肾移植术后巨细胞病毒感染对受者NKT细胞表达CD226的影响  

Cytomegalovirus active infection after kidney transplantation affecting the expression of activation receptor CD226 on NKT cell

作　　者：于涛 刘志佳[1] 肖漓[1] 陈文[2] 药晨 孔祥瑞 周林[1] 许小东 石炳毅[1] Yu Tao;Liu Zhijia;Xiao Li;Chen Wen;Yao Chen;Kong Xiangrui;Zhou Lin;Xu Xiaodong;Shi Bingyi(Organ Transplant Institute,Eighth Medical Center of PLA General Hospital,Beijing 100091,China;Pathology Department of Eighth Medical Center of PLA General Hospital,Beijing 100091,China;Department of Medical Affairs,Eighth Medical Center of PLA General Hospital,Beijing 100091,China)

机构地区：[1]解放军总医院第八医学中心全军器官移植研究所,北京市器官移植与免疫调节重点实验室,北京100091 [2]解放军总医院第八医学中心病理科,北京100091 [3]解放军总医院第八医学中心卫勤部,北京100091

出　　处：《中华医学杂志》2019年第12期884-888,共5页National Medical Journal of China

基　　金：国家自然科学基金(81571555,81370578,81570680).

摘　　要：目的探讨肾移植术后巨细胞病毒感染患者外周血自然杀伤T(NKT)细胞表面CD226分子的表达变化及其意义。方法临床病例对照研究。收集2013年12月至2014年12月间在原解放军第三〇九医院器官移植研究所确诊的肾移植受者CMV病毒感染患者43例;健康对照15例,来自健康体检者和活体器官捐献者;肾移植术后处于稳定期的受者15例,为同时期随访并处于稳定期的肾移植受者。采用流式细胞术,分别检测了肾移植术后稳定期受者、CMV活动性感染者和健康对照者外周血单个核细胞中的NKT细胞比例以及其表达CD226分子的模式和荧光强度,并对淋巴细胞活化性受体CD226分子在CMV感染不同时期的表达进行动态观察。结果肾移植受者CMV感染患者在感染期的NKT细胞占外周血单个核细胞(PBMC)比例为5.19(1.18,25.92)%,恢复期患者为4.89(0.68,25.33)%,差异无统计学意义(P=0.84)。巨细胞病毒活动性感染过程中CD226+NKT比例为(70±13)%,低于健康对照[(87±10)%]和稳定期受者[(80±9)%],差异均有统计学意义(均P<0.001)。恢复期患者CD226+NKT比例恢复,为(81±16)%,与健康对照和稳定期受者相近,差异无统计学意义(P>0.05),但高于感染期,差异有统计学意义(P<0.01)。CMV感染患者NKT细胞CD226表达平均荧光强度(MFI)为101±49,与稳定期和健康对照差异均无统计学意义(均P>0.05)。而在感染恢复期NKT表达CD226 MFI为173±73,高于CMV感染组和肾功稳定组,差异均有统计学意义(P<0.05和P<0.01)。相同患者感染期CD226 MFI为91±40,恢复期为173±73,恢复期上调了CD226表达,差异有统计学意义(P<0.001)。结论巨细胞病毒感染可造成CD226^+NKT细胞比例下降,而感染恢复期CD226+NKT细胞亚群比例恢复,同时合并NKT细胞CD226MFI值的上调,提示NKT细胞表达CD226参与了抗巨细胞病毒感染的过程。Objective To investigate the effect of active cytomegalovirus infection post kidney transplant on the expressing of receptor CD226 on NKT cell.Methods Case controlled study.From December 2013 to December 2014,43 cases of kidney transplant recipient with CMV infection were collected in the Organ Transplantation Research Institute of the former 309th Hospital of PLA.The healthy control group included 15 cases.15 cases of recipients who were stable after operation and followed up in our hospital at the same time were also collected as control.Peripheral blood specimen with EDTA as anticoagulant were used and analyzed by flow cytometry.Results The population of NKT in CMV infection recipients were 5.19(1.18,25.92)%,while in the remission stage the population were 4.89(0.68,25.33)%,Compared with normal healthy controls and the stable recipients,the percentage of CD3^+CD56^+ NKT cells in periphery blood mononuclear cells did not vary among these groups(P>0.05).The CD226^+ NKT population during the active CMV infection was (70±13)%,which was significantly lower than the health control [(87±10)%] and stable recipients [(80±9)%](P<0.001).Whereas in the CMV infection remission stage,the CD226^+NKT population was (81±16)%,which was significantly higher than that of CMV active infection group (P<0.05),and showed no difference with the health control group and stable recipients (P>0.05).The CD226 MFI expressed on NKT in CMV infection group was 101±49,which showed no difference with health controls and stable recipients (P>0.05).However,significantly up regulation of CD226 MFI on NKT was observed in the samples obtained from the same recipients in CMV active infection (91±40) and in CMV regression stage(173±73)(P<0.001).Conclusions The CD226^+ NKT cells population was down during the active CMV infection post kidney transplantation,while the expression of CD226 and the population of CD226+NKT could regression when the CMV infection regressed,which indicates the involvement of CD226 in the process of NKT cells anti-CMV i

关 键 词：巨细胞病毒 肾移植 自然杀伤T细胞 CD226 流式细胞术 

分 类 号：R699.2[医药卫生—泌尿科学]