1.The destructive role of soluble Robo4 secreted by the M1-polarized-microglia during cerebral ischemia-reperfusion in blood-brain barrier integrity.
Jin-Long HUANG ; Chen LI ; Liang-Liang YANG ; Yang GAO ; Pu-Yuan ZHAO ; Zhi-Gang YANG
Acta Physiologica Sinica 2022;74(4):513-524
This project was aimed to investigate the role and the underlying mechanism of microglia polarization on blood-brain barrier (BBB) during cerebral ischemia-reperfusion. After construction of the mouse model of cerebral ischemia-reperfusion, upregulated IL-6 and TNF-α in peripheral blood and increased IL-6 and iNOS in ischemia tissues were confirmed. The supernatant expression of TNF-α and IL-6, as well as IL-6, iNOS and CD86 mRNA, was significantly increased in the of Bv-2 cells after oxygen-glucose deprivation/reoxygenation (OGD/R) model was constructed in vitro. For further understanding the expression pattern of RNAs, the next-generation RNA sequencing was performed and upregulation of Robo4 (roundabout guidance receptor 4) was found both in M1-polarized and OGD/R treated Bv-2 cells, which was also confirmed by RT-qPCR. Extracellular soluble Robo4 (sRobo4) protein also increased in the supernatant of M1-polarized and OGD/R treated Bv-2 cells. Treating bEND3 cells with the Robo4 recombinant protein, M1-polarized Bv-2 cell supernatant or OGD/R Bv-2 cell supernatant decreased trans-endothelial electrical resistance (TEER), suggesting the injury of BBB. In addition, Robo4 was also highly expressed in the serum of patients who experienced acute ischemia stroke and mechanical thrombectomy operation. All the results suggest that increased secretion of Robo4 by M1-polarized-microglia during cerebral ischemia-reperfusion is most likely one of the causes of BBB injury, and Robo4 may be one of the therapeutic targets for BBB functional protection.
Animals
;
Blood-Brain Barrier/metabolism*
;
Brain Ischemia/drug therapy*
;
Glucose/metabolism*
;
Interleukin-6/metabolism*
;
Mice
;
Microglia/metabolism*
;
Oxygen/metabolism*
;
Receptors, Cell Surface/metabolism*
;
Reperfusion
;
Reperfusion Injury/drug therapy*
;
Tumor Necrosis Factor-alpha/metabolism*
2.Effect of acupuncture on patients with cancer-related fatigue and serum levels of CRP, IL-6, TNF-α and sTNF-R1.
Peng QING ; Jian-Fu ZHAO ; Cang-Huan ZHAO ; Jing HU ; Yan-Long LIN ; Ke-Jie HE
Chinese Acupuncture & Moxibustion 2020;40(5):505-509
OBJECTIVE:
To observe the therapeutic effect of acupuncture on cancer-related fatigue (CRF) and to explore its possible mechanism.
METHODS:
A total of 80 patients with CRF were randomized into an observation group and a control group, and finally 67 patients completed the trial (36 patients in the observation group, 31 patients in the control group). Patients in the control group were treated with conventional chemoradiotherapy and symptomatic treatment, while no particular anti-fatigue intervention was adopted. On the basis of treatment in the control group, acupuncture was applied at Baihui (GV 20), Guanyuan (CV 4), Qihai (CV 6), Fengchi (GB 20), Zusanli (ST 36), Sanyinjiao (SP 6) in the observation group, once a day, 5 times as one course, with 2 days interval between each course, totally 4 courses were required. Before and after treatment, scores of functional assessment of cancer therapy-fatigue (FACT-F) in Chinese and McGill quality of life questionnaire (MQOL), serum levels of C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α(TNF-α) and soluble TNF receptor-1 (sTNF-R1) were observed in the two groups.
RESULTS:
①Compared before treatment, the FACT-F score was decreased after treatment in the observation group (<0.05), while there was no significant difference in the control group (<0.05). The change of the FACT-F score in the observation group was larger than that in the control group (<0.05). ②In the observation group, scores of physiological and psychological dimension were decreased (<0.05), score of social support dimension was increased after the treatment (<0.05). The score changes of physiological, psychological and social support dimension in the observation group were larger than those in the control group (all <0.05). ③After treatment, the serum levels of IL-6, TNF-α and sTNF-R1 were decreased in the observation group (<0.05), while the serum levels of CPR and IL-6 were increased in the control group (<0.05). The serum levels of CPR, IL-6 and TNF-α in the observation were lower than those in the control group (<0.05).
CONCLUSION
①Acupuncture can improve the related symptoms of depression, weakness and headache in patients with CRF, strengthen their cognition of the support from society and family, and boost the confidence in curing the disease. ②Acupuncture can effectively down-regulate serum levels of the relative inflammatory factors, which may be its possible mechanism on treating CRF.
Acupuncture Points
;
Acupuncture Therapy
;
Biomarkers
;
blood
;
C-Reactive Protein
;
analysis
;
Fatigue
;
etiology
;
therapy
;
Humans
;
Interleukin-6
;
blood
;
Neoplasms
;
complications
;
therapy
;
Quality of Life
;
Receptors, Tumor Necrosis Factor, Type I
;
blood
;
Tumor Necrosis Factor-alpha
;
blood
3.Fimasartan attenuates renal ischemia-reperfusion injury by modulating inflammation-related apoptosis.
Jang Hee CHO ; Soon Youn CHOI ; Hye Myung RYU ; Eun Joo OH ; Ju Min YOOK ; Ji Sun AHN ; Hee Yeon JUNG ; Ji Young CHOI ; Sun Hee PARK ; Chan Duck KIM ; Yong Lim KIM
The Korean Journal of Physiology and Pharmacology 2018;22(6):661-670
Fimasartan, a new angiotensin II receptor antagonist, reduces myocyte damage and stabilizes atherosclerotic plaque through its anti-inflammatory effect in animal studies. We investigated the protective effects of pretreatment with fimasartan on ischemia-reperfusion injury (IRI) in a mouse model of ischemic renal damage. C57BL/6 mice were pretreated with or without 5 (IR-F5) or 10 (IR-F10) mg/kg/day fimasartan for 3 days. Renal ischemia was induced by clamping bilateral renal vascular pedicles for 30 min. Histology, pro-inflammatory cytokines, and apoptosis assays were evaluated 24 h after IRI. Compared to the untreated group, blood urea nitrogen and serum creatinine levels were significantly lower in the IR-F10 group. IR-F10 kidneys showed less tubular necrosis and interstitial fibrosis than untreated kidneys. The expression of F4/80, a macrophage infiltration marker, and tumor necrosis factor (TNF)-α, decreased in the IR-F10 group. High-dose fimasartan treatment attenuated the upregulation of TNF-α, interleukin (IL)-1β, and IL-6 in ischemic kidneys. Fewer TUNEL positive cells were observed in IR-F10 compared to control mice. Fimasartan caused a significant decrease in caspase-3 activity and the level of Bax, and increased the Bcl-2 level. Fimasartan preserved renal function and tubular architecture from IRI in a mouse ischemic renal injury model. Fimasartan also attenuated upregulation of inflammatory cytokines and decreased apoptosis of renal tubular cells. Our results suggest that fimasartan inhibited the process of tubular injury by preventing apoptosis induced by the inflammatory pathway.
Animals
;
Apoptosis*
;
Blood Urea Nitrogen
;
Caspase 3
;
Constriction
;
Creatinine
;
Cytokines
;
Fibrosis
;
In Situ Nick-End Labeling
;
Interleukin-6
;
Interleukins
;
Ischemia
;
Kidney
;
Macrophages
;
Mice
;
Muscle Cells
;
Necrosis
;
Plaque, Atherosclerotic
;
Receptors, Angiotensin
;
Reperfusion Injury*
;
Tumor Necrosis Factor-alpha
;
Up-Regulation
4.Clinical value of detecting serum soluble CD163 level in patients with atrial fibrillation.
Shi-Mao ZHONG ; Yu-Hua QIN ; Zuo-Cha LI ; Ye-Sheng WEI
Journal of Southern Medical University 2016;36(10):1406-1409
OBJECTIVETo investigate the relationship between atrial fibrillation (AF) and serum soluble CD163.
METHODSA total of 336 patients with heart valve disease were included in this study, including 167 with AF and 169 with sinus rhythm. The clinical data were compared between the two grops, and Logistic regression analysis was used to identify the risk factors associated with AF.
RESULTSThe levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), tumor necrosis factor (TNF), interleukin-6 (IL - 6), high-sensitivity C-reactive protein (hs-CRP) and left atrial diameter (LAD) all differed significantly between the two groups (P<0.05). Serum soluble CD163 levels in AF patients were significantly higher than those in patients with sinus rhythm (P<0.05). Serum soluble CD163 was positively correlated with TNF (r=0.244, P=0.244), IL-6 (r=0.186, P=0.186), hs-CRP (r=0.183, P=0.183) and LAD (r=0.194, P=0.194) in patients with AF. Logistic regression analysis showed that LAD, IL-6, TNF, hs-CRP and CD163 were all associated with AF. ROC curve analysis showed that the area under curve of serum soluble CD163 was 0.861 in patients with AF (CI 95%: 0.820-0.901, P<0.01) with a sensitivity and a specificity of 80.8 and 76.9%, respectively.
CONCLUSIONSerum soluble CD163 level may be a risk factor for AF, and an increased soluble CD163 level may indicate active inflammation in AF patients.
Antigens, CD ; blood ; Antigens, Differentiation, Myelomonocytic ; blood ; Atrial Fibrillation ; blood ; C-Reactive Protein ; analysis ; Heart Atria ; pathology ; Humans ; Inflammation ; blood ; Interleukin-6 ; blood ; Lipoproteins, HDL ; blood ; Lipoproteins, LDL ; blood ; Receptors, Cell Surface ; blood ; Risk Factors ; Tumor Necrosis Factor-alpha ; blood
5.Corn silk extract improves cholesterol metabolism in C57BL/6J mouse fed high-fat diets.
Jae Hoon CHA ; Sun Rim KIM ; Hyun Joong KANG ; Myung Hwan KIM ; Ae Wha HA ; Woo Kyoung KIM
Nutrition Research and Practice 2016;10(5):501-506
BACKGROUND/OBJECTIVES: Corn silk (CS) extract contains large amounts of maysin, which is a major flavonoid in CS. However, studies regarding the effect of CS extract on cholesterol metabolism is limited. Therefore, the purpose of this study was to determine the effect of CS extract on cholesterol metabolism in C57BL/6J mouse fed high-fat diets. MATERIALS/METHODS: Normal-fat group fed 7% fat diet, high-fat (HF) group fed 25% fat diet, and high-fat with corn silk (HFCS) group were orally administered CS extract (100 mg/kg body weight) daily. Serum and hepatic levels of total lipids, triglycerides, and total cholesterol as well as serum free fatty acid, glucose, and insulin levels were determined. The mRNA expression levels of acyl-CoA: cholesterol acyltransferase (ACAT), cholesterol 7-alpha hydroxylase (CYP7A1), farnesoid X receptor (FXR), lecithin cholesterol acyltransferase (LCAT), low-density lipoprotein receptor, 3-hyroxy-3-methylglutaryl-coenzyme A reductase (HMG-CoA reductase), adiponectin, leptin, and tumor necrosis factor α were determined. RESULTS: Oral administration of CS extract with HF improved serum glucose and insulin levels as well as attenuated HF-induced fatty liver. CS extracts significantly elevated mRNA expression levels of adipocytokines and reduced mRNA expression levels of HMG-CoA reductase, ACAT, and FXR. The mRNA expression levels of CYP7A1 and LCAT between the HF group and HFCS group were not statistically different. CONCLUSIONS: CS extract supplementation with a high-fat diet improves levels of adipocytokine secretion and glucose homeostasis. CS extract is also effective in decreasing the regulatory pool of hepatic cholesterol, in line with decreased blood and hepatic levels of cholesterol though modulation of mRNA expression levels of HMG-CoA reductase, ACAT, and FXR.
Adipokines
;
Adiponectin
;
Administration, Oral
;
Animals
;
Blood Glucose
;
Cholesterol*
;
Diet
;
Diet, High-Fat*
;
Fatty Liver
;
Glucose
;
Homeostasis
;
Insulin
;
Leptin
;
Metabolism*
;
Mice*
;
Oxidoreductases
;
Phosphatidylcholine-Sterol O-Acyltransferase
;
Receptors, Lipoprotein
;
RNA, Messenger
;
Silk*
;
Sterol O-Acyltransferase
;
Triglycerides
;
Tumor Necrosis Factor-alpha
;
Zea mays*
6.Association of TNFRSF1B +676 gene polymorphism with the risk of rheumatoid arthritis in Han Chinese population in Hunan.
Xi XIE ; Fen LI ; Jinwei CHEN ; Jiesheng GAO ; Fanggen LU
Journal of Central South University(Medical Sciences) 2016;41(9):891-897
OBJECTIVE:
To study the association of TNFRSF1B +676 gene (rs1061622) polymorphism with the risk of rheumatoid arthritis (RA ) in Han Chinese population of Hunan.
METHODS:
A total of 112 patients with RA from Han Chinese population in Hunan were recruited, along with 129 healthy controls. TNFRSF1B +676 (rs1061622) gene polymorphisms were examined by PCR-RFLP. Serum levels of soluble TNFR II were analyzed by ELISA.
RESULTS:
RA patients displayed a similar TNFRSF1B +676 genotype to controls (GG/TG/TT: 5/62/45 vs 9/56/64, P=0.167), but signifi cant diff erence was found between female RA patients and female controls (GG/TG/TT: 3/49/24 vs 8/28/48, P<0.001). No significant difference was found in the frequency of TNFRSF1B +676 T or G allele between RA patients and controls (P>0.05). RA patients showed a signifi cantly higher level of serum soluble tumor necrosis factor receptor II (sTNFR II) than controls [(7.83±2.61) ng/mL vs (4.32±1.67) ng/mL, P<0.001], but there was no diff erence among the three genotypes (P>0.05). No association was found between TNFRSF1B+676 gene polymorphism and RA clinical characteristics.
CONCLUSION
In Han Chinese population of Hunan province, TNFRSF1B+676 gene polymorphisms are not associated with the genetic risk of RA .
Alleles
;
Arthritis, Rheumatoid
;
ethnology
;
genetics
;
Asian Continental Ancestry Group
;
Female
;
Gene Frequency
;
Genetic Association Studies
;
Genetic Predisposition to Disease
;
Genotype
;
Humans
;
Male
;
Polymorphism, Genetic
;
genetics
;
Polymorphism, Single Nucleotide
;
Receptors, Tumor Necrosis Factor, Type II
;
blood
;
genetics
;
Risk Factors
7.Study of the change and role of protein C system in ulcerate colitis.
Xu-Hong LIN ; Hui-Chao WANG ; Dan-Dan WEI ; Bin WANG ; Quan-Xing GE ; Chun-Yang BAI ; Ya-Qiang WANG ; Xue-Qun REN
Acta Physiologica Sinica 2015;67(2):214-224
Hypercoagulable state and thrombosis are major lethal causes of ulcerate colitis (UC). The aim of the present study is to explore the change and role of protein C (PC) system in UC thrombosis. 4% dextran sulfate sodium (DSS) was used to induce the UC model, and the body weight, the length of colon, and the weight of spleen were measured after intake of DSS as drinking water for 1 week. The macroscore and microscore were examined. The quantity of macrophage in colon smooth muscle was observed by immunofluorescence, and TNF-α and IL-6 levels in plasma were evaluated by ELISA. Intravital microscopy was applied to observe colonic mucosal microvascular circulation, activities of PC and protein S (PS) were determined by immunoturbidimetry, endothelial cell protein C receptor (EPCR) and thrombomodulin (TM) expressions were detected by immunohistochemistry. In vitro, TNF-α and IL-6 levels were tested in supernatant of macrophage separated from colonic tissue. After stimulation of mouse colonic mucosa microvascular endothelial cells by TNF-α and IL-6 respectively, the activities of PC, PS, activated protein C (APC) were evaluated, and the expressions of EPCR and TM were detected by Western blotting. The results revealed that compared with control, the DSS mouse showed weight loss (P < 0.05), a shortened colon (P < 0.05), and swelled spleen (P < 0.05), accompanied by higher histological score (P < 0.05), as well as infiltration of macrophages, elevated TNF-α and IL-6 levels in plasma (P < 0.01). The intravital microscopy results revealed that compared with control, DSS mice showed significantly enhanced adhesion of leukocytes and colonic mucosal microvascular endothelial cells (P < 0.01), meanwhile, decreased activity of PC and PS in plasma (P < 0.01 or P < 0.05), and down-regulated expression of EPCR (P < 0.01). The degree of inflammation was negatively correlated with the PC activity. In vitro, TNF-α and IL-6 levels were increased in the supernatant of macrophages from DSS mice colonic tissue (P < 0.05), and after incubation of TNF-α or IL-6 with colonic mucosal microvascular endothelial cells, the APC activity was decreased (P < 0.05 or P < 0.01), and expression of EPCR was down regulated (P < 0.05). These results suggest that PC system is inhibited in UC mouse. Presumably, the mechanism may be due to the secretion of cytokines from macrophages and subsequential influence on the function of endothelia cells. Furthermore, enhancement of PC system activity may serve as a new strategy for the treatment of UC.
Animals
;
Blood Coagulation Factors
;
metabolism
;
Colitis, Ulcerative
;
chemically induced
;
physiopathology
;
Dextran Sulfate
;
Immunohistochemistry
;
Inflammation
;
Interleukin-6
;
blood
;
Intestinal Mucosa
;
pathology
;
Macrophages
;
cytology
;
Mice
;
Protein C
;
metabolism
;
Receptors, Cell Surface
;
metabolism
;
Spleen
;
pathology
;
Tumor Necrosis Factor-alpha
;
blood
8.Early effects of tumor necrosis factor inhibition on bone homeostasis after soluble tumor necrosis factor receptor use.
Mie Jin LIM ; Seong Ryul KWON ; Kowoon JOO ; Min Jung SON ; Shin Goo PARK ; Won PARK
The Korean Journal of Internal Medicine 2014;29(6):807-813
BACKGROUND/AIMS: Our aim was to assess whether short-term treatment with soluble tumor necrosis factor (TNF) receptor affects circulating markers of bone metabolism in rheumatoid arthritis (RA) patients. METHODS: Thirty-three active RA patients, treated with oral disease-modifying antirheumatic drugs (DMARDs) and glucocorticoids for > 6 months, were administered etanercept for 12 weeks. Serum levels of bone metabolism markers were compared among patients treated with DMARDs at baseline and after etanercept treatment, normal controls and naive RA patients not previously treated with DMARDs (both age- and gender-matched). RESULTS: Bone-specific alkaline phosphatase (BSALP) and serum c-telopeptide (CTX)-1 levels were lower in RA patients treated with DMARDs than in DMARD-naive RA patients. After 12 weeks of etanercept treatment, serum CTX-1 and sclerostin levels increased. In patients whose DAS28 improved, the sclerostin level increased from 1.67 +/- 2.12 pg/mL at baseline to 2.51 +/- 3.03 pg/mL, which was statistically significant (p = 0.021). Increases in sclerostin levels after etanercept treatment were positively correlated with those of serum CTX-1 (r = 0.775), as were those of BSALP (r = 0.755). CONCLUSIONS: RA patients treated with DMARDs showed depressed bone metabolism compared to naive RA patients. Increases in serum CTX-1 and sclerostin levels after short-term etanercept treatment suggest reconstitution of bone metabolism homeostasis.
Adult
;
Alkaline Phosphatase/blood
;
Arthritis, Rheumatoid/blood/diagnosis/*drug therapy
;
Biological Markers/blood
;
Bone Morphogenetic Proteins/blood
;
Bone Remodeling/*drug effects
;
Collagen Type I/blood
;
Female
;
Genetic Markers
;
Homeostasis
;
Humans
;
Immunoglobulin G/*administration & dosage
;
Immunosuppressive Agents/*administration & dosage
;
Inflammation Mediators/blood
;
Male
;
Middle Aged
;
Peptides/blood
;
Receptors, Tumor Necrosis Factor/*administration & dosage
;
Time Factors
;
Treatment Outcome
;
Tumor Necrosis Factor-alpha/antagonists & inhibitors
9.Effect of multimodality therapies on plasma soluble tumor necrosis factor receptor I in OSAHS patients.
Xiaohui FENG ; Fei ZHOU ; Jihua WANG ; Xuping XIAO
Journal of Clinical Otorhinolaryngology Head and Neck Surgery 2014;28(6):366-368
OBJECTIVE:
As a subtype membrane receptor of tumor necrosis factor alpha, not much is known about the link between the soluble TNF receptor-I and obstructive sleep apnea hypopnea syndrome. We hypothesized that the TNF receptor might play an important role in the inflammation in patients with OSAHS, moreover this study was undertakan to investigate the effects of multimodality therapies on its periphery blood level.
METHOD:
Seventy-seven adults with habitual snoring and mean age of 34.9 +/- 11 years old consented to participate in the study. All participants were studied with overnight polysomnography, physical examination and a blood crew at baseline. According to the severity of OSAHS, they were categorized into three groups and one control group. Moderate and severe OSAHS groups returned for a repeat test of polysomnography and a blood crew at 3 months after the ENT surgery or continuous positive airway pressure (CPAP). serum levels were measured by using an immunoluminometric assay kit.
RESULT:
(1) Compared with control non-OSAHS group, serum sTNF-R I levels prior to treatment in OSAHS groups were significantly greater, with a mean serum levels at (742 +/- 258 & 340 +/- 102) pg/ml (P < 0.05), respectively. (2) Plasma solube tumor necrosis factor receptor-I responsed sensitively to the effect of comprehensive therapies when we compared its prior treatment levels with post ones. (3) Analysis was used to assess the associations adjusting for age, gender, BMI and weight ,a positive assosiation were found between apnea-hypopnea index (AHI) and sTNF-R I (r = 0.646, P < 0.01) a negative assosiation were found between lowest nadir oxygen saturation (LSaO2) and (r = 0.522, P < 0.01).
CONCLUSION
ln summary, independent of age, gender, BMI and weight ,our datas suggest a relationship can be found between the the severity of OSAHS and periphery blood level of soluble TNF receptor-I. Comprehensive therapies is effective in changing sTNF-R I. sTNF-R I may be recommended as a Inflammation factor of OSAHS.
Adult
;
Biomarkers
;
blood
;
Continuous Positive Airway Pressure
;
Female
;
Humans
;
Male
;
Middle Aged
;
Polysomnography
;
Receptors, Tumor Necrosis Factor
;
blood
;
Sleep Apnea, Obstructive
;
blood
;
therapy
;
Snoring
;
blood
;
Tumor Necrosis Factor-alpha
10.Predictive Value of Conjointly Examined IL-1ra, TNF-R I, TNF-R II, and RANTES in Patients with Primary Glomerulonephritis.
Journal of Korean Medical Science 2013;28(2):261-267
Interleukin-1 receptor antagonist (IL-1ra), tumor necrosis factor soluble receptors (sTNF-R) type I and II, and regulated upon activation, normal T-cell expressed and secreted (RANTES) play an important role in the modulation of primary glomerulonephritis (GN) course. The aim of the study was to assess whether pre-treatment measurements of IL-1ra, sTNF-R, and RANTES assessed conjointly may be useful as predicting factors in patients with GN. In 84 patients (45 males and 39 female) serum concentration (pg/mL) and urinary excretion (pg/mgCr) of cytokines were measured. After 12 months of therapy with steroids and cyclophosphamide the patients were divided into two subgroups: Responders (R) and Non-Responders (NR) according to the treatment results. The urinary IL-1ra, TNF-RI and RII were significantly higher in R than NR (1,732 vs 646 with P < 0.001, 13.1 vs 6.3 with P = 0.005, and 33.6 vs 14.4 with P = 0.012). The urinary RANTES excretion was increased in NR (79.6 vs 28.5; P < 0.001). The multivariable analysis showed that if conjointly assessed, only urinary IL-1ra, TNF-R I and R II, RANTES with 85% probability pointed the feature remission (R). In conclusion, the urinary excretion of IL-1ra, TNF-R I and R II, and RANTES examined conjointly are effective in predicting favorable response to immunosuppressive treatment in patients with GN.
Adult
;
Cyclophosphamide/therapeutic use
;
Female
;
Glomerulonephritis/drug therapy/*metabolism/pathology
;
Humans
;
Immunosuppressive Agents/therapeutic use
;
Interleukin 1 Receptor Antagonist Protein/*analysis/blood/urine
;
Lymphocyte Activation
;
Male
;
Middle Aged
;
Multivariate Analysis
;
Predictive Value of Tests
;
Receptors, Tumor Necrosis Factor, Type I/*analysis/blood/urine
;
Receptors, Tumor Necrosis Factor, Type II/*analysis/blood/urine
;
Steroids/therapeutic use
;
T-Lymphocytes/immunology/metabolism

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