中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2009年
22期
1741-1743
,共3页
莫春柏%宋文利%王智平%郑建明%付迎欣%冯刚%裴广辉%赵杰%史晓峰%刘航
莫春柏%宋文利%王智平%鄭建明%付迎訢%馮剛%裴廣輝%趙傑%史曉峰%劉航
막춘백%송문리%왕지평%정건명%부영흔%풍강%배엄휘%조걸%사효봉%류항
T淋巴细胞%调节性%肾移植%免疫耐受%Foxp3
T淋巴細胞%調節性%腎移植%免疫耐受%Foxp3
T림파세포%조절성%신이식%면역내수%Foxp3
T-lmyphocytes,regulatory%Kidney transplantation%Immune tolerance%Foxp3
目的 探讨不同免疫抑制剂方案对肾移植术受者外周血CD4~+ Foxp3~+调节性T细胞(regulatory T cells,Treg)表达水平的影响.方法 定群研究了2006年1月至2008年1月在本移植中心接受初次移植50例随访满1年肾移植受者,分为钙调神经蛋白抑制组(钙调神经蛋白抑制剂+吗替麦考酚酯+强的松)19例,其中环孢素组10例,他克莫司组9例;雷帕霉素组(雷帕霉素+吗替麦考酚酯+强的松)31例.另取20例行规律血液透析终末期肾病患者为对照组.采用流式细胞仪的方法检测3组外周血CD4~+ Foxp3~+ Treg占CD4~+ T细胞的比例,比较各组间表达水平与不同免疫抑制方案的关系.结果 钙调神经蛋白抑制剂组、雷帕霉素组和终末期肾病组3组年龄、性别比无统计学差异(P>0.05).钙调神经蛋白抑制剂组、雷帕霉素组2组冷缺血时间、HLA错配率、群体反应性抗体(PRA)和急性排斥反应发生率无统计学差异(P>0.05).雷帕霉素组和终末期肾病组CD4~+ Foxp3~+ T细胞占CD4~+ T细胞的比例均明显高于钙调神经蛋白抑制组,差异有统计学意义(P<0.01).使用环孢素患者和他克莫司患者外周血中CD4~+ Foxp3~+ T细胞占CD4~+ T细胞的比例之间无显著性差异(P>0.05).结论 肾移植术后服用雷帕霉素组患者外周血CD4~+ Foxp3~+ Treg占CD4~+ T细胞的比例显著高于服用钙调神经蛋白抑制组患者,提示雷帕霉素有助于诱导宿主对移植肾免疫耐受.
目的 探討不同免疫抑製劑方案對腎移植術受者外週血CD4~+ Foxp3~+調節性T細胞(regulatory T cells,Treg)錶達水平的影響.方法 定群研究瞭2006年1月至2008年1月在本移植中心接受初次移植50例隨訪滿1年腎移植受者,分為鈣調神經蛋白抑製組(鈣調神經蛋白抑製劑+嗎替麥攷酚酯+彊的鬆)19例,其中環孢素組10例,他剋莫司組9例;雷帕黴素組(雷帕黴素+嗎替麥攷酚酯+彊的鬆)31例.另取20例行規律血液透析終末期腎病患者為對照組.採用流式細胞儀的方法檢測3組外週血CD4~+ Foxp3~+ Treg佔CD4~+ T細胞的比例,比較各組間錶達水平與不同免疫抑製方案的關繫.結果 鈣調神經蛋白抑製劑組、雷帕黴素組和終末期腎病組3組年齡、性彆比無統計學差異(P>0.05).鈣調神經蛋白抑製劑組、雷帕黴素組2組冷缺血時間、HLA錯配率、群體反應性抗體(PRA)和急性排斥反應髮生率無統計學差異(P>0.05).雷帕黴素組和終末期腎病組CD4~+ Foxp3~+ T細胞佔CD4~+ T細胞的比例均明顯高于鈣調神經蛋白抑製組,差異有統計學意義(P<0.01).使用環孢素患者和他剋莫司患者外週血中CD4~+ Foxp3~+ T細胞佔CD4~+ T細胞的比例之間無顯著性差異(P>0.05).結論 腎移植術後服用雷帕黴素組患者外週血CD4~+ Foxp3~+ Treg佔CD4~+ T細胞的比例顯著高于服用鈣調神經蛋白抑製組患者,提示雷帕黴素有助于誘導宿主對移植腎免疫耐受.
목적 탐토불동면역억제제방안대신이식술수자외주혈CD4~+ Foxp3~+조절성T세포(regulatory T cells,Treg)표체수평적영향.방법 정군연구료2006년1월지2008년1월재본이식중심접수초차이식50례수방만1년신이식수자,분위개조신경단백억제조(개조신경단백억제제+마체맥고분지+강적송)19례,기중배포소조10례,타극막사조9례;뢰파매소조(뢰파매소+마체맥고분지+강적송)31례.령취20례행규률혈액투석종말기신병환자위대조조.채용류식세포의적방법검측3조외주혈CD4~+ Foxp3~+ Treg점CD4~+ T세포적비례,비교각조간표체수평여불동면역억제방안적관계.결과 개조신경단백억제제조、뢰파매소조화종말기신병조3조년령、성별비무통계학차이(P>0.05).개조신경단백억제제조、뢰파매소조2조랭결혈시간、HLA착배솔、군체반응성항체(PRA)화급성배척반응발생솔무통계학차이(P>0.05).뢰파매소조화종말기신병조CD4~+ Foxp3~+ T세포점CD4~+ T세포적비례균명현고우개조신경단백억제조,차이유통계학의의(P<0.01).사용배포소환자화타극막사환자외주혈중CD4~+ Foxp3~+ T세포점CD4~+ T세포적비례지간무현저성차이(P>0.05).결론 신이식술후복용뢰파매소조환자외주혈CD4~+ Foxp3~+ Treg점CD4~+ T세포적비례현저고우복용개조신경단백억제조환자,제시뢰파매소유조우유도숙주대이식신면역내수.
Objective To investigate the effect of the different immunosuppression therapy on CD4~+ Foxp3~+ regulatory T cells (CD4~+ Foxp3~+ Treg cells) in the peripheral blood monocytes of kidney transplantation recipients.Methods A Closed Cohort study was conducted in 50 primary living kidney transplant recipients between January 2006 and January 2008,who had been followed up for 1 year.The recipients divided into calcineurin inhibitors group (CNI + MMF + Pred) (19 recipients,including ciclosporin group 10 recipients and tacrolimus group 9 recipients),rapamycin group (RAPA + MMF + Pred) (31recipients).Twenty end-stage renal disease patients were in control group.The frequency of CD4~+ Foxp3~+ Treg cells in total CD4~+ T cells was analyzed by flow cytometry in peripheral blood from three groups,results were compared.Results The clinical variables of recipients such as age,sex,cold ischemia time,human leucocyte antigen mismatch,panel reaction antibody,rejection episode were no significant difference.The percentage of CD4~+ Foxp3~+ Treg cells in total CD4~+ cells was significantly higher in rapamycin group and end-stage renal disease group than calcineurin inhibitors group(P <0.01).The level of CD4~+ Foxp3~+ Treg cells between ciclosporin group and tacrolimus group was no significant difference (P>0.05).Conclusion The level of CD4~+ Foxp3~+ Treg was significantly higher in patients receiving RAPA + MMF + Pred than the patients receiving CNI + MMF + Pred,which suggested that RAPA may be play a more important role in immune tolerance indution.
