Al-Wedaie Fatima, Farid Eman, Tabbara Khaled, El-Agroudy Amgad E, Al-Ghareeb Sumaya M
From the Department of Microbiology and Immunology, College of Medicine, Arabian Gulf University; and the Department of Pathology, Salmaniya Medical Complex, Manama, Kingdom of Bahrain.
Exp Clin Transplant. 2015 Apr;13 Suppl 1:170-6.
Studying regulatory T cells in kidney allograft acceptance versus chronic rejection may help in the understanding of more mechanisms of immune tolerance and, in the future, may enable clinicians to induce immune tolerance and decrease the use of immunosuppressive drugs. The aim of the current study was to evaluate regulatory T cells in kidney transplant patients with stable graft versus transplant with biopsy-proven chronic rejection.
The 3 groups that were studied included: kidney transplanted patients with no rejection episodes (n = 43); transplanted patients with biopsy-proven renal rejection (n = 27); and healthy age-matched nontransplanted individuals as controls (n = 42).The percentage of regulatory T cells (CD4+CD25+Foxp3+) in blood was determined by flow cytometry.
The regulatory T cell percentage was significantly lower in chronic rejection patients than control or stable graft groups. No significant difference was observed in regulatory T cell percentage between the stable graft and control groups. In the stable graft group, patients on rapamycin had a significantly higher regulatory T cell percentage than patients on cyclosporine. No effect of donor type, infection, or duration after transplant was observed on regulatory T cell percentage.
The results of the current study are consistent with previous studies addressing the function of regulatory T cells in inducing immunotolerance after kidney transplant. Considering the established role of regulatory T cells in graft maintenance and our observation of high regulatory T cell percentage in patients receiving rapamycin than cyclosporine, we recommend including rapamycin when possible in immunosuppressive protocols. The findings from the current study on the chronic rejection group support ongoing research of having treatment with regulatory T cells, which may constitute a novel, efficient antirejection therapy in the future.
研究肾移植受者中调节性T细胞在移植肾接受与慢性排斥反应中的作用，有助于深入了解免疫耐受的更多机制，未来可能使临床医生诱导免疫耐受并减少免疫抑制药物的使用。本研究的目的是评估移植肾功能稳定的肾移植患者与经活检证实为慢性排斥反应的肾移植患者体内的调节性T细胞。
研究的3组包括：无排斥反应的肾移植患者（n = 43）；经活检证实有肾排斥反应的移植患者（n = 27）；以及年龄匹配的健康未移植个体作为对照（n = 42）。通过流式细胞术测定血液中调节性T细胞（CD4+CD25+Foxp3+）的百分比。
慢性排斥反应患者的调节性T细胞百分比显著低于对照组或移植肾功能稳定组。移植肾功能稳定组与对照组之间的调节性T细胞百分比无显著差异。在移植肾功能稳定组中，使用雷帕霉素的患者调节性T细胞百分比显著高于使用环孢素的患者。未观察到供体类型、感染或移植后时间对调节性T细胞百分比有影响。
本研究结果与以往关于肾移植后调节性T细胞诱导免疫耐受功能的研究一致。考虑到调节性T细胞在移植肾维持中的既定作用，以及我们观察到接受雷帕霉素治疗的患者调节性T细胞百分比高于接受环孢素治疗的患者，我们建议在免疫抑制方案中尽可能使用雷帕霉素。本研究中慢性排斥反应组的结果支持正在进行的关于调节性T细胞治疗的研究，这可能在未来构成一种新型、有效的抗排斥疗法。
