 3 verified IA, and two healthy blood donors.
As Lalvani stated, ELISPOT has conducted a study of frozen peripheral blood samples, which has been approved by our institutional review committee.
All patients agreed to the study.
All patients were treated with 200 mg/B to prevent fungal infection. i. d.
When collecting peripheral blood specimens
Separation from patient PBMCs or healthy subjects with Ficoll-
Gradient centrifuge of Bmmcs (
Linaris, bertingen is the Lord, Germany)
Then at 96-
Polyammonium diammonium-
Bached plate coated with resistanceIFN-or IL-
10 monoclonal antibodies (
Mabtech, nakesterland, Sweden).
Stimulate cells with heat
Inactivated spores prepared from patient isolates, or prepared with water --
Soluble cell extracts of plant toxins.
A total of 1x10 and 2.
5 × 10 vivo cells/holes, cultured in ifn-15and IL-
The 16 u2009 h was measured 10 times respectively.
All test conditions are carried out in triplicate if points-forming cells (SFC)
10 cells in/antigen-
Stimulation wells are twice higher than control Wells (non-antigen-
Stimulating cells)
There are at least 20 attractions.
The analysis was conducted by an author (PB)
X-ray, medical history and personal identification data of blind patients, using automatic ELISPOT counter (AID-
Strasberg Limited, Germany).
Patient 1 is 59-year-
Elderly women with acute leukemia (AML)
, Presenting the ovalar nodules surrounded by fever and opaque aura of ground glass (GG-O)
In the left lung, in the high-
Resolution computed tomography (HRCT)
During the reduction of neutral granules after induction chemotherapy (iCHT)(, 07/01/05).
Culture and molecular examination of blood, urine, feces and lung perfusion (BALf)
Bacterial, fungal, or viral pathogens are repeatedly negative.
Both in serum and in asthma, GM is negative.
Although vancomicine, meronix and livitine B (L-amB)at 3u2009mg/kg/day.
The second high resolution ct showed the expansion of nodule shadow without changing GG-O.
Negative serum GM (, 07/06/05). The L-
The AmB dose was increased to 5 mg/kg/day.
A few days later, the patient returned completely to the blood system and became a barren land.
High resolution ct shows GG-after 1 week-
O and nodules, with cavity and crescent formation of air (, 07/14/05).
The patient received a video.
Auxiliary laparoscopic surgery (VATS)
Resection of pulmonary solid lesions.
IA was found by histological and immune tissue chemistry examination. ()Kinetics of -specific T-
Cell response through interferonand IL-
10 ELISPOT analyses in Patient 1. ()
The chest high resolution ct of Patient 1 showed changes in the radiological signs during the course of pulmonary Qujing. ()Kinetics of -specific T-
Cell response through interferonand IL-
10 ELISPOT analyses of patient 2. ()Kinetics of -specific T-
Cell response through interferonand IL-
10 ELISPOT analyses of patient 3. ()-specific T-
Cell response through interferonand IL-
Ten ELISPOT analyses were performed in 4-10 patients and blood donors.
In blood donors, the control holes of the PHA have more than 500sfc sfc/10 PBMCs.
Dark gray column representation-specific IFN--
Produce T cells
Number of white columns indicated-
Specific il-10-
Produce T cells
Light gray column representing T-
Cell reaction in the PHA hole.
The results show an average of three copiesd.
BD of blood donors;
PHA, plant toxin; SFCs, spot-forming cells;
Single nuclear cell in peripheral blood; IFN-
Interferon gamma; IL-
10. il 10; s. d.
Standard deviation.
Patient 2 is 67-year-
In elderly women, there was a decrease in neutral cell lines, fever and bilateral lung infiltration after iCHT in AML.
Culture and molecular examination of blood, urine, feces and asthma were negative for bacterial, fungal or viral pathogens. Second-
Line-experience antibiotic therapy results in resolution of all lung infiltration except one, as detected by high resolution ct, lung infiltration expands in the upper right lobe.
Repeated complete Culture and molecular examination of blood, urine, feces and asthma are still negative for pathogens.
The serum GM antigen was negative, and the asthma was positive. L-
AmB starts at 3 mg/kg/day.
Bone marrow of patients (2)
Increasing levels of interferon-
T1, regression needs to be achieved in all three patients; (3)
Continuous level of IL-10-
T2, this may have an offset effect on the increasing level of interferon-
T1 to avoid excessive inflammatory response in Patient 1, Patient 3, and patient 2, similar to what was observed in a mouse model; and (4)
Persistence of interferon-
T1 response patients 2 months after 3 lesions were removed, indicating a protective immune recovery similar to what was observed in healthy subjects ().
In patient 2, the recurrence of leukemia may hinder the long-term
Sustained growth of interferon-
Maintenance of T1 and specific T-cell response ().
In addition, in patients 1 and 2, the dynamics of ELISPOT appeared to be closely related to changes in the radiological signs in IA: a preliminary increase in the size of lung lesions associated with high levels of IL-10-
T2 followed by stability and gradually reduced the size of lung lesions associated with increased interferon-T1 level ().
Patient 2 delayed occurrence of radiation signs with reduced lung lesions (not shown)
May be associated with delayed elevation of interferon compared to patient 1-
T1 in front ().
By expanding previous findings, this analysis may represent the understanding of interferon--T1/IL-10-
At each point in time in IA, T2 is dynamically tilted at high-risk patients.
Custom message
Chat Online 编辑模式下无法使用
Chat Online inputting...