慢性移植肾病外周血Th17细胞及其因子变化的意义  

Changes of peripheral blood CD_4^+ helper T cells and the related cytokines expression at the chronic allograft nephropathy

作　　者：张蓬杰[1] 张志明[2] 石斌娅[1] 杜鹏[1] 段斌[1] 陈瑞[1] 孙建国[1] 

机构地区：[1]陕西省人民医院肾移植科,西安710068 [2]西安市中心医院检验科

出　　处：《陕西医学杂志》2016年第1期100-103,共4页Shaanxi Medical Journal

摘　　要：目的:探讨外周血CD_4^+Th_(17)/CD_4^+T比率及IL-17、IL-6与IL-23在慢性移植肾肾病患者中的变化及意义。方法:使用流式细胞术检测慢性移植肾肾病、移植肾功能正常以及未行肾移植的慢性肾功能不全尿毒症期和健康人四组人群中Th_(17)细胞及其相关因子。结果:CAN患者组CD_4^+Th_(17)/CD_4^+T比率为3.96±0.28%,血清IL-17、IL-6与IL-23分别为:273.12±17.62pg/ml,231.52±45.32pg/ml,548.79±15.25pg/ml;移植肾功正常组:CD_4^+Th_(17)/CD_4^+T比率为2.47±0.25%,血清IL-17、IL-6与IL-23分别为142.32±10.15pg/ml,157.26±8.17pg/ml,251.20±13.28pg/ml;尿毒症组:CD_4^+Th_(17)/CD_4^+T比率为1.48±0.29%,血清IL-17、IL-6与IL-23分别为44.52±6.12pg/ml,67.38±10.38pg/ml,35.43±9.32pg/ml;健康组:CD_4^+Th_(17)/CD_4^+T比率为1.59±0.31,血清IL-17、IL-6与IL-23分别为36.87±8.14pg/ml,60.28±8.72pg/ml,38.15±8.56pg/ml。移植肾病组指标明显高于移植肾功能正常组(P<0.05),接受移植组较未行移植组各指标均明细升高(P<0.05),而未移植尿毒症组与健康组各指标无明显差别(P>0.05)。结论:移植后患者CD_4^+Th_(17)/CD_4^+T比率及细胞因子表达均升高;CAN组较移植肾功能正常组外周血CD_4^+Th_(17)/CD_4^+T比率及细胞因子表达升高更为明显;未接受移植两组间CD_4^+Th_(17)/CD_4^+T比率及细胞因子变化不明显。Objective： To investigate the changes of CD4 ＋ helper T cells （Th17 cells） and the related cyto- kines expression in the peripheral blood at the chronic allograft nephropathy （CAN） after kidney transplantation. Methods ..Thirty patients with CAN were examined for CD4 ＋ Th17/CD4 ＋T ratio in the peripheral blood using the flow cytometry, IL-17, IL-6 and IL-23 levels in plasma of these subjects were measured by enzyme- linked mimunoadsorbent assay, and the data were compared with those of thirty-five kidney recipients with normal graft function, thirty-three patients with chronic renal function （CRF）, and twenty-five normal subjects. All the recipients had no more than 2 HLA mismatch and received the same inductive and maintenance drug treatment. Results.. The recipients with CAN had significantly higher CD4 ＋ Th17/CD4 ＋T ratio and the related cytokines IL-17 ,IL-6 and IL-23 expression compared with those with normal graft function （3.96±0.28 vs 2.47±0.25 and 273.12±17.62 vs 142.32 ±10.15, 231.52±45.32 vs 157. 26±8.17, 548. 79±15.25 vs 251.20±13.28, P〈0.05）. The recipients whatever they had normal renal graft function showed significant difference in CD4 ＋ Thl7/CD4 ＋ T ratio and the related cytokines IL-17,IL-6 and IL-23 expression from the patients with CRF （1.48±0.29 and 44.52±6.12 67.38±10.38 35. 43±9. a2） and the normal control subjects（1.59±0.31 and 36.87±8.14 60.28±8. 72 38. 15±8.56）. The patiengts with CRF had no difference in CD4 ＋ ThlT/CD4 ＋ T ratio and the related cytokines from the normal control subjects. Conclusion：The peripheral blood CD4 ＋ Th17/CD4 ＋T ratio and the related cytokines IL-17,IL-6 and IL-23 expression in the kidney recipients with CAN are significantly higher than those of recipients with normal renal graft function, which does correlate with elevated creatinine level, suggesting a role of Th17 and the related cytokines in the occurrence and development of CAN.

关 键 词：肾移植 肾病/血液 白细胞介素17/代谢 白细胞介素6/代谢 

分 类 号：R692[医药卫生—泌尿科学]