肝移植受体术后外周血来源树突状细胞乙肝表面抗原提呈功能检测  

Hepatitis B Virus Surface Antigen Presenting Function of Peripheral Blood Dendritic Cells from Liver Transplant Receipients

作　　者：赖威[1] 卢实春[1] 李幼平[2] 严律南[1] 李波[1] 李胜富[2] 刘隽[1] 戴军[1] 赵冀[1] 

机构地区：[1]四川大学华西医院普外科华西肝移植中心,成都610041 [2]四川大学华西医院移植工程与移植免疫卫生部重点实验室

出　　处：《四川大学学报（医学版）》2007年第2期234-238,共5页Journal of Sichuan University(Medical Sciences)

基　　金：973(项目编号2003CB515504)资助

摘　　要：目的了解处于乙肝病毒临床清除状态的肝移植受体术后外周血来源树突状细胞提呈乙肝病毒表面抗原的能力及其影响因素。方法选取18例术后肝移植受体为病例组,6例健康成人为对照组,以细胞因子诱导法从外周血获得树突状细胞,经乙肝病毒表面抗原处理后进行混合淋巴细胞培养,检测并比较两组树突状细胞刺激淋巴细胞增殖的能力,并进行多因素分析。结果肝移植受体术后外周血来源的树突状细胞刺激淋巴细胞增殖的能力弱于健康对照组(cpm值4310.8±1820.3vs19002.5±3357.8,P<0.001),提呈乙肝病毒表面抗原的能力弱于健康对照组(cpm值4974.9±2414.7vs39258.4±5554.9,P<0.001)。结论肝移植受体术后外周血来源树突状细胞提呈乙肝表面抗原的能力低下,此种功能缺陷可能是导致受体针对乙肝病毒的主动免疫反应性低的重要原因,并且其提呈作用受术前乙肝病毒复制状态、术后时间、术后预防方案及术后外周血单个核细胞乙肝病毒含量影响。Objective To test the hepatitis B virus （HBV） antigen presenting capacity of peripheral blood dendritic cells （DCs） from liver transplant recipients who were in the condition of postoperative HBV clinical clearance. Methods Blood samples were obtained from 18 postoperative liver transplant recipients and 6 healthy adults. The peripheral blood mononuclear cells （PBMC） were isolated and cultured in vitro. The DCs were induced by recombainant human interleckin-4 （rhIL-4） and recombainant human granulocyte-macrophage colonystimulating factor （rhGM-CSF） and collected on day 7 of the culture. The DCs were then incubated with hepatitis B virus surface antigen （HBsAg） for 3 hours, and cocultured with allogeneic PBMC for 5 days. The 3HTdR was added with 1μci per well 18 hours before the end of the culture. The cpm values were identified for all of the cells. Results Under the same culture condition, the proliferation of the cells from the liver transplant recipients was poorer than those from the healthy adults （cpm value 4310. 8±1820. 3 vs 19002. 5±3357.8, P〈0. 001）. The capacity of antigen presenting of DCs from the liver transplant recipients was significantly weaker than those from the healthy adults （cpm value 4974. 9±2414. 7 vs 39258.4±5554. 9, P〈0. 001）. Conclusion Antigen presenting capacity of DCs from liver transplant reciplents, who are in the condition of postoperative HBV clinical clearance, is weakened, it might be the reason of the deficient immune response to HBV and hepatitis B vaccine of patients with liver transplant. The antigen presenting function is associated with the preoperative HBV replication, length after operation, prophylaxis of HBV re-infection/HB recurrence, and postoperative PBMV HBV DNA.

关 键 词：肝移植 外周血单个核细胞 树突状细胞 乙肝病毒 抗原提呈 

分 类 号：R657.3[医药卫生—外科学] R512.62[医药卫生—临床医学]