Autoimmune hemolytic anemia (AIHA) is an autoimmune disease in which the life span of red blood cells is shortened by red blood cell autoantibodies. Due to immune intolerance and abnormal immune regulation, the hyperfunction of B lymphocytes produces too many red blood cell autoantibodies. Anti-CD20 monoclonal antibody is a second-line drug for warm antibody AIHA and first-line drug for cold antibody AIHA by reducing B lymphocytes. At present, the optimal dose of anti-CD20 monoclonal antibody in the treatment of AIHA has not been determined. There are no reports on the treatment of primary AIHA with second- or third-generation anti-CD20 monoclonal antibodies.
Objective:To observe the effects of testosterone on optic nerve an d retinal ganglion cells (RGC) in experimental autoimmune encephalomyelitis (EAE ).
Methods:Fourty one female Wistar rats were randomly divide d into 3 groups: the normal group (10 rats), the untreated control group (15 rats) and the testos terone group (16 rats). The rats in the first two groups were fed with 1% ethano l every day, and the rats in the testosterone group were fed with methyltestoste rone (0.25 mg/kg) every day. On the 20th day, EAE model was induced in the untre ated control group and the testosterone group by injecting guinea pig spinal cor d homogenate in complete Freund's adjuvant and bordetella pertussis vaccine. RGC were labeled with flurogold (FG) by injecting it in superior colliculus and lat eral geniculate body 7 days before establishing EAE model. All rats were fed wit h drugs continuously, and after 1430 days, rats in normal group and rats in un t reated control and testosterone groups who had symptoms within 48～72 hours were observed by light microscopy and flash visual evoked potential (FVEP) to detect the functional and morphological changes of optic nerve. The number of RGC was counted by fluorescence microscopy，and apoptosis of RGC was observed by termina l deoxynucleotidyl transferasemediated biotinylated UTP nick end labeling (TUN E L)
Results:EAE rats presented weakness or paralysis of tail a nd hind limbs 10 days after establishing EAE model. Compared with the rats in the untreated contr ol group, the rats in the testosterone group had longer disease delitescence and lower clinical score (P=0.042). Extensive demyelination of optic nerves wi th the circuitous configuration was found in the untreated control group; while mild demyelination of optic nerves with regular figure was found in the testosterone group. In the testosterone group, the latency of N1、P and N2 wave was shorter w hile the amplitude ofN1-P and P-N2was higher than that in the untreated cont rol group (Plt;0.05). The number of RGC was (2284plusmn;132), (934plusmn;78, and (1725 plusmn;95)cells/mm2 in the normal, untreated control and testosterone groups, respectively; w hich was higher in testosterone group than that in untreated control group (P=0.028). The number of TUNEL positive cells was (4.02plusmn;0.16), (24.44plusmn;2.22), and (9.84plusmn;2.36) cells per high power field (times;400) in the 3 grou ps, respectively; wh ich was less in testosterone group than that in untreated control group (P＝0.025).
Conclusions:Testosterone may reduce the incidence and clinical score of EAE, inhibit the apoptosis of RGC, alleviate the demyelinatio n of optic nerves, and improved the conduction function of optic nerves.
ObjectiveTo evaluate the middle- and long-term effectiveness of primary total hip arthroplasty (THA) in patients with chronic autoimmune inflammatory diseases. MethodsBetween January 1990 and June 2006, 42 patients (51 hips) with chronic autoimmune inflammatory diseases underwent THA. There were 15 males (18 hips) and 27 females (33 hips) with an average age of 36.9 years (range, 22-70 years). The locations were the left side in 29 hips and the right side in 22 hips. Of 42 cases, there were 11 cases of systemic lupus erythematosus (13 hips), 16 cases of rheumatoid arthritis (22 hips), and 15 cases of ankylosing spondylitis (16 hips). The causes of THA included avascular necrosis of the femoral head in 26 cases (34 hips), ankylosis of the hip in 15 cases (16 hips), and fracture of the femoral neck in 1 case (1 hip). The Harris score was 32.49 ± 9.50. The physical component summary (PCS) and mental component summary (MCS) of short form 36 health survey scale (SF-36) scores were 25.53 ± 4.46 and 42.28 ± 6.27, respectively. ResultsAll incisions healed primarily. All 42 patients were followed up 5-21 years (mean, 9.1 years). At last follow-up, the Harris score was 89.25 ± 8.47; PCS and MCS of the SF-36 were 51.35 ± 4.28 and 55.29 ± 8.31, respectively; and significant differences in the scores were found between pre- and post-operation (P lt; 0.05). Complications included limp (4 cases), prosthesis dislocation (2 cases, 2 hips), periprosthetic fracture (1 case, 1 hip), aseptic loosening (2 cases, 2 hips), and ectopic ossification (3 cases, 3 hips). ConclusionTHA seems to be a good choice for patients with chronic autoimmune inflammatory diseases.
The pathogenesis of Vogt-Koyanagi Harada disease (VKH) has not yet been fully defined. Current studies mainly suggest that VKH is actually an autoimmune disease, especially related to the immune response mediated by various signal transduction pathways involved in the function of T cells. In recent years, the influence of the balance imbalance of various T cell subsets in cellular immunity on the pathogenesis of VKH has been a hot research direction. Currently, T helper cell 17/T regulatory cells, balance is the focus of clinical research, meanwhile, new discoveries and potential clinical treatment schemes have been made for related cellular pathways, particularly the Janus kinase/signal transducers and activators of transcription pathway and NF-kappa B pathway. The exploration of B cells in the pathogenesis of VKH has also achieved initial results through the successful application of various targeted drugs. In the future, further screening and localization of genes or proteins that are abnormally regulated or expressed in VKH, for which early comprehensive and in-depth exploration will be helpful, thus improve the efficacy of clinical treatment programs and develop new therapeutic targets.
