OBJECTIVETo explore the immune tolerance induction (ITI) in a severe hemophilia A patient with inhibitor, and to improve the therapeutic efficacy for patient.

METHODSThe FVIII:C was assayed by one-stage method and FVIII antibody by Bethesda method. Mutation screening of FVIII gene intron 22 inversion was performed using LD-PCR.

RESULTSFVIII gene intron 22 inversion was detected in this patient. Clinical tolerance to FVIII was successfully induced after administration of the ITI regimen combined with immunosuppression. A fall of inhibitor titer from 8 BU to 0 BU after treatment for 3 months, and in vivo FVIII recovery (> 66%) was normalized. The patient had no bleeding episode in the following 6 months.

CONCLUSIONThis is the first case report on successful immune tolerance induction therapy in Chinese hemophilia A patient. ITI is the most effective therapy for hemophilia A with inhibitor.

Autoantibodies ; immunology ; Factor VIII ; genetics ; Hemophilia A ; genetics ; Humans ; Immune Tolerance ; drug effects ; Immunosuppression

The effects of the two antipsychotic drugs, chlorpromazine and haloperidol, the focus of this study, on cell-mediated immunity in male ICR mice. The peripheral blood WBC count decreased significantly in both cholorpromazine and haloperidol. The absolute lymphocyte count decreased only in the haloperidol-treated groups. The absolute number of thy-1-bearing cells described in both the chlorpromazine and haloperidol groups, the most remarkable effects evidencing itrself in the booster groups of higher dosage chlorpromazine (15 mg/kg), and lower and higher-dosage haloperidol (1 mg/kg and 5 mg/kg). The absolute spleen T-lymphocyte count was decreased significantly in the chlorpromazine higher-dosage booster-dose group and the haloperidol higher-dosage (5 mg/kg) single-dose group and the haloperidol lower and higher-dosage (1 mg/kg and 5mg/kg) booster-dose group. Also, chlorpromazine and haloperidol significantly impaired the in-vitro lymphocyte response to phytohemagglutinin (PHA) and produced a negative reaction of the delayed-hypersensitivity type induced by BCG vaccination. These findings suggest that chlorpromazine and haloperidol suppress the cellular immune responses in mouse.
Animal ; Antipsychotic Agents/toxicity* ; Immune Tolerance/drug effects ; Immunity, Cellular/drug effects* ; Male ; Mice ; Mice, Inbred ICR

This study was aimed to investigate the effect of 1,25(OH)(2) vitamin D(3) [1,25(OH)(2) Vit D(3)] on the differentiation, maturation and function of human dendritic cells (DC) in vitro and its mechanism. Human peripheral blood mononuclear cells were induced to differentiate to DC in vitro. The DC in test group were cultured with 1,25(OH)(2) Vit D(3) 1 nmol/L for 9 d, while the DC in control group were cultured with the equivalent of absolute alcohol. The expression of co-stimulatory molecules on DC were analyzed by flow cytometry. T cell proliferation induced by DC was assessed by MTT method. The expression of indoleamine 2, 3-dioxygenase (IDO) protein was determined by Western blot. The results showed that compared with the control group, the expression of CD80, CD83 and CD86 on DC in test group was significantly down-regulated (P < 0.05), while the CD1a was up-regulated (P < 0.05). The expression rate of CD80, CD83, CD86, CD1a in test group were (40.43 ± 9.83)%, (20.04 ± 4.73)%, (14.45 ± 5.38)%, (58.48 ± 10.72)% respectively, while in control group were (29.36 ± 13.34)%, (35.91 ± 10.19)%, (27.15 ± 11.64)%, (72.20 ± 12.79)% respectively. Compared with the control group, 1,25(OH)(2) Vit D(3)-treated DC exhibited a markedly reduced ability to stimulate allogenic T cell proliferation and up-regulated IDO protein expression.It is concluded that 1,25(OH)(2) Vit D(3) efficiently inhibits the maturation of DC and DC-mediated T cell proliferation, which may be related to the up-regulation of IDO protein expression.
Cell Differentiation ; drug effects ; Cell Proliferation ; drug effects ; Cells, Cultured ; Cholecalciferol ; pharmacology ; Dendritic Cells ; cytology ; immunology ; Flow Cytometry ; Humans ; Immune Tolerance ; drug effects ; Indoleamine-Pyrrole 2,3,-Dioxygenase ; metabolism

OBJECTIVETo explore the biological characteristics and the immuno-suppression function of tolerogenic dendritic cells (tDC) induced by tacrolimus.

METHODSHuman monocytes derived from peripheral blood were cultured in the cGMP-compliant CellGro DC medium supplemented with GM-CSF and IL-4 to obtain dendritic cells (DCs), and 0.1 μmol/L immunosuppressive drug tacrolimus was added to the culture medium at the third and fifth day to obtain tDCs. The molecular markers of them and the livability were assayed by flow cytometry. Then the tolerance functionality of tDCs induced by many agents and these tDCs modulated allogeneic CD4 T cells was determined via CFSE proliferation assay. And the research also analyzed the biological characters and immunosuppression function of tDCs induced by tacrolimus after storing.

RESULTStDCs induced by tacrolimus exhibit a typical tolerogenic phenotype, whose level of costimulatory molecules CD80, CD83, CD86 and HLA-DR is (2.95 ± 1.32)%, (2.33 ± 1.60)%, (90.02 ± 7.42)% and (91.80 ± 6.18)%, respectively. It's survival rate was (85.2 ± 4.72)%. And immunosuppressive drugs didn't influence the differentiation of tDCs from monocytes. tDCs induced by immunosuppressive drugs dexamethasone, cyclosporin A and tacrolimus had lower immunogenic than control DCs as CD4+ T proliferation rate of tDCs induced by tacrolimus is 0.42% and could not primed allogeneic CD4+ T cells proliferation. Functional analyses showed that tDCs induced by tacrolimus can more effectively suppressed mature DC-induced T cell proliferation than other tDCs, whose inhibition rate can reach (67.01 ± 19.73)%. Importantly, tDCs induced by tacrolimus had phenotypical and functional stability after storing.

CONCLUSIONtDCs induced by tacrolimus with tolerance functionality are a promising cellular therapeutic for immunomodulation.

Cell Proliferation ; drug effects ; Cells, Cultured ; Dendritic Cells ; drug effects ; immunology ; Humans ; Immune Tolerance ; drug effects ; Lymphocyte Culture Test, Mixed ; Tacrolimus ; pharmacology

This study was aimed to investigate the effect of dexamethasone (Dex) on immunosuppressive ability of mesenchymal stem cells (MSC) during expansion and differentiation of MSC. MSC were cultured in 96-well flat-bottom plates. Proliferation assays were performed by using the BrdU colorimetric ELISA Kit. To explore the effect of Dex on MSC immunosuppressive ability, MSC were firstly cultured in complete culture medium for 14 d with Dex (10 nmol/L), and then, peripheral blood mononuclear cells (PBMNC) were co-cultured with MSC in 96-well flat-bottom plates for 3 d. Phytohemagglutinin A (PHA, 10 µg/ml) was used to stimulate activation of PBMNC. The concentrations of IFN-γ in culture supernatants was detected by ELISA. The results indicated that there was no obvious difference in representative phenotypes of MSC between experimental and control groups after MSC were treated with low concentration of Dex (10 nmol/L) for 14 d, but the suppression of Dex-treated MSC on lymphocyte activation in same concentration of cells was significantly reduced as compared with control group. After the Dex-treated MSC were co-cultured with IFN-γ for 12 h, the immunoregulatory ability of MSC was recovered in a certain degree. It is concluded that the Dex impairs the immunosuppressive ability of MSC, the IFN-γ can protect and reverse the immunosuppressive ability of MSC impaired by Dex, so that, when the immunoregulatory activity of MSC is investigated, it is necessary to avoid adding Dex in the culture medium.
Cells, Cultured ; Dexamethasone ; adverse effects ; Humans ; Immune Tolerance ; drug effects ; Interferon-gamma ; immunology ; Leukocytes, Mononuclear ; Lymphocyte Activation ; immunology ; Mesenchymal Stromal Cells ; cytology ; drug effects ; immunology

Asian Continental Ancestry Group ; Drugs, Chinese Herbal ; pharmacology ; therapeutic use ; Female ; Humans ; Immune Tolerance ; drug effects ; Materia Medica ; therapeutic use ; Medicine, Chinese Traditional ; Pregnancy ; Pregnancy Complications ; drug therapy

OBJECTIVETo investigate the effect of in vivo administration of rhG-CSF and/or rhIL-11 on mice immune system function.

METHODST cell subgroups, suppressor T cells (CD8+ CD28-, CD4+ CD25+, CD3+ CD4- CD8- T cells), expression of CD28 on T cells, and spleen T cells intracellular IL4/IFN-gamma secretion were determined by multicolor flow cytometry. MTT was used to determine the T cell proliferation capacity and mixed lymphocyte reactions.

RESULTSIn vivo administration of cytokines decreased the percentage of lymphocytes (P < 0.05), rhIL-11 and rhG-CSF in combination significantly decreased the CD4+/CD8+ ratio and increased the percentage of CD8+ CD28- suppressor T cells compared to either cytokine alone (P < 0.01). There was no difference in the percentage of CD3+ CD4- CD8- and CD4+ CD25+ suppressor T cells between either of the cytokines. Furthermore, cytokines treatments significantly decreased the capacities of splenic T cells proliferation and the response to alloantigens compared with the PBS treatment (P < 0.05), the combination group being more significantly decreased (P < 0.01). And cytokines treatment significantly decreased the production of IFN-gamma and increased the production of IL-4 compared with the PBS treatment(P < 0.05). The ratio of IFN-gamma/IL-4 were significantly decreased after the combination compared with either of them alone.

CONCLUSIONThe combination of rhIL-11 and rhG-CSF is potentially synergistic in the induction of immune tolerance by their effects on the proliferation capacity and function of T lymphocytes.

Animals ; CD28 Antigens ; metabolism ; Granulocyte Colony-Stimulating Factor ; pharmacology ; Immune Tolerance ; Interleukin-11 ; pharmacology ; Mice ; Mice, Inbred C57BL ; Recombinant Proteins ; T-Lymphocytes ; drug effects ; immunology ; metabolism

INTRODUCTIONWe report a successful case of immune tolerance to factor VIII (FVIII) inhibitor after a major operation. An attempt was made to induce immune tolerance with inhibitor in a haemophilia A patient, who was required to undergo an above-knee amputation. We opted to give high-dose FVIII infusion with no immunosuppression.

OUTCOMEThe highest preoperative FVIII inhibitor level was 5 BU and the peak postoperative FVIII inhibitor level was 1.5 BU demonstrated on Day 9 post operation. High-dose FVIII support was provided during the perioperative period and continued with a low maintenance dose to achieve a FVIII level of 30% to 40%. The requirement of high-dose FVIII lasted from day 6 to 23 post operation and this was tailed down to a maintenance dose over the next 37 days. There were only 2 episodes of mild oozing from the wound at around Day 9, which coincided with the peak postoperative FVIII inhibitor level. Both bleeding episodes were arrested adequately by administering a single dose of FEIBA during each episode. Immune tolerance was demonstrated after around 3 months and a follow-up period of 233 days showed no recurrence of FVIII inhibitor with the normalisation of FVIII half-life study.

CONCLUSIONAfter immune tolerance, the patient suffered fewer episodes of joint haemorrhage and required a lower amount of FVIII infusion as well. The cost may be high initially but the longterm cost-effectiveness has to be carefully evaluated.

Adult ; Amputation ; Coagulants ; administration & dosage ; immunology ; Factor VIII ; administration & dosage ; immunology ; Hemophilia A ; complications ; Humans ; Immune Tolerance ; drug effects ; Male ; Perioperative Care ; Postoperative Care

OBJECTIVETo explore the immunoregulatory effects of human amniotic mesenchymal cells (hAMCs) on allogeneic peripheral blood lymphocytes.

METHODSThe hAMCs were isolated from abandoned human amnion. Peripheral blood mononuclear lymphocytes (PBMLs) were separated from healthy donors by density gradient centrifugation. Then, PBMLs were treated with phytohemagglutinin (PHA) and different concentrations of hAMCs. Proliferation effect of PBMLs was tested using MTS assay, and production of IFN-gamma and TNF-alpha by PBMLs was detected by ELISA.

RESULTShAMCs could remarkably inhibit the lymphocytes proliferation. When the ratios of hAMCs to PBMLs were 0.05: 1, 0.10 :1, 0.20: 1, the inhibitory rates of PBMLs proliferation were 16.91%, 20.83% and 28.19%, respectively. HAMCs also decreased the production of IFN-gamma and TNF-alpha by PBMLs in a dose-dependent manner (P<0.01).

CONCLUSIONSHAMCs could inhibit the proliferation of allogeneic lymphocytes and reduce secretion of IFN-gamma and TNF-alpha, which might be one of the mechanism for prevention and remission of transplant rejection.

Amnion ; cytology ; Cell Proliferation ; Humans ; Immune Tolerance ; Interferon-gamma ; biosynthesis ; Lymphocyte Activation ; immunology ; Lymphocytes ; cytology ; drug effects ; immunology ; Mesoderm ; cytology ; Phytohemagglutinins ; immunology ; Tumor Necrosis Factor-alpha ; biosynthesis

The method of gene transfer into corneal endothelium was investigated to provide a foundation for the study of TGF-beta 1 gene transfer to inhibit corneal graft rejection. Two days after direct injection of pMAM TGF-beta 1 mediated by liposome into the anterior chamber of rabbits, one half of corneas were made into paraffin slides and the endothelial layer was carefully torn from the other half to make a single layer slide of endothelia. By means of immunohistochemical technique, the plasmid pMAM TGF-beta 1 expression product TGF-beta 1 in the endothelia was detected. Specific TGF-beta 1 expression was positive in the endothelia on both the paraffin slide and the single layer slide. The results showed that by direct injection into the anterior chamber, foreign plasmid DNA could be transferred into the endothelia and its expression was obtained. This may provide a foundation for further study on TGF-beta 1 participating in local induction of corneal immune tolerance.
Animals ; Anterior Chamber ; Corneal Transplantation ; Endothelium, Corneal ; drug effects ; pathology ; Gene Transfer Techniques ; Immune Tolerance ; Rabbits ; Transforming Growth Factor beta ; administration & dosage ; biosynthesis ; genetics