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目的 探讨严重急性呼吸综合征 (SARS)肺脏的免疫反应类型和状况 ,及免疫器官淋巴细胞亚群的数量变化。方法 采用免疫组织化学方法 ,以CD3、CD4、CD8、CD2 0、CD5 7、CD68、S 10 0、HLA DR单克隆抗体 ,对 1例重型SARS的肺组织及免疫器官中多种淋巴细胞亚群进行标记 ,并以健康人体脾脏及淋巴结作对照 ,观察分析各淋巴亚群的分布及数量变化。结果 该例重型SARS病例肺间质中主要以CD8+淋巴细胞浸润为主 ,杂以少数CD4+淋巴细胞。淋巴细胞亚群半定量分析显示 ,3 1枚胸腔淋巴结中 ,CD3 +、CD4+、CD8+和CD2 0 +细胞数减少的淋巴结百分率分别为 74.2 %、67.7%、74.2 %、83 .9% ,其中各淋巴细胞亚群明显减少者比例较高 ,腹腔淋巴结中各淋巴细胞亚群减少较轻 ;脾脏中CD3 +、CD4+、CD8+、CD2 0 +细胞均呈不同程度的减少 ,其中以CD2 0 +细胞数目减少最为显著 ;而淋巴结及脾脏中CD5 7+、CD68+、S 10 0 +、HLA DR+细胞数目呈相对增加改变。结论 结果提示SARS肺组织原位以细胞免疫反应为主 ,推测肺脏内细胞免疫反应可能具有清除受感染细胞内冠状病毒病原体和诱发肺组织免疫损伤的双重作用 ;疾病后期重型SARS病例免疫器官可能存在淋巴细胞亚群的不同程度减少及比例失衡 ,并呈围病变肺组织愈近 ,淋巴结内主要淋巴细胞?
Objective To investigate the types and status of immune response in lungs of severe acute respiratory syndrome (SARS) and the changes of lymphocyte subsets in immune organs. Methods Immunohistochemistry was used to detect the expression of various lymphocyte subsets in lung tissues and immune organs of a severe SARS patients by using monoclonal antibodies against CD3, CD4, CD8, CD20, CD5 7, CD68, S 10 0 and HLA DR. Marked, and the healthy human spleens and lymph nodes as a control, observed and analyzed the distribution and number of each lymphoid subpopulations. Results The cases of severe SARS cases in the lung stromal mainly CD8 lymphocyte infiltration, mixed with a small number of CD4 lymphocytes. Semi-quantitative analysis of lymphocyte subsets showed that the percentage of lymph nodes with reduced numbers of CD3 +, CD4 +, CD8 + and CD20 + in 31 pleural lymph nodes were 74.2%, 67.7%, 74.2% and 83.9%, respectively The percentage of CD3 +, CD4 +, CD8 +, CD20 + cells in the spleen decreased to a certain extent, and the number of CD20 + cells While the number of CD5 7 +, CD68 +, S 10 0+ and HLA DR + cells in lymph node and spleen showed a relative increase change. Conclusions The results suggest that the cellular immune response in lungs of SARS is predominant in situ. It is speculated that the cellular immune response in the lung may have the dual role of clearing coronavirus and immune-induced lung injury in infected cells. The immune organs may be present in SARS patients in later stage of disease Different degrees of lymphocyte subpopulations decreased and the proportion of imbalance, and the lesion becomes more and more close to the lung tissue, lymph nodes within the main lymphocytes?