肝移植患者外周血Tfh细胞特征的初步研究  

Characteristics of Tfh cells in the peripheral blood in recipients of liver allograft: A pilot study

作　　者：石彦超[1] 孙艳玲[1] 刘振文[1] 王福生[2] 施明[1] 

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

出　　处：《解放军医学杂志》2014年第12期965-968,共4页Medical Journal of Chinese People's Liberation Army

基　　金：全军医学科技"十二五"科研项目重点课题[BWS11J075(11-15)];国家高技术研究发展计划(863计划)(SS2013AA020102);首都临床特色应用研究课题(Z111107058811069)~~

摘　　要：目的检测肝移植术前和术后患者外周血滤泡性辅助性T细胞(Tfh)及其分子表达特点,探讨其在肝移植免疫中的作用。方法肝移植术后患者及健康对照各20例,其中移植术后肝功能稳定者13例,对其进行断面研究;余7例病例资料完整,进行随访研究。应用流式细胞仪检测所有入组者的Tfh细胞频率,并对随访患者进行术后1月的动态监测,同时检测其丙氨酸转氨酶(ALT)水平。结果与移植术前相比,移植术后患者外周血CD4+CXCR5+Tfh和CD4+CXCR5+PD-1+细胞频率明显升高(P<0.05),CD4+CXCR5+ICOS+细胞虽有上升趋势,但无统计学意义。随访发现移植术后肝功能稳定患者CD4+CXCR5+Tfh水平在移植术后明显上升,1周后达峰值随后下降,其ALT水平也在术后第10天达到峰值后降低。随访期间1例患者发生急性排斥反应,其CD4+CXCR5+Tfh水平与ALT水平变化趋势一致。肝功能稳定组与健康对照组相比,CD4+CXCR5+Tfh、CD4+CXCR5+PD-1+和CD4+CXCR5+ICOS+细胞频率均明显升高(P<0.05)。结论外周血CD4+CXCR5+Tfh细胞在肝移植后表达上调,可能参与了肝移植术后的免疫调节。Objective To determine the expression characteristics of peripheral blood follicular helper T cells （Tfh） and their molecules during pre- and post-transplantation period in liver transplant patients to explore the role of Tfh in alloreactive response after liver transplantation. Methods Twenty liver transplant （LT） patients and 20 healthy individuals as control were enrolled in this study. Thirteen LT patients with stable liver function were included for cross-sectional study. Another seven LT patients with complete clinical data were included for follow-up study. The frequencies of Tfh cells were examined by flow cytometry. For the seven patients, Tfh cells and level of alanine aminotransferase （ALT） were monitored dynamically for one month after LT. Results The frequencies of CD4^＋CXCR5^＋Tfh and CD4^＋CXCR5^＋PD-1^＋ cells in peripheral blood increased significantly after liver transplantation as compared with those before liver transplantation （P〈0.05）. In addition, the frequencies of CD4^＋CXCR5^＋ICOS＋ cells showed a rising trend, but no statistical difference. In early follow-up period it was found that the frequencies of CD4^＋CXCR5^＋Tfh obviously increased after liver transplantation in patients with stable liver function, and reached the peak value after one week and then decreased. The ALT level also decreased when reaching peak 10 days after surgery. Interestingly, the frequencies of CD4^＋CXCR5^＋ Tfh in one patient with acute rejection after liver transplantation showed the same trend with ALT levels changes. Furthermore, the frequencies of CD4^＋CXCR5^＋Tfh, CD4^＋CXCR5^＋PD-1^＋ and CD4^＋CXCR5^＋ICOS＋ cells in stable liver function group were higher than those in the healthy control group （P〈0.05）. Conclusion The CD4^＋CXCR5^＋Tfh cells in peripheral blood will be upregulated in liver transplant patients, which indicates that the Tfh may be involved in liver alloreactive response.

关 键 词：肝移植 Tfh细胞 移植免疫学 

分 类 号：R657.3[医药卫生—外科学]