Changes of Thl/Th2 balance and serum cytokine levels in critically ill patients.

危重症患者Thl/Th2平衡及血清细胞因子水平的变化

• 批准号: 12671166
• 负责人: URA Hideki
• 金额: $ 1.34万
• 依托单位: Sapporo Medical University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (C)
• 财政年份: 2000
• 资助国家: 日本
• 起止时间: 2000 至 2001
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-12671166/
• 关键词: Bodily insult; Cellular immunity; Thl; Th2 balance; T-lymphocyte; Monocyte; Cytokine; Intracellular cytokine staining; omega-3 fattv acid; 感染症

OBJECTIVE : To analysis on changes of cellular immune functions and serum cytokine levels for several bodily insults.RESEARCH 1 : Patients who underwent surgery for gastrointestinal malignancies were divided into two groups, with or without postoperative infection. In the preoperative state, the proportions of IFN-y -producing CD4^+ T (Th l) cells, which were detected by intracellular cytokine stainings using flow cytometry, were almost equal in the two groups, and the proportion decreased on POD 1 in both groups. On POD 7, the proportion of Thl cells recovered to the preoperative level in the non-infection group, while the suppression was further reinforced in the infection group. In contrast, the proportion of IL-4-producing CD4^+ T (Th2) cells showed little change through the course in both groups. Changes of HLA-DR and CD16 expression on monocytes were similar to those of the proportion of Thl cells. There were no differences on changes of serum cytokine levels between the two grou … More ps.RESEARCH 2 : Patients with sepsis were allocated into two groups : group 1, those who received an omega-3 fatty acids-enriched enteral diet ; group 2, those who received a conventional enteral diet. Peripheral blood samples were collected from each patient on days 1, 4, and 8 of feeding. Serum concentrations of CRP and IL-6 gradually decreased as time passed in both groups, and there was no difference in their concentrations between the two groups. The proportion of Th2 subset in CD4^+ T cells was almost unchanged through the course in both groups. In contrast, the proportion of Thl subset in group 1 patients significantly increased on day 8 comparing with that on day 1, while that in group 2 patients showed little. HLA-DR expression on monocytes was also significantly increased in group 1, whereas only a slight increase was found in group 2.CONCLUSIONS : These results suggest that bodily insults quickly induce the suppression of Thl cell functions, which may correlate with the occurrence of infection, and that omega-3 fatty acid-enriched enteral nutrition may be beneficial to activate cellular immunity for critically ill patients. Less

目的：分析几种机体损伤对机体细胞免疫功能和血清细胞因子水平的影响。研究一：将胃肠道恶性肿瘤手术患者分为术后感染组和术后无感染组。在术前状态下，使用流式细胞术通过细胞内细胞因子染色检测的产生IFN-γ的CD 4 ^+ T（Th 1）细胞的比例在两组中几乎相等，并且在POD 1时两组中的比例下降。术后第7天，非感染组Th 1细胞比例恢复到术前水平，而感染组Th 1细胞比例进一步受到抑制。相反，两组中产生IL-4的CD 4 ^+ T（Th 2）细胞的比例在整个过程中几乎没有变化。单核细胞表面HLA-DR和CD 16表达的变化与Th 1细胞比例的变化相似。两格鲁血清细胞因子水平变化无显著性差异， ...更多信息 ps.研究2：脓毒症患者分为两组：第1组，接受富含omega-3脂肪酸的肠内饮食的患者;第2组，接受常规肠内饮食的患者。在喂养的第1、4和8天从每名患者收集外周血样品。两组患者血清CRP和IL-6浓度均随时间推移逐渐下降，两组间无差异。两组患者的Th 2亚群在CD 4 ^+ T细胞中的比例在整个病程中几乎没有变化。第1组患者Th 1亚群比例在第8天较第1天明显升高，而第2组患者Th 1亚群比例在第8天较第1天无明显变化。结论：机体损伤可迅速抑制Th 1细胞功能，这可能与感染的发生有关，富含omega-3脂肪酸的肠内营养可能有助于激活危重患者的细胞免疫功能。少

项目成果

巽 博臣, 平田公一. 浦 英樹: "臓器不全の発症機序"現代医療. 33(S4). 2813-2818 (2001)

Hiroomi Tatsumi，Koichi Hirata：“器官衰竭的发病机制”现代医学33（S4）。

浦 英樹, 平田公一, 巽 博臣, 山口浩司, 他4名: "ω-3系脂肪酸による細胞性免疫能の賦活効果に関する検討"日本外科代謝栄養学会雑誌. (in press). (2002)

Hideki Ura、Koichi Hirata、Hiroomi Tatsumi、Koji Yamaguchi 等 4 人：“ω-3 脂肪酸对细胞免疫的激活作用的研究”日本外科代谢与营养学会杂志（2002 年出版）。 ）

Tatsumi H, Ura H, Hirata K, Ikeda S, Yamaguchi K, et al.: "Surgical influence on Th1/Th2 balance and monocyte surface antigen expression and its relation to infectious complications"World Journal of Surgery. (in press).

Tatsumi H、Ura H、Hirata K、Ikeda S、Yamaguchi K 等人：“手术对 Th1/Th2 平衡和单核细胞表面抗原表达的影响及其与感染并发症的关系”《世界外科杂志》。

Ura H, Hirata K, Tatsumi H, Yamaguchi K, Katsuramaki T, Mukaiya M, Nara S, Asai Y.: "Immunomodulatory effects of omega-3 fatty acids in septic patients."Jpn J Surg Metab Nutri. 36. 11-18 (2002)

Ura H、Hirata K、Tatsumi H、Yamaguchi K、Katsuramaki T、Mukaiya M、Nara S、Asai Y.：“omega-3 脂肪酸对脓毒症患者的免疫调节作用。”Jpn J Surg Metab Nutri。

浦 英樹, 平田公一, 巽 博臣, 山口浩司, 他4名: "ω-3系脂肪酸による細胞性免疫能の賦活効果に関する検討"外科と代謝・栄養. 36(1). 11-18 (2002)

Hideki Ura、Koichi Hirata、Hiroomi Tatsumi、Koji Yamaguchi 等 4 人：“ω-3 脂肪酸对细胞免疫的激活作用的研究”《外科、代谢和营养》36(1) 11-18 (2002)。