T淋巴细胞亚群在肝移植术后长期生存患者外周血中的变化  

Proportion of T lymphocytes subgroup in peripheral blood of long-term survival patients after liver transplantation

作　　者：谢炜[1,2] 杨占宇[1] 刘翔德[1] 

机构地区：[1]第三军医大学西南医院全军肝胆外科研究所,重庆400038 [2]重庆市中山医院肝胆外科,重庆400013

出　　处：《第三军医大学学报》2012年第22期2306-2310,共5页Journal of Third Military Medical University

基　　金：国家自然科学基金面上项目(81070376)~~

摘　　要：目的分析肝移植术后长期生存患者外周血中Th1细胞和CD3+CD8low抑制性T细胞(Ts)及CD4+CD25+Foxp3+Treg水平的变化及其临床意义。方法研究对象为肝移植术后长期生存患者的外周血,血清学检测肝功能生化指标与FK506的含量,采用荧光标记单克隆抗体和流式细胞术检测Th1细胞、CD3+CD8low抑制性T细胞及CD4+CD25+Foxp3+Treg含量变化,分析表达变化特点及与免疫抑制药物FK506(他克莫司)的相关性。结果通过对肝移植术后存活2～3、8～10年患者及健康人外周血中Th1细胞、CD3+CD8low抑制性T细胞及CD4+CD25+Foxp3+Treg的含量检测显示三者水平呈逐渐下降趋势,最终接近至健康人的水平;肝移植术后生存2～3年组外周血中3种细胞百分比计数水平均显著高于健康对照组(P<0.05);生存8～10年患者CD3+CD8low抑制性T细胞百分比计数水平显著高于健康人组(P<0.05),而Th1及CD4+CD25+Foxp3+Treg细胞百分比计数较2～3年组的水平显著降低(P<0.05);生存8～10年组患者中CD3+CD8low抑制性T细胞较生存2～3年组的水平虽然也降低,但无显著性差异(P>0.05);肝移植术后长期存活患者血清FK506浓度与三者水平呈直线正相关。结论肝移植术后患者产生免疫耐受一定程度上取决于Th1细胞、CD3+CD8low抑制性T细胞及CD4+CD25+Foxp3+Treg的平衡。Objective To detect the levels of Th1 cells,CD3＋CD8low suppressor T cells and CD4＋CD25＋Foxp3＋Treg in the peripheral blood of long-term survival patients underwent liver transplantation.Methods A total of 40 patients who underwent liver transplantation in our institute during January 2001 to December 2009 were enrolled and followed up till January 2012.They were 23 males and 17 females,with an age ranging form 45 to 58,and further divided into 2-3 year survival group（n=20） and 8-10 year survival group（n=20）.Another 20 sex-and age-matched health individuals served as normal control.The serum levels of AST,ALT,GGT and FK506（tacrolimus） was detected by serological analysis.The proportions of Th1 cells,CD3＋CD8low suppressor T cells and CD4＋CD25＋Foxp3＋Treg were detected by fluorescence labeling monoclonal antibodies and flow cytometry.The correlation of these changes with serum level of FK506 was analyzed.Results The proportions of the Th1 cells,CD3＋CD8low suppressor T cells and CD4＋CD25＋Foxp3＋Treg were gradually decreased in the patients undergoing liver transplantation after 2-3 and 8-10 years,were approached to those of healthy control.The percentages of Th1 cells,CD3＋CD8low suppressor T cells and CD4＋CD25＋Foxp3＋Treg were significantly larger in 2-3 year survival group than in healthy people（P0.05）.Furthermore,the expressions of Th1 cells and CD4＋CD25＋Foxp3＋Treg in 8-10 year survival group were decreased significantly than in 2-3 year survival group（P0.05）,but there were not significant change in CD3＋CD8low suppressor T cells between 2-3 year and 8-10 year survival group（P0.05）.All of them were positively correlated with the serum level of K506.Conclusion Formation of immune tolerance in patients after liver transplantation may be,to some extent,resulted from the balance of Th1 cells,CD3＋CD8low suppressor T cells,and CD4＋CD25＋Foxp3＋Treg.

关 键 词：肝移植 免疫耐受 TH1细胞 CD3+CD8low抑制性T细胞 

分 类 号：R392.12[医药卫生—免疫学] R446.11[医药卫生—基础医学]