肝移植急性排斥反应时外周血Th17细胞的特征及意义  

Characteristics of Th17 Cells in Peripheral Blood in Liver Allograft Recipients with Acute Rejection

作　　者：王英[1] 石彦超[1] 施明[1] 张敏 王洪波[1] 孙艳玲[1] 苏海滨[1] 金磊[2] 刘振文[1] 王福生[2] 

机构地区：[1]北京大学医学部解放军第302医院肝移植研究中心,北京100039 [2]解放军第302医院肝病生物治疗中心,北京100039

出　　处：《现代生物医学进展》2014年第36期7030-7033,共4页Progress in Modern Biomedicine

基　　金：国家"863"课题(2013AA020102);全军医学科技"十二五"科研项目重点课题(BWS11J075(11-15));首都临床特色应用研究课题(Z111107058811069)

摘　　要：目的:观测肝移植患者术前及术后急性排斥时外周血中Th17细胞频率变化特征,探讨其与肝移植术后急性排斥发生的关系。方法:对18例于我院进行肝移植手术的患者进行随访研究,应用流式细胞仪检测各随访点外周血中Th17细胞频率。随访期间发生急性排斥反应的患者为急排组(n=7,男女比为5/2),未发生急性排斥反应者为非急排组(n=11,男女比为8/3),比较两组患者肝移植前后外周血中Th17细胞频率的变化规律。结果:急排组与非急排组患者肝移植术前外周血中Th17细胞频率无统计学差异(P=0.672),而急排组患者发生急性排斥反应时与非急排组患者相比Th17细胞频率明显升高(P=0.002)。在随访研究中,急排组患者在发生急性排斥反应时外周血中Th17细胞频率较未发生急性排斥反应时增高,且Th17细胞频率与ALT变化趋势一致,呈明显正性相关。而非急排组患者术后随访期间外周血中Th17细胞频率无统计学差异。结论:肝移植患者术后发生急性排斥反应时外周血中Th17细胞频率明显升高,变化趋势与ALT水平一致,呈正性相关,可能成为诊断急性排斥反应的潜在指标。Objective： To investigate the characteristics of Th17 cells in peripheral blood in liver transplant patients, and its association with acute rejection（AR）. Methods： 18 patients who underwent liver transplantation in our hospital were enrolled for this study.Peripheral blood was obtained from these participants longitudinally： pretransplantation, posttransplantation within 1 year＇s follow up, and at the time of an episode of AR to measure the frequencies of circulating Th17 cells by flow cytometry. All participants were divided into two groups： acute rejection group who suffered an AR（n=7, male/female is 5/2） during 1 year＇s follow up after liver transplanttation, and non-rejection group who were in stable liver function（n=11, male/female is 8/3）. The characteristics of circulating Th17 cells between the 2groups were analyzed. Results： There were no significant difference in the levels of circulating Th17 cells in pretransplantation（P=0.672）.However, the frequency of circulating Th17 cells were significantly higher in acute rejection group as compared with the non-rejection group（P=0.002）. Also, the longitudinal analysis revealed that the frequency of circulating Th17 cells dramatically increased at the time in acute rejection occurrence as compared with pretransplantation（P=0.007）. In addition, we found that the variation tendency of frequency of circulating Th17 cells was similiar with the level of ALT. The frequency of Th17 cells was maintained stable level in non-rejection group during the follow up period. Conclusion： The frequency of Th17 cells in peripheral blood significantly increased in AR with a similar variation tendency for the ALT level. It would be potentially acting as a marker for AR diagnosis in liver transplantation.

关 键 词：肝移植 TH17细胞 急性排斥反应 

分 类 号：R657.3[医药卫生—外科学] R392.4[医药卫生—临床医学]