同种异体肺移植术后血浆IL-10水平变化及与受者发生临床细菌感染死亡的关联  

Plasma IL-10 level after allogeneic lung transplantation and its relationship with bacterial infectious death in clinic

作　　者：王雪[1] 潘旭峰[2] 丁旭苹 杨骏[2] 侯亚菲[1] 金海振 潘雁[2] 祝敏芳[2] 王韡旻[2] 潘常青[2] 路丽明[1] WANG Xue*;PAN Xu-feng;DING Xu-ping;YANG Jun;HOU Ya-fei;JIN Hai-zhen;PAN Yan;ZHU Min-fang;WANG Wei-min;PAN Chang-qing;LU Li-ming(Shanghai Institute of Immunology Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China;Department of Thoracic Surgery Shanghai Chest Hospital,Shanghai Jiao Tong University,Shanghai 200030,China)

机构地区：[1]上海交通大学医学院上海市免疫学研究所,上海200025 [2]上海交通大学附属胸科医院胸外科,上海200030

出　　处：《现代免疫学》2024年第1期1-9,25,共10页Current Immunology

基　　金：国家自然科学基金面上项目(81671579,82071856);国家重点研发计划重点专项项目(2020YFA0113101,2017YFA0104600)。

摘　　要：为探讨同种异体肺移植受者术后血浆IL-10水平变化及其与细菌感染死亡的关联,研究收集肺移植后死亡受者和存活受者、长期预后良好受者和健康志愿者的血浆样本。血常规分析死亡受者的外周血免疫细胞分布;影像学检查观察死亡受者肺部病原体的感染情况;细菌体外培养和病原微生物高通量基因组测序分析死亡受者的病原体感染类型;Luminex多因子检测法监测全体血浆样本多细胞因子的浓度。结果显示,死亡受者术后外周血白细胞计数、中性粒细胞计数和百分比、CRP浓度、中性粒细胞计数/淋巴细胞计数比值均增加,红细胞计数、血小板计数等则减少;术后肺部出现高密度影;血液、支气管肺泡灌洗液和痰液中出现多种细菌混合感染。动态监测细胞因子浓度发现相较于存活受者、预后良好受者和健康志愿者,死亡受者术后血浆IL-10浓度、IL-10/IFN-γ比值均显著升高(均P<0.0001)。综上,研究首次发现血浆IL-10水平变化与受者发生临床细菌感染死亡有密切关联。The purpose of this study was to investigate the changes in postoperative plasma IL-10 levels in allogeneic lung transplant recipients and its relationship with death due to bacterial infection.To this end,plasma samples were collected from healthy volunteers and lung transplantation recipients who either deceased,survived or lived with a good long-term prognosis.For the deceased group,the immune cell distributions in peripheral blood were analyzed by routine blood analysis.The pathogenic infection status was examined by imaging and the type of pathogenic infection was analyzed by in vitro bacteria culture and by high-throughput genomic sequencing of pathogenic microorganisms.In addition,the concentration of multiple cytokines in all plasma samples was monitored by Luminex multifactor detection.The results showed that in the deceased recipients,postoperative white blood cell count(WBC),absolute neutrophil count(NEUT)and percentage(NEUT%),CRP concentration,and neutrophil-lymphocyte ratio(NLR)were all increased,while red blood cell count(RBC)and platelet count(PLT)were decreased.Moreover,some high-density shadows were observed in the postoperative lungs along with multiple bacterial infections in the blood,bronchoalveolar lavage fluid(BALF),and sputum.Dynamic monitoring of cytokines concentration showed that plasma IL-10 concentration and IL-10/IFN-γratio were all significantly increased(all P<0.0001)in the deceased recipients after allogeneic lung transplantation compared to those of survived recipients,recipients with good prognosis and healthy volunteers.Altogether,this work suggests,for the first time,that the change in plasma IL-10 level is highly related with increased bacterial infection and mortality in lung transplantation recipients.

关 键 词：肺移植 细菌感染 死亡 白细胞介素10 

分 类 号：R392.4[医药卫生—免疫学]