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活体供肝移植受者中CD8+CD28-抑制性T细胞的分析。

Analysis of CD8+CD28- T-suppressor cells in living donor liver transplant recipients.

作者信息

Lin Yi-Xin, Wang Lan-Lan, Yan Lu-Nan, Cai Pei, Li Bo, Wen Tian-Fu, Zeng Yong

机构信息

Center of Liver Transplantation and Department of Surgery, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2009 Jun;8(3):241-6.

Abstract

BACKGROUND

Human CD8+CD28- T-suppressor (Ts) cells have been considered to indicate a reduced need for immunosuppression in pediatric liver-intestine transplant recipients and recipients of deceased heart-kidney transplants. However, in adult-to-adult living donor liver transplantation (A-A LDLT) little information is available and the clinical significance is still unknown.

METHODS

Flow cytometry was used to detect the population of CD8+CD28- Ts cells present in peripheral blood in A-A LDLT recipients (n=31), patients with end-stage liver disease (n=24) and healthy controls (n=19). Meanwhile, we tested the graft function and trough levels of immunosuppression in recipients. The clinical and follow-up data of 31 transplant recipients were analyzed.

RESULTS

Compared with diseased controls (P=0.007) and healthy individuals (P=0.000), a notable expansion of CD8+CD28- Ts cells was found in recipients of A-A LDLT. This was associated with graft function, levels of immunosuppression and rejection episodes.

CONCLUSIONS

To monitor the CD8+CD28- Ts cells levels is important to evaluate the immune state of recipients. Meanwhile, it is also important to promote expansion of CD8+CD28- Ts cells in recipients of A-A LDLT, not only to sustain good graft function and decrease the dosage of immunosuppressants, but also to reduce the occurrence of rejection.

摘要

背景

人类CD8+CD28- T抑制细胞(Ts细胞)被认为表明小儿肝肠移植受者及已故供心-肾移植受者对免疫抑制的需求降低。然而,在成人对成人活体肝移植(A-A LDLT)中,相关信息较少,其临床意义仍不清楚。

方法

采用流式细胞术检测A-A LDLT受者(n=31)、终末期肝病患者(n=24)和健康对照者(n=19)外周血中CD8+CD28- Ts细胞的数量。同时,我们检测了受者的移植物功能和免疫抑制的谷值水平。对31例移植受者的临床和随访数据进行了分析。

结果

与患病对照者(P=0.007)和健康个体(P=0.000)相比,A-A LDLT受者中CD8+CD28- Ts细胞显著扩增。这与移植物功能、免疫抑制水平和排斥反应发作有关。

结论

监测CD8+CD28- Ts细胞水平对于评估受者的免疫状态很重要。同时,促进A-A LDLT受者中CD8+CD28- Ts细胞的扩增也很重要,这不仅可以维持良好的移植物功能并减少免疫抑制剂的用量,还可以减少排斥反应的发生。

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