An imbalance in T-helper cell subsets alters immune response after cardiac surgery.
An imbalance in T-helper cell subsets alters immune response after cardiac surgery.
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T 辅助细胞亚群的不平衡会改变心脏手术后的免疫反应。
DOI：
10.1016/s1010-7940(96)80267-3
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发表时间：
1996
期刊：
影响因子：
--
通讯作者：
B. Reichart
中科院分区：
文献类型：
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作者：
A. Markewitz;E. Faist;S. Lang;L. Hültner;C. Weinhold;B. Reichart
越来越多的证据表明，体外循环(CPB)心脏手术后细胞免疫功能发生改变。这项前瞻性随机研究的目的是调查(1)T辅助细胞(TH)亚群，即TH1/TH2的失衡是否可能导致这些变化，以及(2)它们是否可以被抵消。A组20例为对照组，B组20例应用消炎痛和胸腺五肽进行免疫调节。体外试验包括测量TH、IL-2作为主要由TH1细胞产生的细胞因子，以及IL-6作为主要由TH2产生的细胞因子。用迟发型变态反应(DTH)皮肤反应和特异性抗体(AB)产生分别作为TH1和TH2诱导的免疫反应的体内试验。术后，A组患者TH、IL-2合成和DTH皮肤反应较基础值持续显著降低，而IL-6合成无改变，AB产生增加(P<；0.05)。B组患者TH、IL-2、IL-6合成及DTH皮肤反应均未见明显变化(P<；0.05 vs A)。B组术后AB产生显著增加。这些结果表明CPB后TH1诱导的细胞免疫反应受到显著抑制，而TH2诱导的反应保持正常。通过清除体外循环的副产物，正常的TH2反应可能有助于心脏手术后的恢复。每当术后感染需要抑制TH1反应时，抑制TH1反应可能具有临床意义，但可以通过吲哚美辛和胸腺五肽的免疫调节干预有效地抵消。
Growing evidence indicates that cell-mediated immunity is altered after cardiac surgery with cardiopulmonary bypass (CPB). The objective of this prospective randomized study was to investigate (1) if an imbalance in T-helper cell (TH) subsets, i.e. TH1/TH2, may be responsible for these alterations and (2) if they can be counteracted. Twenty patients formed control group A. Twenty group B patients received indomethacin and thymopentin for immunomodulation. In vitro tests included measurements of TH, interleukin (IL)-2 as a cytokine primarily produced by TH1 cells, and IL-6 as a cytokine primarily produced by TH2. Delayed-type hypersensitivity (DTH) skin response and specific antibody (AB) production were used as in vivo tests for TH1- and TH2-induced immune response, respectively. Postoperatively, group A patients showed a persistent, significant reduction of TH, IL-2 synthesis and DTH skin response as compared to baseline values, while IL-6 synthesis remained unaltered and AB production increased (P < 0.05). In group B patients no change in TH, IL-2 and IL-6 synthesis, or DTH skin response was observed (P < 0.05 vs A). Postoperative AB production increased significantly in group B. These results indicate a significant suppression of TH1-induced cell-mediated immune response following CPB, while TH2-induced response remains normal. A normal TH2 response may be helpful for recovery following cardiac surgery by cleaning the body of the byproducts of CPB. A suppression of TH1 response may gain clinical significance whenever a postoperative infection requires this response, but can be effectively counteracted by immunomodulatory intervention with indomethacin and thymopentin.
胸腺五肽在严重烧伤患者中的前瞻性研究。
DOI：
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发表时间：
1987
期刊：
Surgery, gynecology & obstetrics
影响因子：
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作者：
Waymack,JP;Jenkins,M;Warden,GD;Solomkin,J;LawJr,E;Hummel,R;Miller,A;Alexander,JW
通讯作者：
Alexander,JW
功能性 CD4 T 细胞亚群在完整的免疫系统中相互作用。
DOI：
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发表时间：
1993
期刊：
Journal of immunology (Baltimore, Md. : 1950)
影响因子：
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作者：
Murray,JS;Madri,J;Pasqualini,T;Bottomly,K
通讯作者：
Bottomly,K
严重受伤患者单核细胞前列腺素 E2 产生改变的机制。
DOI：
10.1001/archsurg.1988.01400270027003
发表时间：
1988
期刊：
Archives of surgery (Chicago, Ill. : 1960)
影响因子：
--
作者：
Miller-Graziano,CL;Fink,M;Wu,JY;Szabo,G;Kodys,K
通讯作者：
Kodys,K