中国组织工程研究

中国组织工程研究 ›› 2011, Vol. 15 ›› Issue (53): 9881-9884.doi: 10.3969/j.issn.1673-8225.2011.53.001

• 肝移植 liver transplantation •    下一篇

他克莫司和西罗莫司对行肝癌肝移植患者Foxp3+调节性T细胞产生及肝癌复发的影响

陈国勇，孙建军，李彩丽，陈建斌，汤高枫，谢占涛，赵会博，季  节，蒋进发   

  1. 郑州人民医院，河南省郑州市450003
  • 收稿日期:2011-09-13 修回日期:2011-11-25 出版日期:2011-12-31 发布日期:2011-12-31
  • 通讯作者: 孙建军，硕士，副主任医师，郑州人民医院，河南省郑州市 450003 sunjjandy@sohu.com
  • 作者简介:陈国勇，男，1971年生，河南省郑州市人，汉族，1996年河南医科大学毕业，副主任医师，主要从事肝胆疾病的外科治疗及肝移植的研究。 andydapao@163.com
  • 基金资助:

    豫科计(2009)1号(编号：092102310347)，课题名称：他克莫司和西罗莫司对肝癌肝移植患者Foxp3+ Treg产生的影响及其防治排斥反应的效果研究。

Effects of tacrolimus and sirolimus on generation of Foxp3+ regulatory T cells and recurrence of hepatocellular carcinoma in patients with hepatocellular carcinoma after liver transplantation

Chen Guo-yong, Sun Jian-jun, Li Cai-li, Chen Jian-bin, Tang Gao-feng, Xie Zhan-tao, Zhao Hui-bo, Ji Jie, Jiang Jin-fa   

  1. People’s Hospital of Zhengzhou, Zhengzhou  450003, Henan Province, China
  • Received:2011-09-13 Revised:2011-11-25 Online:2011-12-31 Published:2011-12-31
  • Contact: Sun Jian-jun, Master, Associate chief physician, People’s Hospital of Zhengzhou, Zhengzhou 450003, Henan Province, China sunjjandy@sohu.com
  • About author:Chen Guo-yong, Associate chief physician, People’s Hospital of Zhengzhou, Zhengzhou 450003, Henan Province, China andydapao@163.com
  • Supported by:

    Science and Technology Program of Henan Province, No. 092102310347*

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摘要：

背景：通过促进调节性T细胞的产生及增强其功能的发挥已成为维持移植物免疫耐受的有效手段。
目的：探讨他克莫司和西罗莫司对行肝移植的肝癌患者Foxp3+调节性T细胞产生及肝癌复发的影响。
方法：纳入符合米兰标准的肝癌肝移植患者40例，随机分为西罗莫司组和他克莫司组，每组20例，移植后第2~12个月间每月抽取受试者外周血检测Foxp3+调节性T细胞，并行彩超和外周血检测甲胎蛋白，必要时肝穿刺活检观察排斥反应及肿瘤的复发情况。
结果与结论：流式细胞仪检测结果显示，西罗莫司组外周血Foxp3+调节性T细胞阳性率明显高于他克莫司组(P < 0.05)，移植肝穿刺活检证实西罗莫司组排斥反应与他克莫司组差异无显著性意义(P > 0.05)，而移植肝彩超、外周血甲胎蛋白检测及移植肝穿刺活检或手术亦证实在肝癌复发率方面西罗莫司组明显低于他克莫司组(P < 0.05)。说明西罗莫司在肝癌肝移植中对肿瘤复发的抑制作用方面优于他克莫司，且排斥反应较他克莫司并未增加，甚至有更好的免疫耐受效果。

关键词: 西罗莫司, 他克莫司, 肝癌肝移植, 肝癌复发, Foxp3+调节性T细胞

Abstract:

BACKGROUND: Increasing the generation and function of regulatory T cells has become an effective means of maintaining the immune tolerance of grafts.
OBJECTIVE: To study the effects of tacrolimus and sirolimus on generation of Foxp3+ regulatory T cells and recurrence in patients with hepatocellular carcinoma after liver transplantation.
METHODS: Forty patients with hepatocellular carcinoma accord to Milan criteria were randomly divided into tacrolimus group and sirolimus group with 20 patients in each group. Peripheral blood of patients was extracted monthly during the 2-12 months after transplantation for detection of Foxp3+ regulatory T cells. Color doppler ultrasound and the peripheral blood alpha-fetoprotein detection were performed. Liver biopsy was performed to observe the rejection and recurrence. 
RESULTS AND CONCLUSION: Flow cytometry results showed that positive rate of Foxp3+ regulatory T cells in the sirolimus group was significantly increased compared with the tacrolimus group (P < 0.05). Liver biopsy showed no significant difference in rejection between the two groups (P > 0.05). The hepatocellular carcinoma recurrence rate in the sirolimus group was obviously lower than the tacrolimus group by color doppler ultrasound, peripheral blood alpha-fetoprotein detection and liver biopsy (operation) (P < 0.05). It is suggested that sirolimus is superior to tacrolimus in inhibiting recurrence of liver transplantation, and the rejection of sirolimus does not increase compared with tacrolimus, or even has better results in immunological tolerance.

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