性激素与CD4^+CD25^+调节性T细胞的相关性及在肾移植免疫耐受中的作用研究  

The Relationship Between Sex Hormones And Regulation T Cells and its Role in Immune Tolerance After Renal Transplantation

作　　者：袁渊[1] 曾甫清[2] 翟晓强[2] 李恒[2] 王振迪[2] 顾朝辉[2] 陈亮[2] 

机构地区：[1]湖北省十堰市郧阳医学院附属太和医院泌尿外科,湖北十堰442000 [2]华中科技大学同济医学院附属协和医院泌尿外科

出　　处：《临床泌尿外科杂志》2010年第10期732-735,共4页Journal of Clinical Urology

摘　　要：目的:为明确肾移植术后因供肾、受肾性别差异而排斥反应发生率不同,移植肾存活率不同而进行性激素水平的研究,明确性激素与CD4^+CD25^+调节性T细胞(CD4^+CD25^+Treg)的相关性及在肾移植免疫耐受中的作用。方法:选取正常对照组、肾移植组患者各20例,用ELISA法测定外周血性激素睾酮(T)、雌二醇(E_2)水平,用流式细胞术(FCM)测定CD4^+CD25^+Treg占CD^+T细胞比值。结果:肾移植术后女性E_2水平逐渐由高变低,男性T水平逐渐由低变高,CD^+CD25^+Treg水平也随时间相关性而逐渐升高,以单因素方差分析发现:E_2水平平稳期与正常对照组比较无显著差异(P>0.05);T平稳期与正常对照组比较无显著差异(P>0.05);肾移植男性受者早期2周内调节T细胞水平与正常值比较有明显差异(P<0.05),门诊随访肾移植达2年患者其调节t细胞与正常对照组无明显差异(P>0.05)。T与CD4^+CD25^+Treg术后均依时间相关性而逐渐上升,以直线相关性分析发现两者有明显相关性(P<0.05)。结论:肾移植术后随着下丘脑-垂体-性腺轴的恢复,患者性激素水平及CD4^+CD25^+Treg水平均逐渐恢复正常。排除体重、年龄、透析时间、HLA配型、缺血时间、术后糖皮质激素、免疫抑制剂治疗方式等因素的影响,T与CD4^+CD25^+Treg有明显相关性,男性在肾移植术后不仅可以通过雄激素直接抑制效应T细胞发挥主要免疫抑制作用,还可以通过增加CD4^+CD25^+Treg水平来发挥次要免疫抑制作用。Objective：Investigate the relevance of sex hormones and the CD4^＋CD25^＋ Treg, and the their roles in immune tolerance for renal transplantation. Methods：20 patients of normal control group and 20 of Renal trans- plant patients were selected. ELISA method was employed to detect the sex hormones levels in peripheral blood, the FCM accounting for the CD4^＋CD25^＋ Treg ceils. Results：Compared with the control group, the levels of testosterone gradually increased, and the Estradiol levels gradually decreased as the time correlation after renal transplantation , the level of CD4^＋CD25^＋ Treg T cells also increased gradually as the time went on. Exclude the im- pact of weight, age, dialysis time, HLA matching and other factors ,the sex hormone testosteronel and the level of CD4^＋CD25^＋ Treg showed the significant correlation by the linear correlation analysisP〈0.05. Conclusions： After renal transplantation the males not only can inhibit T Lymphocytes directly to play the major immunosuppression, but also can increase the level o.f regulation T cells to play the secondary immunosuppression.

关 键 词：肾移植 性激素 CD4^+CD25^+调节T细胞 免疫耐受 

分 类 号：R699.2[医药卫生—泌尿科学]