CAJ | 학술논문

目的建立检测巨细胞病毒(CMV)特异性细胞毒性T淋巴细胞(CTL)的新方法,探讨其在肾移植受者外周血的比例及其意义.方法筛选2009年1月至2010年12月期间在解放军第三○九医院全军器官移植研究所接受初次肾移植受者共计30例入组,健康体检志愿者10名作为健康对照组.采用四聚体技术(tetramer technology),在流式细胞仪上直接检测各组的CMV抗原特异性CTL的表达比例.结果移植组和健康对照组外周血CMV抗原特异性CTL(CMV-pp65特异性CD8+T细胞)的阳性率在0.16％～7.21％.移植患者根据是否发生CMV活动性感染,分为巨细胞病毒阳性组(CMV+组,n=15)和巨细胞病毒阴性组(CMV-组,n=15).CMV+组患者的CMV抗原特异性CTL的比例(2.95％ ±0.62％)显著高于CMV-组患者(1.17％±0.45％)和健康对照组(0.65％±0.17％),差异具有统计学意义(P=0.003、0.006).CMV+组患者在CMV抗原(CMV-pp65)阳性期,其CMV抗原特异性CTL的比例为(2.95％±0.62％),转阴后,比例明显下降至(1.50％±0.32％).CMV+组患者的CMV抗原特异性CTL比例与CMV-pp65阳性细胞数呈显著正相关(Pearson检验,r=0.871,P＜0.01).结论肾移植受者外周血CMV特异性CTL比例对于判断CMV预后具有重要评价指导意义,为今后肾移植术后CMV感染靶向治疗提供依据.
목적 건립검측거세포병독(CMV)특이성세포독성T림파세포(CTL)적신방법,탐토기재신이식수자외주혈적비례급기의의.방법 사선2009년1월지2010년12월기간재해방군제삼○구의원전군기관이식연구소접수초차신이식수자공계30례입조,건강체검지원자10명작위건강대조조.채용사취체기술(tetramer technology),재류식세포의상직접검측각조적CMV항원특이성CTL적표체비례.결과 이식조화건강대조조외주혈CMV항원특이성CTL(CMV-pp65특이성CD8+T세포)적양성솔재0.16％～7.21％.이식환자근거시부발생CMV활동성감염,분위거세포병독양성조(CMV+조,n=15)화거세포병독음성조(CMV-조,n=15).CMV+조환자적CMV항원특이성CTL적비례(2.95％ ±0.62％)현저고우CMV-조환자(1.17％±0.45％)화건강대조조(0.65％±0.17％),차이구유통계학의의(P=0.003、0.006).CMV+조환자재CMV항원(CMV-pp65)양성기,기CMV항원특이성CTL적비례위(2.95％±0.62％),전음후,비례명현하강지(1.50％±0.32％).CMV+조환자적CMV항원특이성CTL비례여CMV-pp65양성세포수정현저정상관(Pearson검험,r=0.871,P＜0.01).결론 신이식수자외주혈CMV특이성CTL비례대우판단CMV예후구유중요평개지도의의,위금후신이식술후CMV감염파향치료제공의거.
Objective To establish a new detection method for cytomegalovirus (CMV) specific cytotoxic CD8 + T cells and examine its proportion and significance in peripheral blood from kidney transplant recipients.Methods A total of 30 recipients of kidney transplantation from January 2009 to December 2010 for the first time were enrolled.And 10 healthy volunteers were selected as health control group.Tetramer technology was applied.The proportions of CMV antigen specific T cells expressed in each group were detected directly by flow cytometry.Results The positive rate of CMV antigen specific CTL,CMV-pp65 specific CD8 +T cell was between 0.16％-7.21％ in kidney transplant recipients (n =30) and health control group (n =10).The proportions of CMV antigen specific CTL were 2.95％ ± 0.62％ in CMV+ group.And it was significantly higher than that in CMV-group (1.17％ ± 0.45％) and health control group (0.65％ ±0.17％) (P =0.003,0.006).In CMV + group,the proportion of CMV antigen specific CTL was 2.95％ ±0.62％ in CMV-pp65 positive phase and decreased significantly to 1.50％ ±0.32％ after turning into negative phase.In CMV + group (n =15),the proportion of CMV antigen specific CTL was positively related with the number of CMV-pp65 positive cells (Pearson test,r =0.871,P ＜ 0.01).Conclusions The proportion of specific CTL is an important guide for evaluating and judging the prognosis of CMV infection.And it may provide rationales for future targeted therapy in kidney transplant recipients.