Minguela A, Torío A, Marín L, Muro M, Villar L M, Díaz J, Ramírez P, Parrilla P, García-Alonso A M, Alvarez-López M R
Section of Immunology, University Hospital Virgen-Arrixaca, Murcia, Spain.
Hum Immunol. 1999 Jun;60(6):500-9. doi: 10.1016/s0198-8859(99)00016-6.
Membrane HLA class-I expression (mHLA-I), soluble HLA class-I antigens (sHLA-I) and interleukin (IL)-10 are different factors implicated in the special acceptance of liver allograft. In this study, pre- and post-operative levels of mHLA-I in peripheral blood lymphocytes (PBL) and serum sHLA-I were analyzed in 86 liver transplants, immunosuppressed with Cyclosporine-A, methylprednisolone and azathioprine, and classified into acute-rejection (AR, n = 28) and non-acute-rejection (NAR, n = 58) groups. Serum IL-10 was studied in 47 recipients (AR-group, n = 16 and NAR-group, n = 31). Pre-transplant values of mHLA-I and sHLA-I showed a bimodal distribution (high/low) in NAR-recipients, but in AR-patients were mainly included in the low expression/secretion zone (mHLA-I, p < 0.02 and sHLA-I, p < 0.05). Consequently, average pre-transplant mHLA-I (868 +/- 109 versus 998 +/- 123, p < 0.05) and sHLA-I (1.3 +/- 0.4 versus 2.02 +/- 0.7 microg/ml, p < 0.01) was lower in the AR- than in the NAR-group. After transplant both parameters decreased in the NAR-group, but increased in AR-recipients previous to and on rejection diagnosis day. Additionally, serum IL-10 levels were significantly higher (p < 0.01) in the NAR than in the AR-group during the first 24 h post-transplant. In conclusion, low pre-transplant mHLA-I and sHLA-I levels pre-dispose liver recipients to acute rejection, whereas early post-transplant increases of serum IL-10 appear to be related to a good liver allograft acceptance.
膜性人类白细胞抗原I类分子表达（mHLA-I）、可溶性人类白细胞抗原I类分子抗原（sHLA-I）和白细胞介素（IL）-10是与肝移植特殊免疫耐受相关的不同因素。在本研究中，对86例接受环孢素A、甲泼尼龙和硫唑嘌呤免疫抑制治疗的肝移植患者术前和术后外周血淋巴细胞（PBL）中的mHLA-I水平及血清sHLA-I水平进行了分析，并将其分为急性排斥反应（AR，n = 28）组和非急性排斥反应（NAR，n = 58）组。对47例受者（AR组，n = 16；NAR组，n = 31）的血清IL-10进行了研究。NAR受者移植前mHLA-I和sHLA-I值呈双峰分布（高/低），但AR患者主要集中在低表达/分泌区（mHLA-I，p < 0.02；sHLA-I，p < 0.05）。因此，AR组移植前mHLA-I（868±109对998±123，p < 0.05）和sHLA-I（1.3±0.4对2.02±0.7μg/ml，p < 0.01）的平均水平低于NAR组。移植后，NAR组这两个参数均下降，但AR受者在排斥反应诊断日之前及当日升高。此外，移植后最初24小时内，NAR组血清IL-10水平显著高于AR组（p < 0.01）。总之，移植前mHLA-I和sHLA-I水平低使肝移植受者易发生急性排斥反应，而移植后早期血清IL-10升高似乎与肝移植的良好免疫耐受有关。
