CAJ | 학술논문

背景：骨髓间充质干细胞在体内外均具有免疫调节能力，但其对肾移植受者体内CD4+T细胞免疫状态的影响目前仍不清楚。目的：探讨ImmuKnow检测技术对肾移植受者CD4+T细胞免疫状态的监测作用及骨髓间充质干细胞诱导治疗对受者细胞免疫功能的影响。方法：选择2011年1月至2013年6月于解放军南京军区福州总医院行同种异体肾移植并接受自体骨髓间充质干细胞诱导治疗的受者24例，以各项移植前指标匹配、接受巴利昔单抗诱导治疗的肾移植受者48例作为对照。两组受者分别于移植前、移植后第14，30，60，90，180天，以及在发生急性排斥或感染时抽取静脉血，以ImmuKnow法检测CD4+T细胞三磷酸腺苷水平。结果与结论：移植后6个月内，骨髓间充质干细胞组急性排斥和移植后总感染发生率均低于巴利昔单抗组，但差异无显著性意义。两组受者移植后外周血CD4+T细胞三磷酸腺苷水平均明显低于移植前(P<0.05)，但两组之间比较差异无显著性意义。骨髓间充质干细胞组12例、巴利昔单抗组26例发生了移植后感染，这些受者发生感染时CD4+T细胞三磷酸腺苷水平均明显低于病情稳定时(P<0.01)。结果表明骨髓间充质干细胞诱导治疗可有效降低肾移植受者的细胞免疫功能，而ImmuKnow法检测外周血CD4+T细胞三磷酸腺苷含量可有效反映受者的细胞免疫状态。
배경：골수간충질간세포재체내외균구유면역조절능력，단기대신이식수자체내CD4+T세포면역상태적영향목전잉불청초。목적：탐토ImmuKnow검측기술대신이식수자CD4+T세포면역상태적감측작용급골수간충질간세포유도치료대수자세포면역공능적영향。방법：선택2011년1월지2013년6월우해방군남경군구복주총의원행동충이체신이식병접수자체골수간충질간세포유도치료적수자24례，이각항이식전지표필배、접수파리석단항유도치료적신이식수자48례작위대조。량조수자분별우이식전、이식후제14，30，60，90，180천，이급재발생급성배척혹감염시추취정맥혈，이ImmuKnow법검측CD4+T세포삼린산선감수평。결과여결론：이식후6개월내，골수간충질간세포조급성배척화이식후총감염발생솔균저우파리석단항조，단차이무현저성의의。량조수자이식후외주혈CD4+T세포삼린산선감수평균명현저우이식전(P<0.05)，단량조지간비교차이무현저성의의。골수간충질간세포조12례、파리석단항조26례발생료이식후감염，저사수자발생감염시CD4+T세포삼린산선감수평균명현저우병정은정시(P<0.01)。결과표명골수간충질간세포유도치료가유효강저신이식수자적세포면역공능，이ImmuKnow법검측외주혈CD4+T세포삼린산선감함량가유효반영수자적세포면역상태。
BACKGROUND:Bone mesenchymal stem cells have immunological regulation function both in vitro and in vivo, while the effect of bone marrow mesenchymal stem cells on CD4+T cellimmune function in patients receiving kidney transplantation remains unclear. OBJECTIVE:To explore the monitoring significance of CD4+T-cellimmune function by ImmuKnow assay and to determine the effect of induction therapy with bone marrow mesenchymal stem cells on cellimmune function in patients receiving kidney transplantation. METHODS:From January 2011 to June 2013, 24 patients receiving al ograft renal transplantation with autologous bone marrow mesenchymal stem cells were included and another 48 patients receiving al ograft renal transplantation and Simulect induction therapy with various matched preoperative characters served as controls. In both groups, adenosine triphosphate levels in CD4+T cells in the peripheral blood were determined by the ImmuKnow assay preoperatively and at 14, 30, 60, 90, 180 days postoperatively, as wel as during acute rejection and infection episodes. RESULTS AND CONCLUSION:During the 180 days postoperatively, fewer patients in the bone marrow mesenchymal stem cellgroup had acute rejection and injection than the Simulect group, but no significant differences were observed. Postoperative adenosine triphosphate levels in CD4+T cells were significantly lower than those determined preoperatively in both groups (P<0.05), while no significant differences were observed between the two groups. A total of 12 patients in the bone marrow mesenchymal stem cellgroup and 26 patients in the Simulect group had infection episodes, and the adenosine triphosphate levels in CD4+T cells during the infection episodes were lower than clinical stable patients in both groups (P<0.01). For patients receiving renal transplantation, induction therapy with bone marrow mesenchymal stem cells can effectively decrease the cellimmune function, which can be reflected by the adenosine triphosphate levels in CD4+T cells in the peripheral blood determined by the ImmuKnow assay.