Sadeghi M, Daniel V, Weimer R, Wiesel M, Hergesell O, Opelz G
Department of Transplantation-Immunology and Department of Urology, University of Heidelberg, Heidelberg, Germany.
Clin Transplant. 2003 Apr;17(2):151-7. doi: 10.1034/j.1399-0012.2003.00037.x.
In this retrospective study, we tried to define pre- and post-transplant immunological parameters that identify patients at risk for early acute rejection. Lymphocyte subpopulations and plasma levels of cytokines and neopterin were determined pre- and post-transplant in 32 renal transplant recipients with biopsy-proven early acute graft rejection. Recipients without early acute rejection served as controls. High pre-transplant interferon-gamma (IFN-gamma) plasma levels (p = 0.006), consistently high levels of neopterin early post-transplant (p = 0.008), a post-transplant switch from a Th1 to a Th2 cytokine pattern with decreasing IFN-gamma (p = 0.02), low CD8+ lymphocyte counts (p = 0.006) and consistently high CD19+ B lymphocyte counts were associated with acute rejection. Our data suggest that patients with a pre-transplant Th1 and an early post-transplant Th2 cytokine pattern are pre-disposed for early acute rejection.
在这项回顾性研究中，我们试图确定移植前后的免疫学参数，以识别有早期急性排斥反应风险的患者。对32例经活检证实发生早期急性移植排斥反应的肾移植受者，在移植前后测定淋巴细胞亚群以及细胞因子和新蝶呤的血浆水平。未发生早期急性排斥反应的受者作为对照。移植前血浆干扰素-γ（IFN-γ）水平较高（p = 0.006）、移植后早期新蝶呤水平持续较高（p = 0.008）、移植后细胞因子模式从Th1转变为Th2且IFN-γ水平降低（p = 0.02）、CD8+淋巴细胞计数较低（p = 0.006）以及CD19+B淋巴细胞计数持续较高均与急性排斥反应相关。我们的数据表明，移植前为Th1细胞因子模式且移植后早期为Th2细胞因子模式的患者易发生早期急性排斥反应。
