San Segundo D, Fernández-Fresnedo G, Rodrigo E, Ruiz J C, González M, Gómez-Alamillo C, Arias M, López-Hoyos M
Immunology Service, Hospital Universitario Marqués de Valdecilla-IFIMAV, Santander, Spain.
Transplant Proc. 2012 Nov;44(9):2538-41. doi: 10.1016/j.transproceed.2012.09.083.
Regulatory T cells (Tregs) have gained an important role in mechanisms of tolerance and protection against the transplant rejection. However, only limited retrospective data have shown a relationship between peripheral blood Tregs and better long-term graft survival. The purpose of the present study was to investigate prospectively circulating Treg levels and their association with long-term graft survival.
Ninety kidney transplant recipients underwent measurement of Treg levels in peripheral blood before as well as at 6 months and 1 year posttransplantation. Receiver operating characteristic curves were applied to test the sensitivity and specificity of Treg levels to predict prognosis.
Treg levels before transplantation correlated with those at 6 months and 12 months posttransplantation (P < .001 and P = .002, respectively). Patients who maintained high Treg levels (above 70th percentile) at both 6 and 12 months displayed better long-term graft survival at 4 and 5 years follow-up (P = .04 and P = .043 respectively). There was no effect on patient survival.
Detection of high levels of peripheral blood Tregs was associated with better graft survival possibly using as a potential marker of prognosis.
调节性T细胞（Tregs）在耐受机制以及预防移植排斥反应中发挥着重要作用。然而，仅有有限的回顾性数据表明外周血Tregs与更好的长期移植物存活之间存在关联。本研究的目的是前瞻性地调查循环Treg水平及其与长期移植物存活的关系。
90名肾移植受者在移植前以及移植后6个月和1年测量外周血中的Treg水平。应用受试者工作特征曲线来测试Treg水平预测预后的敏感性和特异性。
移植前的Treg水平与移植后6个月和12个月的水平相关（分别为P <.001和P =.002）。在6个月和12个月时均维持高Treg水平（高于第70百分位数）的患者在4年和5年随访时显示出更好的长期移植物存活（分别为P =.04和P =.043）。对患者存活没有影响。
检测到外周血中高水平的Tregs可能与更好的移植物存活相关，可作为一种潜在的预后标志物。
