肾移植排斥反应中细胞毒性T淋巴细胞相关抗原4的作用

摘要

背景：细胞毒性T淋巴细胞相关抗原4是新近发现的共刺激分子，在肿瘤及自身免疫性疾病中研究较多，在肾移植领域缺少研究。　　目的：探讨细胞毒性T淋巴细胞相关抗原4在肾移植排斥反应中的作用。　　方法：纳入肾移植患者50例，根据移植后肾功能分为2组，急性排斥组20例，移植肾功能稳定组30例。同时选择30例健康查体者作为健康对照组。分别抽取外周静脉血，采用ELISA法及流式细胞术检测观察对象血清及外周血淋巴细胞中的细胞毒性T淋巴细胞相关抗原4水平。　　结果与结论：细胞毒性T淋巴细胞相关抗原4在肾移植后急性排斥组、肾功能稳定组及健康对照组血清中的表达水平差异有显著性意义(F=70.0081，P=0.0000)。肾功能稳定组显著低于健康对照组(P=0.0000)，急性排斥组显著低于健康对照组(P=0.0000)，急性排斥组显著低于肾功能稳定组(P=0.0000)。细胞毒性T淋巴细胞相关抗原4在肾移植后急性排斥组、肾功能稳定组及健康对照组淋巴细胞中的表达水平差异无显著性意义(F=1.8656，P=0.1617)。提示细胞毒性T淋巴细胞相关抗原4在肾移植患者发生排斥反应时血清中表达减低，具有一定的相关性，可能参与了排斥反应的发生。%BACKGROUND:Cytotoxic T lymphocyte-associated antigen 4 is a newly discovered costimulatory molecule. It has been studied more in tumor and autoimmune diseases, less in the field of kidney transplantation. OBJECTIVE:To explore the role of cytotoxic T lymphocyte-associated antigen 4 in acute rejection after renal transplantation. METHODS:Fifty patients undergoing renal transplantation were divided into acute rejection group (20 cases) and stable graft function group (30 cases). Another 30 healthy persons served as control group. Blood samples were extracted from the peripheral blood. Cytotoxic T lymphocyte-associated antigen 4 was detected by enzyme linked immunosorbent assay and flow cytometry. RESULTS AND CONCLUSION:The expression of cytotoxic T lymphocyte-associated antigen 4 in the serum showed significant differences in the acute rejection group, stable graft function group and healthy control group (F=70.008 1, P=0.000 0), but showed no difference in peripheral blood lymphocytes of three groups (F=1.865 6, P=0.161 7). Compared with the healthy control group, the expression levels of cytotoxic T lymphocyte-associated antigen 4 in peripheral blood lymphocytes of acute rejection group and stable graft function group were significantly decreased (P=0.000 0). In addition, the acute rejection group had a lower cytotoxic T lymphocyte-associated antigen 4 expression than the stable graft function group (P=0.000 0). In renal transplant rejection, the expression of cytotoxic T lymphocyte-associated antigen 4 in serum was reduced, showing some correlation with acute rejection after renal transplnatation. Cytotoxic T lymphocyte-associated antigen 4 might be involved in the rejection.