Pawlowska J, Michalkiewicz J, Czubkowski P, Jankowska I, Teisseyre M, Socha P, Kalicinski P, Socha J
Department of Gastroenterology, Hepatology and Nutrition, The Children's Memorial Health Institute, Al. Dziei Polokich 20, Warsaw 04-736, Poland.
Transplant Proc. 2003 Dec;35(8):3026-8. doi: 10.1016/j.transproceed.2003.10.088.
The aim of this study was to examine whether liver transplantation reverses the abnormal distribution of lymphocyte subsets previously observed in biliary atresia children, namely a selective decrease in the naive CD4/CD45RA+ T cell subset and an increase in the B and natural killer cell subpopulations. Eight biliary atresia children aged 1.08 to 6 years were studied before and 1 year after LTx for comparison with 15 age-matched healthy controls. The posttransplant immunosuppressive regimens included prednisone [0.1 mg/kg] and tacrolimus (level range: a 10-12 microg/dL). The percentage, absolute cell number, and receptor density were assessed by the use of double color flow cytometry (EPICS-XL MCL fluorocytometer). Biliary atresia patients were compared after LTx with subjects before LTx, essentially showing no statistically significant changes in lymphocyte subsets. We conclude that LTx of biliary atresia children does not reverse the abnormal lymphocyte subset distribution present before transplantation. Hence, these changes may reflect either their independence from the liver status or may result from immunosuppressive treatment that contributes to defective CD4+ T cell regeneration reflected by a deficiency in CD4/CD45RA+ naive T cells.
本研究的目的是检验肝移植是否能逆转先前在胆道闭锁儿童中观察到的淋巴细胞亚群异常分布，即初始CD4/CD45RA + T细胞亚群选择性减少以及B细胞和自然杀伤细胞亚群增加。对8名年龄在1.08至6岁的胆道闭锁儿童在肝移植前和肝移植后1年进行了研究，并与15名年龄匹配的健康对照进行比较。移植后的免疫抑制方案包括泼尼松[0.1mg/kg]和他克莫司（血药浓度范围：10 - 12μg/dL）。使用双色流式细胞术（EPICS-XL MCL荧光细胞仪）评估百分比、绝对细胞数和受体密度。将胆道闭锁患者肝移植后的淋巴细胞亚群与肝移植前的受试者进行比较，结果显示淋巴细胞亚群基本没有统计学上的显著变化。我们得出结论，胆道闭锁儿童的肝移植并不能逆转移植前存在的异常淋巴细胞亚群分布。因此，这些变化可能反映出它们与肝脏状态无关，或者可能是由于免疫抑制治疗导致CD4 + T细胞再生缺陷，表现为CD4/CD45RA +初始T细胞缺乏。
