中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (18): 3259-3262.doi: 10.3969/j.issn.1673-8225.2011.18.008

• 肾移植 kidney transplantation • 上一篇    下一篇

流式细胞技术检测肾移植后外周血白细胞介素18受体的表达

郝俊文1，闵志廉2，李香铁1，陈英剑1，郑军华2   

  1. 1解放军济南军区总医院泌尿外科，山东省济南市250031
    2解放军第二军医大学长征医院泌尿外科，上海市 200003
  • 收稿日期:2010-11-17 修回日期:2011-03-18 出版日期:2011-04-30 发布日期:2011-04-30
  • 通讯作者: 闵志廉，教授，解放军第二军医大学长征医院泌尿外科，上海市 200003
  • 作者简介:郝俊文☆，男，1963年生，山东省寿光市人，汉族，2005年解放军第二军医大学毕业，博士，主任医师，主要从事泌尿外科、肾脏移植临床与研究。 hjw.jnjz@126. com
  • 基金资助:

    全军医学科研“十五”规划重点课题(01Z061)。

Clinical implication of monitoring interleukin-18 receptor in peripheral lymphocytes using flow cytometric after renal transplantation

Hao Jun-wen1, Min Zhi-lian2, Li Xiang-tie1, Chen Ying-jian1, Zheng Jun-hua2   

  1. 1Department of Urology, General Hospital of Jinan Military Area Command of Chinese PLA, Jinan  250031, Shandong Province, China
    2Department of Urology, Changzheng Hospital of Second Military Medical University, Shanghai  200003, China
  • Received:2010-11-17 Revised:2011-03-18 Online:2011-04-30 Published:2011-04-30
  • Contact: Min Zhi-lian, Professor, Department of Urology, Changzheng Hospital of Second Military Medical University, Shanghai 200003, China
  • About author:Hao Jun-wen☆, Doctor, Chief physician, Department of Urology, General Hospital of Jinan Military Area Command of Chinese PLA, Jinan 250031, Shandong Province, China hjw.jnjz@126.com
  • Supported by:

    the Key Subject of Military Medical Research during the Tenth Five-year Period, No. 01Z061*

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摘要：

背景：细胞因子常常在肾移植后排斥反应早期即被释放，因此可以作为排斥反应的早期诊断指标。
目的：观察尿毒症患者肾移植前后外周血白细胞介素18受体(IL-18R)表达的变化。
方法：将2004-09/2005-09在解放军济南军区总医院进行的肾移植尿毒症32例患者分为肾功能稳定组24例，急性排斥组8例。另选择以往手术后移植肾功能正常，平均存活时间4年的肾移植患者12例为长期存活组。同期查体未发现异常健康自愿者7例为健康对照组。提取受试者的外周血淋巴细胞，加入双荧光标记的鼠抗人CD4/IL-18Rα及CD8/IL-18Rα单克隆抗体，利用流式细胞仪进行测定。
结果与结论：流式细胞技术检测CD4/IL-18Rα及CD8/IL-18Rα在尿毒症组的阳性率明显高于健康对照组(P=0.02，P=0.04)。肾功能稳定组及长期存活组外周血CD4/IL-18Rα及CD8/IL-18Rα的表达明显低于急性排斥组(P < 0.05)。急性排斥反应组激素冲击治疗后其阳性率明显低于激素冲击治疗前(P < 0.05)。3例耐激素排斥反应者IL-18R表达值高于5例激素治疗有效者。结果显示外周血CD4/IL-18Rα及CD8/IL-18Rα的变化可以较早预测肾移植后急性排斥反应，预测肾移植后恢复情况，评估排斥反应对激素治疗的效果。

关键词: 白细胞介素18, 白细胞介素18受体, 流式细胞技术, 肾移植, 排斥反应

Abstract:

BACKGROUND: As cytokines are often released in the early stage following renal transplantation, they can used as an indicator for early diagnosis of rejection.
OBJECTIVE: To investigate the expression of interleukin 18 receptor (IL-18R) in peripheral blood of uremia patients before and after renal transplantation.
METHODS: The expression of CD4/IL-18Rα and CD8/IL-18Rα in peripheral lymphocytes was determined using flow cytometric analysis in 32 uremia patients receiving renal transplantation including 24 patients with stable function, 8 with acute rejection, 12 who had a long-term survival (average 4 years), and 7 healthy controls.
RESULTS AND CONCLUSION: CD4/IL-18Rα and CD8/IL-18Rα positive rates were higher in the uremia patients than the healthy controls (P=0.02, P=0.04). The expression of CD4/IL-18Rα and CD8/IL-18Rα in peripheral lymphocytes in the patients with stable function and those who had a long-term survival was lower than that in the patients with acute rejection. After steroid plus therapy, the positive rates for CD4/IL-18Rα and CD8/IL-18Rα were decreased significantly in the patients with acute rejection (P < 0.05). IL-18Rα expression was stronger after steroid pulse therapy in the 3 patients resistant to steroids than in the 5 patients responsive to steroid treatment. The results demonstrate that detection of CD4/IL-18Rα and CD8/IL-18Rα in the peripheral lymphocytes by flow cytometric analysis was an easy, hopeful, and noninvasive means for the diagnosis and treatment of patients with acute rejection after renal transplantation.

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