脓毒症患者外周血单核细胞PD-L1/PD-1表达及临床意义  

PD-1/PD-L1 expression in peripheral blood mononuclear cells and its clinical value in septic patients

作　　者：刘敏龙[1] 赵玉杰[1] 陈海燕[2] 张小玲[1] 刘媛媛[1] 王国恩[1] 

机构地区：[1]西安交通大学第二附属医院重症医学科,西安710004 [2]西安交通大学第二附属医院科研中心实验室

出　　处：《山西医科大学学报》2016年第6期526-530,共5页Journal of Shanxi Medical University

基　　金：陕西省科学技术研究发展计划基金资助项目(2014k11-02-01);西安交通大学第二附属医院新技术准入项目(17)

摘　　要：目的观察脓毒症患者外周血单核细胞(PBMC)的程序性细胞死亡因子-1(programmed cell death-1,PD-1)及其配体(programmed cell death-1 ligand,PD-L1)表达变化并探讨其临床意义。方法收集2015-01~2015-10入住我科的脓毒症患者38例,对照组为健康人15例。采集脓毒症患者外周血,采集时间点为入住ICU第1天、第3-4天、第7-8天,分离PBMC。流式细胞技术检测单核细胞、树突细胞PD-L1表达及CD8^+T淋巴细胞PD-1表达。并记录相应时间点中性粒细胞和淋巴细胞绝对计数。结果与对照组相比,脓毒症患者入住ICU第1天、第3-4天及第7-8天的单核细胞PD-L1表达和CD8^+T淋巴细胞均明显升高(P<0.01);脓毒症患者入住ICU第1天、第3-4天树突细胞PD-L1表达均明显升高(P<0.05)、第7-8天的树突细胞PD-L1表达有升高趋势,但差异没有统计学意义(P>0.05)。Spearman相关分析,树突细胞PDL1表达与中性粒细胞绝对计数呈正相关(r_s=0.272,P=0.018)。结论患者PBMC的PD-L1/PD-1上调表达可能反映脓毒症诱导的免疫抑制。Objective To explore the expression of programmed cell death-1（PD-1）and its ligand（PD-L1）on peripheral blood mononuclear cells（PBMC）in septic patients and evaluate its clinical value. Methods Totally 38 septic patients and 15 healthy controls（HC）were enrolled in this study. Blood samples were collected from septic patients at day 1 after admission to the ICU,days 3- 4,and days 7- 8. PBMC was obtained to detect PD-L1 expression on monocytes,dendritic cells and PD-1 expression on CD8~＋T cells by flow cytometry. Absolute neutrophil count and absolute lymphocyte count were recorded simultaneously. Results Expression of PDL1 on monocytes（P 0. 01）and PD-1 on CD8~＋T cells（P 0. 05）at each time point in septic patients were increased compared with controls. Expression of PD-L1 on dendritic cells at day 1 and days 3- 4 in septic patients was increased compared with controls（P 0. 05）,and increased at day 7- 8,but there was no significant difference（P 0. 05）. Spearman analysis showed a positive correlation between PD-L1 expression on dendritic cells and absolute neutrophil count（r——s= 0. 272,P = 0. 018）. Conclusion Increased expression of PD-L1 / PD-1 on PBMC might reflect the immunosurpression induced by sepsis.

关 键 词：脓毒症 外周血单核细胞 程序性细胞死亡因子配体-1 程序性细胞死亡因子-1 

分 类 号：R512.62[医药卫生—内科学]