The CD4 slope can be a predictor of immunologic recovery in advanced HIV patients: a case-control study

김계형,이종윤,이선희 대한내과학회 2015 The Korean Journal of Internal Medicine Vol.30 No.5

Background/Aims: Advanced human immunodef iciency virus (HIV) infection, despite sustained viral suppression by highly active antiretroviral therapy (HAART), is a risk factor for poor immunologic recovery. However, some patients with advanced infection do show immunologic recovery. In this study, predictive factors of immunologic recovery were analyzed in advanced HIV patients showing sustained viral suppression. Methods: A case-control study was conducted in HIV-infected adult patients with HIV-1 RNA < 50 copies/mL maintained for 4 years or longer and who were receiving HAART. Advanced HIV infection was defined as a baseline CD4 T cell count < 200/mm3. Immunologic responders were defined as patients showing immunologic recovery (CD4 T cell counts ≥ 500/mm3 at 4 years with HAART). To analyze the CD4 T cell kinetics, the CD4 slope (monthly changes in the CD4 T cell count) was estimated for each patient using a linear regression between the CD4 T cell count and the time since HAART initiation. Results: Of 102 eligible patients, 73 had advanced HIV, and 33 (45.2%) showed immunologic recovery. The median CD4 slopes (cells/mm3 per month) during 0 to 6 and 0 to 12 months of HAART in the 73 advanced patients were significantly higher in responders than in non-responders (0 to 6 months, 38.6 vs. 22.8; 0 to 12 months, 24.5 vs. 13.5). Multivariate analyses showed opportunistic infections at the start of HAART (adjusted odds ratio [OR], 0.28) and a CD4 slope ≥ 20 during 0 to 12 months of HAART (adjusted OR, 10.10) were independently associated with immunologic recovery. Conclusions: The CD4 slope can be an early predictor of long-term immunologic recovery in advanced HIV patients.

면역학적 존재의 진화론적 능동성

최종덕 한국의철학회 2013 의철학연구 Vol.15 No.-

The immunology has been understood as a defense mechanism. The defense mechanism means how to protect self against non-self. The defense mechanism is regarded as passive responses with micro-physiological functions to check and keep away foreign invaders. This paper argues that the immune system does not contain the defense mechanism only but also the immunologic activeness. In order to make my points, I offer a philosophical homology between evolutionary thinking and immune system. This paper therefore draws on evolutionary relevances and proofs of immunologic cases. In section 2, I explain why evolutionary thinking is important at immune system. Furthermore, I will try to bear out the validity of the immunologic activeness by the examples of immune specificity, immunologic memory and immune tolerance in section 3. My goal here is to argue that the immunologic activeness is an evolutionary product that was adapted from passive immune prototype.

Changes in Immunologic Function after Transarterial Chemoembolization in Patients with Hepatocellular Carcinoma

( Hana Park ),( Ji-ye Song ),( Hee Jung An ),( Yun Bin Lee ),( Joo Ho Lee ),( Mi Na Kim ),( Young Eun Chon ),( Yeon Jung Ha ),( Seong Gyu Hwang ),( Kyu Sung Rim ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Transarterial chemoembolization (TACE) is widely used as a treatment modality for intermediate stage of hepatocellular carcinoma (HCC). Although several studies showed enhanced natural killer (NK) cell response after local treatment for HCC have been reported, knowledge of impact on NK cell after TACE is still unrevealed. The aim of this research was to investigate immunologic changes after TACE in HCC patients. Methods: Total 23 patients undergoing TACE for hepatocellular carcinoma were enrolled. Absolute counts of peripheral blood lymphocytes followed by phenotypic and functional characterization of NK cell population were carried out the day before, 1 and 4 weeks after TACE. Results: Peripheral blood lymphocytes kinetics revealed decrease of NK cell population at 1 week after TACE from the baseline (4.18% at 1 week vs. 9.54% at baseline, P=0.047), and restoration of NK cell population at 4 week after TACE from 1 week after TACE (12.24% at 4 week vs. 4.18% at baseline, P=0.040). This was along with significantly increased level of inhibitory NK receptor, NKG2A, at both time points of 1 week and 4 week after TACE from the baseline (20.24% at 1 week from 4.26% at baseline, P<0.001; 23.92% at 4 week from 4.26% at baseline, P<0.001), while there were no significant changes in activating NK receptors. Anti-K562 cell cytotoxicity appeared consistently decreased in terms of absolute activity at 1 week after TACE as compared to baseline, and showed a tendency to restore at 4 weeks after TACE. Conclusions: Unlike previously reported immunologic changes in patients with local treatment for HCC, immunologic function seems to be compromised shortly after TACE. This result suggests that various therapeutic strategies can have different effects on body immune function, and better understanding of the changes in the immune system in HCC patients will promise better tumor control.

Immunologic evaluation of delayed hypersensitivity to meat in adults

( Hyun Jung Jin ),( Young Hee Nam ),( Eui Kyung Hwang ),( Yoo Seob Shin ),( Young Min Ye ),( Hae Sim Park ) 대한내과학회 2011 대한내과학회 추계학술발표논문집 Vol.2011 No.1

Background: Mammalian meat allergy is not common in adults, but increasing in recent years. Although the pathogenic mechanisms are not understood, various immunological and non-immunologic mechanisms were suggested. The aim of this study was to evaluate clinical and immunological characteristics of the patients with delayed hypersensitivity developed after consumption of meat. Methods: Thirty patients with delayed hypersensitivity to beef and/or pork (developed 2 hrs later) were enrolled from Ajou University Hospital. Skin prick tests were performed with commercial beef and pork extracts (Bencard, Bradford, UK) and considered positive if they produced a wheal with a diameter ≥ 3 mm. Serum specific IgE antibodies to beef, pork and galactose- α-1,3- galactose (α-gal) were measured by immunoCAP (Phadia, Sweden). Serum specific IgG1 and G4 antibodies to beef and pork were measured by ELISA. Results: Twenty (66.7%) were female and 25 (83%) were atopics. The most common symptoms were urticaria/angioedema (83.3%) followed by anaphylaxis (16.7%) and gastrointestinal symptoms (13.3%). The skin prick test to beef and pork extracts showed negative results in all, while serum specific IgE to beef and pork was found in 16.7% and 10% of them. The specific IgE to α-gal was found in 3(10%) patients. High serum specific IgG1 to beef and pork was detected in 2(6.7%) and 3 patients (10%), while serum specific IgG4 was detected in 3(10%) and 1 patient (3.3%). Conclusion: We suggested that IgE mediated response to α-gal as well as IgE and IgG responses to beef and pork may induce delayed hypersensitivity to meat. Future investigations will be needed on cellular immune mechanisms. This study was supported by a grant from the Korea Science and Engineering Foundation (KOSEF) funded by the Korean government (MEST, 2009-0078646).

飼料 중 아연 給源이 가금의 면역스트레스에 미치는 영향

高泰松 건국대학교 1995 學術誌 Vol.39 No.2

The influences of dietary 35 ppm of zinc (Zn) in oxide (ZnO) and sulfate (ZnSO4) and Zn-proteinate chelate (complex) forms on immune responses in chicks challenged with Salmonella typhymurium lipopolysaccaride (LPS) was compared with those in saline-injected. Immunogen - injected birds resulted in significantly (p<0.05) lower rates in daily gain and diet consumption. Feed efficiency were similar in ZnO and ZnSO4 diets and lowered significantly (p<0.0001) in complex and Zn-deficiency diets. Immulogic stress did not affect plasma zinc levels, but which was increaseed significantly (p<0.05) in bird fed ZnO, Zn levels of liver cytosol were increased significantly in ZnO and ZnSO4, decreased in Zn-deficiency and not shown any significant difference in Complex diet. And erythrocyte cytosol had higher Zn levels in ZnO, ZnSO4 and Complex and similar value in Zn-free diets. Metalothionein (MT) levels in liver cytosol of immunized birds was not influenceed in ZnO, increased in ZnSO4 and decreased in Complex and Zn-free diets. In erythrocyte cytosol of immunized birds gave higher MT levels in ZnO, ZnSO4 and Zn-free diets and similar values in Complex diet. In liver cytosol activity of Cu/ZnSOD was similar in ZnO, higher in ZnSO4 and lower in Complex and Zn-free diets. Immunization increased activity of MnSOD in ZnO, ZnSO4 and Zn-free diets while showed similar values in Complex diet. In erythrocyte cytosol, ZnO, ZnSO4 and Compex diets increased activity of Cu/ZnSOD while Zn-free diet gave similar value. Immunologic stress did not change MnSOD activity significantly while Complex diet increased MnSOD activity compared with those fed ZnO and ZnSO4 diets. The results indicated that immunologic responses were different among birds fed different dietary zinc sources. Key word : Immunologic Stress, Zinc Oxide, Zinc Sulfate, Zn-Protein Complex, Metallothionein, Cu/ZnSOD, MnSOD, Broiler

성인 급성 림프구성 백혈병의 예후 : - 33 예의 환자들을 대상으로 한 분석 -

조유숙(You Sook Cho),이규형(Kyoo Hyung Lee),이제환(Je Hwan Lee),김성배(Sung Bae Kim),김상위(Sang We Kim),서철원(Cheol Won Suh),이정신(Jung Shin Lee),김우건(Woo Kun Kim),김상희(Sang Hee Kim),지현숙(Hyun Sook Chi),박찬정(Chan Jung Park 대한내과학회 1997 대한내과학회지 Vol.52 No.3

Objectives: Rate of complete remission and long-term survival in adult acute lymphoblastic leukemia group has not been as satisfactory as that in childhood ALL. Recently introduction of induction chemotherapy of more intensive combination and various trials of postremission therapy are making improved results better looked forward to. And subtypes of ALL according to the degree of differentiation into T and B cells are identified by using immunologic markers hopefully to work out proper treatment for each subtype. Methods: We analited results of treatment and differences of complete remission rate, remission duration and overall survival as to various immunologic markers and clinicopathologic characteristics in 33adult ALL patients. Results: Eighty five percents of the 27cases that had VPDL chemotherapy achieved complete remission and both overall median survival and mediom duration of remission were 52weeks. No definite prognostic factors were detected influencing complete remission rate, remission duration and overall survival except that patients with serum albumin level higher than 4.0mg/dL showed highter complete remission rate. Although mature B-ALL showed the shortest overall median survival, degree of differenciation of B-cell and other immunologic markers did not influence on complete remission rate, remission duration or overall survival. Conclusion: Further studies are needed to delire the prognostic factors in adult ALL

Step aerobics의 RPE가 여고생의 면역기능에 미치는 영향

Sun-Ok Kwon(권선옥),Seon-Tae Jeong(정선태) 한국생명과학회 2010 생명과학회지 Vol.20 No.2

J시 소재 K여자고등학교 1학년 중에서 %fat이 30% 이상인 24명을 유의추출법에 의해 운동그룹 A (8명), B (8명) 그룹과 통제그룹(8명)으로 3그룹으로 구분하여 Borg의 주관적운동강도를 이용, A그룹은 RPE 15-17(hard-very hard; 힘듦-매우 힘듦)×3 sets, B그룹은 RPE 11-13 (fairly light-somewhat hard; 알맞음-약간 힘듦)×3 sets로 설정하여 step aerobics (step box: 길이 68 ㎝, 폭 28 ㎝, 높이 15 ㎝, 무게 450 g)를 1일 50-60분간, 주3회(월, 수, 금)로 총 8주간 실시하였다. 본 연구는 step aerobics의 RPE가 비만 여고생의 면역기능(Neutrophil, Lymphocyte, Monocyte, Eosinophil, Basophil, IgG, IgA, IgM)에 어떠한 영향을 미치는가를 알아보는 것이었다. 자료처리는 SPSS Ver. 14.0을 이용하여 집단과 시기 간 상호작용의 효과를 알아보기 위하여 repeated two-way ANOVA를, 집단 내 운동 전?후는 paired t-test를 실시하였고, 집단 간은 변화율(% diff.)을 구하여 one-way ANOVA를 실시하여 다음과 같은 결론을 얻었다. WBC에서, 집단 내 비교에서 A그룹은 Neutrophil, Monocyte, Basophil, Eosinophil 모두 증가하였으나 Lymphocyte는 변화가 없었고, B그룹은 Eosinophil은 감소하였으나 Neutrophil, Lymphocyte, Monocyte, Basophil 모두 변화가 없었으며, 통제군은 Neutrophil, Basophil, Eosinophil은 감소하였으나 Lymphocyte와 Monocyte는 변화가 없었다. 집단 간 비교의 Neutrophil은 A그룹이 B그룹과 통제군보다 더 많이 증가하였고, Lymphocyte는 집단 간 차이가 없었으며, Monocyte는 A, B그룹이 통제군보다 많이 증가하였다. Basophil과 Eosinophil은 A그룹이 B그룹과 통제군보다 더 많이 증가하였다. Immunoglobin에서, 집단 내 비교에서 A그룹은 IgG는 증가하였으나 IgA와 IgM는 변화가 없었고, A그룹은 IgA는 증가하였으나 IgG는 감소하였고 IgM은 변화가 없었다. 통제군은 IgG은 감소하였으나 IgA와 IgM은 변화가 없었다. 집단 간 비교의 IgA는 A그룹이 통제군보다 증가하였고, IgG는 A그룹이 B그룹과 통제군보다 증가하였으나 IgM은 집단 간 차이가 없었다. 요약하면 세 집단 모두 운동프로그램 전?후의 WBC와 Ig 수준이 연령에 맞게 참고치 내의 수준에 머물렀지만 step aerobics를 RPE 15-17로 실시한 A그룹의 경우가 가장 많은 측정항목에서 증가를 보였고, 이 결과는 참고치 범위 내에서 면역기능의 항진을 보여주는 것으로 면역기능의 향상을 위한 step aerobics의 RPE 강도는 힘듦-매우 힘듦(15-17)의 수준으로 실시하는 것이 효과적인 것으로 생각된다. Out of the tenth graders of K girl's high school in J city, 24 students whose %fat was over 30% were divided into 3 groups through Purposing Sampling. Groups A and B were exercise groups and C was the control group. Using Borg's RPE (rating of perceived exertion), RPE 15-17 (hard-very hard) × 3 sets were set up for group A, RPE 11-13 (fairly light-somewhat hard) × 3 sets were set up for group B, and both groups performed step aerobics (step box: 68cm in length, 28㎝ in width, 15cm in hight, 450g in weight) for 50-60 minutes a day, 3 days a week for 8 weeks in total. This research was conducted to find out the effects of various RPE in step aerobics on the immunologic function (neutrophil, lymphocyte, monocyte, eosinophil, basophil, IgG, IgA, and IgM levels) of overweight female high school students. By using SPSS Ver. 14.0, a repeated two-way ANOVA was conducted to find out the effects of interaction between the groups and time period, paired t-test to evaluate data within each group, and pre- and post experiment difference rates (%diff) to perform one-way ANOVA for group comparisons. The following results were found. As for WBC, within group A, neutrophil, monocyte, basophil, and eosinophil levels increased, while lymphocyte levels remained the same. Within group B, eosinophil levels decreased while neutrophil, lymphocyte, monocyte, and basophil levels showed no differences. Within the control group, neutrophil, basophil, and eosinophil levels decreased while lymphocyte and monocyte levels showed no differences. As for the group comparisons, neutrophil levels increased more in group A than group B and the control group. There were no differences in lymphocyte levels among the three groups. Monocyte levels increased more in group A and B than the control group. Basophil and Eosinophil increased more in group A than group B and the control group. As for immunoglobin, within group A, the IgG level increased but the levels of IgA and IgM did not change. Within group B, the IgA level increased but the level of IgG decreased, and the level of IgM did not change. Within the control group, the IgG level decreased but the levels of IgA and IgM did not change. As for the group comparisons, the level of IgA increased more in group A than the control group, and the level of IgG increased more in group A than group B and the control group, but levels of IgM among the three groups did not show any difference. In summary, WBC and Ig levels showed that the three groups remained at the reference interval even after the exercise program. However, group A, which performed RPE 15-17 in step aerobics, showed increase in more measured items than the other groups, and this implies that the immunologic function has improved in the range of the reference intervals. Therefore, it will be effective to conduct step aerobics with the RPE 15-17 (hard-very hard) in order to increase the immunologic function.

역전사 중합효소연쇄반응을 이용한 태아혈액의 Interleukin-1β, Tumor Necrosis Factor-α, Transforming Growth Factor-β의 발현양상

최석태 ( Seok Tae Choi ),윤보현 ( Bo Hyun Yoon ),신희철 ( Hee Chul Syn ) 대한산부인과학회 1997 Obstetrics & Gynecology Science Vol.40 No.12

Background: For the successful pregnancy, the feto-maternal immunologic bidirectional interaction should be programed to accept the fetal semiallograft and assist the feto-placental growth in early pregnancy. It has been known that these signaling materials for interacting are cytokines. Up to the present, the potential roles of cytokines in normal pregnancy are, first, as a signal material of maternal immunologic recognition of fetal semiallograft, second, as a substance like growth- factor to promote the feto-placental growth and differentiation, third, as a material to alter the maternal immunity for fetal survival, fourth, as a mediator to initiate or prevent the labor. We have proposed the hypothesis that various cytokines may be expressed simultaneously, and then, may regulate the maintenance of pregnancy by interacting with each other harmonically after midpregnancy. Because the maintenance of pregnancy and the mechanism of labor depend on the total effect of various cytokines rather than the effect of one specific cytokine. Objectives: To support a potential role of the fetus itself for participating in the bidirectional cytokine regulatory network, and support our hypothesis that various cytokines may be expressed simultaneously, and then, may regulate the maintenance of pregnancy by interacting with each other harmonically after midpregnancy. Study dasign: For exploring the actual immunologic status of fetus itself in utero, we have chosen the seventeen fetal blood samples which have been taken at the cordocentesis or at the delivery without labor after midpregnancy(20th~39th weeks of gestation). After extracting the RNA from these fetal blood samples, we have tried to demonstrate the expression of interleukin-1β and tumor necrosis factor-a mRNA, and simultaneously, demonstrate the expression of transforming growth factor-β mRNA by using reverse transcriptase-po1ymerase chain reaction(rt-PCR) technique. Results: In this study we found that the expression of interleukin-1β mRNA was demonstrated from as early as 22nd weeks to term gestation, and the expression of tumor necrosis factor-α mRNA was demonstrated from as early as 2300rd weeks to term gestation, and the expression of transforming growth factor-β mRNA was demonstrated from as early as 21st weeks to term gestation. Conclusion: On the basis of these findings, first, we support the result of recent study that the fetus itself may participate in the bidirectional cytokine regulatory network after midpregnancy, second, we prove the possible hypothsis that various cytokines may be expressed simultaneously, and then, may regulate the maintenance of pregnancy by interacting with each other harmonically after mid pregnancy.

Mesenchymal stem cells reciprocally regulate the M1/M2 balance in mouse bone marrow-derived macrophages

Cho, Dong-Im,Kim, Mi Ra,Jeong, Hye-yun,Jeong, Hae Chang,Jeong, Myung Ho,Yoon, Sung Ho,Kim, Yong Sook,Ahn, Youngkeun Nature Publishing Group 2014 Experimental and molecular medicine Vol.46 No.1

<P>Mesenchymal stem cells (MSCs) have been widely studied for their applications in stem cell-based regeneration. During myocardial infarction (MI), infiltrated macrophages have pivotal roles in inflammation, angiogenesis and cardiac remodeling. We hypothesized that MSCs may modulate the immunologic environment to accelerate regeneration. This study was designed to assess the functional relationship between the macrophage phenotype and MSCs. MSCs isolated from bone marrow and bone marrow-derived macrophages (BMDMs) underwent differentiation induced by macrophage colony-stimulating factor. To determine the macrophage phenotype, classical M1 markers and alternative M2 markers were analyzed with or without co-culturing with MSCs in a transwell system. For animal studies, MI was induced by the ligation of the rat coronary artery. MSCs were injected within the infarct myocardium, and we analyzed the phenotype of the infiltrated macrophages by immunostaining. In the MSC-injected myocardium, the macrophages adjacent to the MSCs showed strong expression of arginase-1 (Arg1), an M2 marker. In BMDMs co-cultured with MSCs, the M1 markers such as interleukin-6 (IL-6), IL-1β, monocyte chemoattractant protein-1 and inducible nitric oxide synthase (iNOS) were significantly reduced. In contrast, the M2 markers such as IL-10, IL-4, CD206 and Arg1 were markedly increased by co-culturing with MSCs. Specifically, the ratio of iNOS to Arg1 in BMDMs was notably downregulated by co-culturing with MSCs. These results suggest that the preferential shift of the macrophage phenotype from M1 to M2 may be related to the immune-modulating characteristics of MSCs that contribute to cardiac repair.</P>

Hyperimmunoglobulin E (Job`s) Syndrome에서 발현되는 호흡기증상

민병주 ( Min Byeong Ju ),신재승 ( Sin Jae Seung ),이인성 ( Lee In Seong ),신영규 ( Sin Yeong Gyu ) 대한결핵 및 호흡기학회 2002 Tuberculosis and Respiratory Diseases Vol.52 No.6