CAJ | 학술논문

目的探讨胆汁中sLAIR-1及IL-2R的表达在肝移植排斥反应中的意义.方法连续3周应用双单克隆抗体夹心ELISA方法检测55例肝移植受者术后胆汁sLAIR-1及sIL2R水平.结果在22例移植肝功能正常的受体中(对照组),胆汁sIL-2R在(23.1±3.5)～(55.1±6.1)ng/L范围之内呈较低水平的波动,sLAIR-1则波动于(3.2±1.1)～(6.1±1.4)ng/L范围之内,亦呈低水平表达.在急性排斥反应(AR)组,胆汁sIL-2R水平在排斥反应确诊前2 d为(116.1±10.3)ng/L,确诊前1 d则为(136.8±12.7)ng/L,均显著高于对照组(P＜0.01).在经激素冲击治疗3 d时则下降至(74.2±6.2)ng/L,明显低于确诊前1、2 d水平.在对照组,胆汁sLAIR-1在(3.2±1.1)～(6.1±1.4)ng/L范围之内呈较低水平的波动;在AR组确诊前3 d为(18.1±2.2)ng/L,确诊前2 d为(25.1±3.5)ng/L,确诊前1 d则为(31.1±5.5)ng/L,均显著高于对照组(P＜0.01);经激素冲击治疗3 d时,胆汁sLAIR-1水平下降至(8.1±2.5)ng/L,接近对照组水平,且sLAIR-1的下降早于sIL2R.结论胆汁sLAIR-1在发生移植肝急性排斥反应的病人血清中有较高水平的表达,其波动较sIL-2R大,将二者联合进行监测,可望成为早期预测移植物排斥反应发生及转归的诊断指标.
목적 탐토담즙중sLAIR-1급IL-2R적표체재간이식배척반응중적의의.방법 련속3주응용쌍단극륭항체협심ELISA방법검측55례간이식수자술후담즙sLAIR-1급sIL2R수평.결과 재22례이식간공능정상적수체중(대조조),담즙sIL-2R재(23.1±3.5)～(55.1±6.1)ng/L범위지내정교저수평적파동,sLAIR-1칙파동우(3.2±1.1)～(6.1±1.4)ng/L범위지내,역정저수평표체.재급성배척반응(AR)조,담즙sIL-2R수평재배척반응학진전2 d위(116.1±10.3)ng/L,학진전1 d칙위(136.8±12.7)ng/L,균현저고우대조조(P＜0.01).재경격소충격치료3 d시칙하강지(74.2±6.2)ng/L,명현저우학진전1、2 d수평.재대조조,담즙sLAIR-1재(3.2±1.1)～(6.1±1.4)ng/L범위지내정교저수평적파동;재AR조학진전3 d위(18.1±2.2)ng/L,학진전2 d위(25.1±3.5)ng/L,학진전1 d칙위(31.1±5.5)ng/L,균현저고우대조조(P＜0.01);경격소충격치료3 d시,담즙sLAIR-1수평하강지(8.1±2.5)ng/L,접근대조조수평,차sLAIR-1적하강조우sIL2R.결론 담즙sLAIR-1재발생이식간급성배척반응적병인혈청중유교고수평적표체,기파동교sIL-2R대,장이자연합진행감측,가망성위조기예측이식물배척반응발생급전귀적진단지표.
Objective Based on detection of the soluble LAIR-1 (sLAIR-1) and sIL-2R in the bile from recipient after liver transplant, the role of sLAIR-1 and sIL-2R in graft acute rejection were analyzed. Methods Bile sLAIR-1 level and sIL-2R were determined by double mAb sandwich enzyme linked immunosorbent assay in 55 cases of liver transplantation. Results In 22 recipients with normal graft function, sLAIR-1 and sIL-2R were detected at low level in the bile. In the 29 cases of liver acute rejection (AR), significant increase of bile sIL-2R level was detected on the lst and 2nd d before final diagnosis. With the effective methylprednisolone pulse therapy, sIL-2R level was decreased significantly on the 3rd d. On the other hand, remarkable increase of bile sLAIR-1 was found on the lst,2nd and 3rd d before final diagnosis. After of methylprednisolone pulse therapy for 3 d, bile sLAIR-1resturned to the control level. Conclusion Both bile sIL-2R and sLAIR-1 are detected at high level in the recipients suffering from liver acute rejection. The level of bile sLAIR-1 changes dramatically and responsively according to liver acute rejection. Therefore, detecting these two markers synergistically may be a promising monitor for rejection after liver transplantation.