球孢子菌病：早期免疫学发现
Coccidioidomycosis: early immunologic findings.
作者信息
Miller C H, MacKenzie M R, Paglieroni T, Goldstein E
出版信息
West J Med. 1983 Jan;138(1):55-9.
T and B lymphocyte number and lymphocyte response to phytohemagglutinin, pokeweed mitogen, concanavalin A, coccidioidin and streptokinase-streptodornase (SKSD), plus monocyte ingestion of coccidioidin- and IgG-coated chicken erythrocytes were measured in 5 patients with coccidioidal meningitis, 11 with nonmeningeal extrapulmonary cocidioidomycosis and 5 with localized pulmonary infections. These cases were evaluated within six months of the onset of infection. Lymphocytic responses to phytohemagglutinin, pokeweed mitogen, concanavalin A, SKSD and coccidioidin and monocytic ingestion of coccidioidin- and IgG-coated chicken erythrocytes were severely decreased in patients with meningeal and nonmeningeal, extrapulmonary coccidioidomycosis but not in patients with localized pulmonary infections. T and B cell numbers, however, were normal in all groups. Thus, defects in cellular immunity are involved in the pathogenesis of extrapulmonary coccidioidomycosis and measurements of lymphocytic and monocytic function may identify patients prone to extrapulmonary infection.
对5例球孢子菌性脑膜炎患者、11例非脑膜肺外球孢子菌病患者和5例局限性肺部感染患者，检测了T和B淋巴细胞数量以及淋巴细胞对植物血凝素、商陆有丝分裂原、刀豆球蛋白A、球孢子菌素和链激酶-链道酶（SKSD）的反应，此外还检测了单核细胞对球孢子菌素和IgG包被的鸡红细胞的摄取情况。这些病例在感染发病6个月内进行了评估。脑膜和非脑膜肺外球孢子菌病患者对植物血凝素、商陆有丝分裂原、刀豆球蛋白A、SKSD和球孢子菌素的淋巴细胞反应以及单核细胞对球孢子菌素和IgG包被的鸡红细胞的摄取严重降低，但局限性肺部感染患者则未出现这种情况。然而，所有组的T和B细胞数量均正常。因此，细胞免疫缺陷参与了肺外球孢子菌病的发病机制，淋巴细胞和单核细胞功能检测可能有助于识别易发生肺外感染的患者。
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