肝移植术后相关免疫指标的变化及其临床意义
首发时间:2015-01-28
摘要:探讨目的:探讨肝移植术后相关免疫指标的变化,为临床上肝移植抗排斥治疗的指导提供依据。方法:纳入53例在本中心肝移植存活至今潜在免疫耐受者,其中21例3-5年组(3Y组),32例5-11年组(5Y组),另纳入15例肝移植术后反复排斥反应组(RJ组),纳入32例年龄匹配的健康对照组(HC组),应用流式检测外周血单个核细胞中自然杀伤细胞(NK)、B细胞、记忆性T细胞、调节性T细胞(Treg)及其三个亚群的表达,通过ELISA法检测血清中TGF-β的含量。结果:3Y组(19±0.09)、5Y组(20±0.09)、HC组(14±0.07)NK细胞比RJ组(9±0.03)明显升高(P<0.05);3Y组(6.26±2.33)、5Y组(4.80±2.21)、HC组(3.04±1.25)Treg细胞比RJ组(1.09±0.81)明显升高(P<0.05);3Y组(0.23±0.07)、5Y组(0.16±0.02)静息性Treg细胞比HC组(0.07±0.02)、RJ组(0.05±0.01)明显升高(P<0.05);3Y组(0.56±0.11)、5Y组(0.42±0.15)激活性Treg细胞比HC组(0.075±0.02)、RJ组(0.05±0.01)明显升高(P<0.05);3Y组(3.51±0.80)、5Y组(3.71±0.41)无免疫抑制作用的Treg细胞比HC组(1.44±0.14)、RJ组(2.15±0.62)明显升高(P<0.05);记忆性CD8+ T细胞、CD19+B细胞、血清中TGF-β的含量在各组间无显著差异。结论:肝移植术后潜在免疫耐受者外周血单个核细胞中NK细胞、Treg细胞、静息性Treg细胞、激活性Treg细胞、无免疫抑制作用的Treg细胞比例相对术后反复排斥反应者明显升高,提示这些免疫指标可能为潜在的耐受标志物。
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Changes of immune parameters in the liver transplantation recipients
Abstract:Objective To analyze the related immune parameters status in the liver transplantation recipients, in order to give advices of the immunosuppressant adjustment in the future. Methods Fifty three liver transplantation tolerance recipients were included. They had normal liver function until now and took only one immunosuppressive drug. They were divided into potential tolerance 3Y group, about twenty-one cases who were 3-5 years (included 5 years) after transplantation, potential tolerance 5Y group who were more than 5 years after transplantation included thirty-two cases. Another fifteen liver recipients occurred acute rejection twice or more as RJ group and thirty-two age matched healthy donors as HC group. The natural killer (NK) cells, B cells, memory T cells, regulatory T cells and its subsets were detected with flow cytometry. The content of TGF-β in plasma with ELISA. Results The percentage of NK cells (3Y:19±0.09;5Y:20±0.09;HC:14±0.07;RJ:9±0.03)and the regulatory T cells within the CD4+ cells (3Y:6.26±2.33;5Y:4.80±2.21;HC:3.04±1.25,RJ:1.09±0.81)in the 3Y, 5Y and HC groups were significantly higher than that in the RJ group (P<0.05). The proportion of resting Tregs (3Y:0.23±0.07;5Y:0.16±0.02;HC:0.07±0.02,RJ:0.05±0.01), the active Tregs (3Y:0.56±0.11;5Y:0.42±0.15;HC:0.075±0.02,RJ:0.05±0.01) and non-suppressive Tregs (3Y:3.51±0.80;5Y:3.71±0.41;HC:1.44±0.14,RJ:2.15±0.62) increased significantly in the liver transplantation tolerance recipients copared with the HC and RJ groups (P<0.05). No significant difference in B cells, memory T cells and the content of TGF-β between four groups. Counclusion The NK cells, regulatory T cells, resting Tregs, the active Tregs and non-suppressive Tregs increased significantly in liver transplantation tolerance recipients, these immune parameters might be the potential tolerance biomarkers.
Keywords: Liver transplant immune parameters Peripheral blood
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