慢性移植肾病初期外周血CD4^+CD25^+Foxp3^+T细胞变化及意义  

Changes of peripheral blood CD4^+CD25^+ regulatory T cells and TREG-related Foxp3 gene expression at the onset of chronic allograft nephropathy

作　　者：杜传福[1] 于立新[1] 付绍杰[1] 徐健[1] 魏强[1] 

机构地区：[1]南方医科大学南方医院肾移植科,广东广州510515

出　　处：《南方医科大学学报》2012年第9期1366-1368,1372,共4页Journal of Southern Medical University

基　　金：广东省自然科学基金(S2011010003749)

摘　　要：目的研究慢性移植肾病(CAN)发生初期外周血CD4+CD25+Foxp3+T(TREG)细胞变化及意义。方法对25例初发CAN的受者外周血CD4+CD25+high/CD4+T比率及Foxp3表达进行了检测,同时与使用同一抗排斥治疗方案、移植肾功能正常的30例受者、以及未行肾移植的慢性肾功能不全尿毒症期的20例和正常人20例进行比较,研究了CAN发生初期TREG细胞的变化。结果 CAN发生初期的受者,CD4+CD25+Thigh/CD4+比率为0.71±0.33,Foxp3表达率为62.75±10.80;移植肾功正常者,两指标分别为1.17±0.25及70.42±6.87,移植肾病组两指标均明显低于移植肾功能正常组(P<0.01)。无论移植肾功能正常与否,移植受者的CD4+CD25+high/CD4+比率和Foxp3表达率均较未行移植尿毒症患者(1.53±0.35及77.86±7.09)及正常人(1.65±0.28及81.35±2.39)明显降低(P<0.01),而正常人及未移植尿毒症患者两指标无明显差别。结论与移植肾功能正常者相比,CAN发生初期患者外周血中CD4+CD25+high/CD4+比率及Foxp3表达率均明显降低,且与肌酐增高无关,提示TREG在CAN的发生中具有一定意义。Objective To investigate the changes of CD4＋CD25 ＋ regulatory T cells （TREG） and TREG-related foxp3 gene expression in the peripheral blood at the onset of chronic allograft nephropathy （CAN） after kidney transplantation. Methods Twenty-five patients with initial onset of CAN were examined for CD4＋CD25＋high/CD4＋ ratio and the expression of Foxp3 gene in the peripheral blood using the flow cytometry, and the data were compared with those of 30 kidney recipients with normal graft function, 20 patients with chronic renal function （CRF）, and 20 normal subjects. All the recipients had no more than 1 HLA mismatch and received the same inductive and maintenance drug treatment. Results The recipients with CAN had significantly lower CD4＋CD25＋high/CD4＋ ratio and Foxp3 gene expression compared with those with normal graft function （0.71± 0.33 vs 1.17±0.25 and 62.75±10.80 vs 70.42±6.8, respectively, P〈0.01）. The recipients with normal renal graft function showed no significant difference in CD4＋CD25＋high/CD4＋ ratio and Foxp3 gene expression from the normal control subjects. Conclusion The peripheral blood CD4＋CD25＋high/CD4＋ ratio and Foxp3 expression in the kidney recipients with CAN are significantly lower than those of recipients with normal renal graft function, which does not correlate with elevated creatinine level suggesting a role of TREG in the occurrence and development of CAN.

关 键 词：肾移植 慢性移植肾肾病 免疫调节细胞 CD4+CD25+ 叉状头/翅膀状螺旋转录因子 

分 类 号：R692[医药卫生—泌尿科学]