Xu Qin, Liu Yating, Sun Beibei, Wu Yuanyuan, Ruan Mengqi, Zhou Qiang, Wang Qin, Zhang Hao
Clin Lab. 2025 Jul 1;71(7). doi: 10.7754/Clin.Lab.2025.241245.
Functional lymphocytes play a pivotal role in renal injury and rejection following transplantation. Understanding their dynamic changes is essential for evaluating renal allograft function and predicting rejection. However, the early postoperative dynamics of these subsets and their relationship with renal function remain unclear. This study investigated the early postoperative changes in functional CD3+CD8+T (CTL) and CD3-CD16+56+T (NK) lymphocyte subsets in the peripheral blood of renal transplant recipients and their correlation with renal function.
Peripheral blood samples were collected from patients undergoing their first renal transplantation at 1, 2, and 3 weeks postoperatively. Flow cytometry was used to quantify CTL and NK lymphocyte subsets, with granzyme B (Gzm B+) and interferon-gamma (IFNγ+) expression serving as markers of cytotoxic function. Changes in these lymphocyte subsets and their correlation with renal function markers, including serum creatinine levels, were analyzed.
Serum creatinine levels significantly decreased at 2 weeks compared to 1 week (p = 0.009) and stabilized by 3 weeks (p > 0.05), indicating substantial renal recovery. The proportion of CD3+T and CTL cells increased significantly at 2 weeks (p < 0.001 and p = 0.012, respectively) but showed no further changes by 3 weeks (p > 0.05). Conversely, NK cell proportions decreased significantly at 2 weeks (p = 0.011) and remained unchanged thereafter. Both Gzm B+CTL and IFNγ+CTL cell proportions decreased significantly from 1 to 2 weeks (p < 0.001 and p = 0.006, respectively) and stabilized at 3 weeks. While IFNγ+NK cell proportions remained unchanged across all time points (p > 0.05), Gzm B+NK cells increased from 2 to 3 weeks. Serum creatinine levels were negatively correlated with CD3+ T (r = -0.371, p = 0.003) and CTL cell proportions (r = -0.366, p = 0.003) and positively correlated with Gzm B+CTL (r = 0.418, p < 0.001) and IFNγ+CTL cell proportions (r = 0.377, p = 0.003).
Functional CTL cells exhibit significant dynamic changes during the early postoperative period, stabilizing by 3 weeks. These changes are strongly correlated with serum creatinine levels, suggesting their potential as biomarkers for renal allograft function.
功能性淋巴细胞在移植后肾损伤和排斥反应中起关键作用。了解它们的动态变化对于评估肾移植功能和预测排斥反应至关重要。然而，这些亚群术后早期的动态变化及其与肾功能的关系仍不清楚。本研究调查了肾移植受者外周血中功能性CD3+CD8+T（CTL）和CD3-CD16+56+T（NK）淋巴细胞亚群的术后早期变化及其与肾功能的相关性。
收集首次接受肾移植患者术后1周、2周和3周的外周血样本。采用流式细胞术对CTL和NK淋巴细胞亚群进行定量分析，以颗粒酶B（Gzm B+）和干扰素-γ（IFNγ+）表达作为细胞毒性功能的标志物。分析这些淋巴细胞亚群的变化及其与包括血清肌酐水平在内的肾功能标志物的相关性。
与术后1周相比，血清肌酐水平在术后2周显著下降（p = 0.009），并在3周时稳定（p > 0.05），表明肾功能有显著恢复。CD3+T细胞和CTL细胞比例在术后2周显著增加（分别为p < 0.001和p = 0.012），但在3周时无进一步变化（p > 0.05）。相反，NK细胞比例在术后2周显著下降（p = 0.011），此后保持不变。Gzm B+CTL和IFNγ+CTL细胞比例从1周降至2周时均显著下降（分别为p < 0.001和p = 0.006），并在3周时稳定。虽然IFNγ+NK细胞比例在所有时间点均保持不变（p > 0.05），但Gzm B+NK细胞从术后2周增加至3周。血清肌酐水平与CD3+T细胞（r = -0.371，p = 0.003）和CTL细胞比例（r = -0.366，p = 0.003）呈负相关，与Gzm B+CTL（r = 0.418，p < 0.001）和IFNγ+CTL细胞比例（r = 0.377，p = 0.003）呈正相关。
功能性CTL细胞在术后早期表现出显著的动态变化，并在3周时稳定。这些变化与血清肌酐水平密切相关，提示它们有可能作为肾移植功能的生物标志物。
