Studies on the mechanisms of delayed type hypersensitivity and anergy.

1.本文研究了白细胞促凝活性（LPCA），以确定其在体外评价细胞免疫的临床意义，并阐明其效应机制。LPCA是由纯化蛋白衍生物（PPD）和水痘病毒抗原（VVA）特异性刺激的，似乎是一种有用的体外评价迟发型超敏反应（DTH）的检测方法。关于LPCA的效应机制，PPD刺激的T细胞的LPCA与外周血单个核细胞的LPCA相比显著降低。2.对麻疹、肺炎支原体、链球菌病和川崎病的DTH和LPCA进行了临床研究，发现麻疹和肺炎支原体的PPD LPCA均降低。VVA法测得的LPCA在肺炎支原体中显著降低，但在麻疹中不显著。提示麻疹和肺炎支原体引起的免疫力低下机制不同。川崎病患者PPD的LPCA也明显降低。3.川崎病患者采用化学发光法（CL）测定中性粒细胞活性氧的产生。所有患者入院时活性氧生成量均显著高于健康对照组，冠状动脉病变组的CL显著高于无冠状动脉病变组。在超声心动图检测到冠状动脉病变之前，可以发现这些活性氧的产生显著增加。因此，中性粒细胞CL的测量对于预测川崎冠状动脉病变的形成是有用的。炎症与迟发性过敏反应的关系有待进一步研究。

1.Leukocyte procoagulant activity (LPCA) was studied in order to determine the clinical usefulness of evaluating cell-mediated immunity in vitro and also clarify what the effector mechanims were.LPCA was stimulated by purified protein derivative(PPD) and varicella virus antigen(VVA) specifically and seemed to be a useful assay method for evaluating the delayed-type hypersensitivity(DTH) in vitro. Concerning the effector mechanisms of LPCA,LPCA of T cells stimulated by PPD decreased significantly compared to the LPCA of peripheral mononuclear cells. On the other hand,a significant increase of LPCA by VVA was found in both the T cells and the monocytes.It is suggested that PPD and VVA have different pathways as efferctor mechanisms.2.DTH and LPCA were studied clinically on measles,mycoplasma pneumoniae,streptococcosis and Kawasaki disease.LPCA by PPD was decreased in both measles and mycoplasma pneumoniae. LPCA by VVA was decreased significantly in mycoplasma pneumoniae,but not in measles. It is suggested that the mechanisms of anergy in measles and mycoplasma pneumoniae are different. LPCA by PPD was also decreased in Kawasaki disease.3.As for Kawasaki disease,the production of active oxygen of neutrophils was measured by chemiluminescence(CL). The generation of active oxygen was significantly increased on admission in all patients compared with those in healthy controls.The CL of the patients with coronary lesions had higher production than in the patients without coronary lesions. These significant increase in generation of active oxygen could be found before the detection of coronary lesions by echocardiography. Thus the measurement of neutrophils CL is useful for predicting the formation of coronary lesions in Kawasaki disease. Further studies are necessary to clarify the relationship between the inflammation and DTH.