亲属活体肾移植术后受者外周免疫细胞亚群的动态变化  

Dynamic change of peripheral immune cell subsets in living-related kidney transplant patients

作　　者：黎东伟[1] 刘龙山[1] 傅茜[1] 李军[1] 熊韫祎[1] 黄慧婷[1] 邓素雄[1] 费继光[1] 陈立中[1] 王长希[1] 

机构地区：[1]中山大学附属第一医院器官移植中心,广州510080

出　　处：《中华器官移植杂志》2013年第8期458-462,共5页Chinese Journal of Organ Transplantation

摘　　要：目的观察亲属活体。肾移植后受者免疫细胞亚群的动态变化。方法首次肾移植受者16例，应用抗CD25单克隆抗体行免疫诱导，免疫抑制维持方案为他克莫司＋吗替麦考酚酯＋皮质激素。术前及术后6个月内流式多点检测外周血中T淋巴细胞、B淋巴细胞、自然杀伤细胞（NK细胞）重要亚群的比例及其相关重要分子的表达。结果T淋巴细胞在术后3d明显降低，此后逐渐回升至术前水平。CD4’、CD8’T淋巴细胞表面CD25表达及CIN’CD25№“CD127h调节性T淋巴细胞明显降低，术后3个月开始回升，至术后6个月恢复至术前水平。B淋巴细胞比例术后1个月内升高至术前的1．8～2．1倍，术后3个月恢复；CD19’CD5’B淋巴细胞逐渐下降，术后6个月降至术前的45％；记忆性B淋巴细胞逐渐升高至术前的1．3倍；B淋巴细胞活化因子受体（BAFF-R）的表达一直维持在较高水平（91．7％～97．9％）；前生发中心、生发中心细胞比例持续下降。NK细胞比例逐渐下降至术前的44％，但NK细胞表面抑制性受体（NKG2A）与活化性受体（NKG2D）比值明显升高。结论效应性T淋巴细胞和调节性T淋巴细胞表面CD25表达在术后3个月开始恢复；术后早期B淋巴细胞比例明显增加，其活化可能不受抑制；NK细胞比例明显降低，且杀伤功能可能减弱。外周免疫细胞亚群的系缔动杰峪测有助干了锯肾移桔詈者术后的龟癌风盼．Objective To observe the dynamic change of peripheral immune cell subsets in living-related kidney transplant （LRKT） recipients. Method Sixteen de novo LRKT recipients were enrolled in this study. The induction therapy was given （anti-CD25 monoclonal antibody）, and the maintenance immunosuppressive regimen consisted of tacrolimus, mycophenloate mofetil and steroids. Subpopulations of T cells, B cells and NK cells as well as the expression of relative eell surface molecules were monitored by using flow cytometry at multiple time points before/after transplant. Examination data prior to transplant was defined as baseline level. Results The proportion of T cells was decreased within 3 days after transplantation, and then increased steadily to 1.2 times of the baseline at month 6. The CD25 expression in CD4＋ and CD8＋ T cells and the proportion of CD4＋ CD25ghCD127Iw regulatory T cells were decreased significantly within three months post-transplant, and recovered to the baseline at month 6. CD19 g ceils were significantly increased by 1.8-2. 1 times within one month post-transplant, and recovered to the baseline at month 3. CD5＋ CD19＋ B cells were decreased steadily after transplantation and dropped to 45% at month 6. Memory B cells were increased gradually by 1.3 times after transplantation. The BAFF-R expression in B cells maintained at high level （91.7%-97. 9%） within six months post-transplant. The germinal center （GC） founder cells （IgD CD38＋＋ ） and GC B cell subpopulation （IgD- CD38＋＋ ） were consistently decreased after transplantation. NK cells were decreased gradually to 44% at month 6. NKG2A/NKG2D was increased significantly by 2. 4-7. 1 times within six months. Conclusion The CD25 expression in effector T cells and regulatory T cells began to recover after three months post-transplant. B cellsproportion was significantly increased early after transplant without inhibition of activation. NK cells were decreased dramatically after transplantation and the killer functio

关 键 词：肾移植 抗CD25单克隆抗体 免疫诱导 免疫状态监测 

分 类 号：R699.2[医药卫生—泌尿科学]