Delmonico F L, Cosimi A B, Jaffers G J, Schooley R T, Rubin R H, Tolkoff-Rubin N, Fang L T, Russell P S
J Surg Res. 1983 Oct;35(4):271-6. doi: 10.1016/0022-4804(83)90001-x.
Peripheral blood T-lymphocyte populations were monitored sequentially in diabetic recipients of renal allografts. Unfractionated buffy coat preparations were reacted with the murine monoclonal antibodies, OKT3 (all circulating T-cells), OKT4 (helper/inducer/regulatory T-cells), and OKT8 (cytotoxic/suppressor cells). Levels of peripheral blood lymphocyte subpopulations of diabetic patients monitored prior to transplantation revealed no significant abnormalities. Following transplantation, but prior to any therapy for acute rejection, the mean percentage of OKT3, 4, and 8 reactive cells in diabetic recipients closely resembled those observed in nondiabetic recipients. After treatment for acute rejection, a marked decrease in the mean OKT4/OKT8 ratio from normal (1.90 +/- 0.7) was observed in both diabetic (1.04 +/- 0.5), and nondiabetic (1.35 +/- 0.5) allograft recipients. Eleven of thirteen diabetic recipients with long-term functioning allografts were found to have a depressed OKT4/OKT8 ratio (mean 1.03 +/- 0.6). T-cell subset monitoring of diabetics with end-stage renal failure failed to reveal any significant differences from nondiabetic, uremic patients. The high incidence (75%) of allograft rejection noted in these diabetic allograft recipients similarly suggests normal immunocompetence. Following successful completion of rejection therapy, however, reduction in the ratio of OKT4 to OKT8 reactive cells suggests that an alteration in immune responsiveness has occurred. Immunological monitoring of these long-term diabetic recipients with functioning allografts suggests that the observation of a consistently depressed OKT4/OKT8 ratio may (1) be useful in predicting continued allograft function and (2) prompt the more rapid reduction of steroid medication to maintenance dosage since this pattern may be indicative of subclinical viral infection.
对肾移植糖尿病受者的外周血T淋巴细胞群进行了连续监测。未分离的血沉棕黄层制剂与鼠单克隆抗体OKT3（所有循环T细胞）、OKT4（辅助/诱导/调节性T细胞）和OKT8（细胞毒性/抑制性细胞）发生反应。移植前监测的糖尿病患者外周血淋巴细胞亚群水平未显示出明显异常。移植后，但在进行任何急性排斥反应治疗之前，糖尿病受者中OKT3、4和8反应性细胞的平均百分比与非糖尿病受者中观察到的非常相似。在治疗急性排斥反应后，糖尿病（1.04±0.5）和非糖尿病（1.35±0.5）同种异体移植受者的平均OKT4/OKT8比值均从正常水平（1.90±0.7）显著下降。在13名具有长期功能同种异体移植的糖尿病受者中，有11名的OKT4/OKT8比值降低（平均1.03±0.6）。对终末期肾衰竭糖尿病患者的T细胞亚群监测未发现与非糖尿病尿毒症患者有任何显著差异。这些糖尿病同种异体移植受者中高发生率（75%）的同种异体移植排斥反应同样表明免疫功能正常。然而，在成功完成排斥反应治疗后，OKT4与OKT8反应性细胞比值的降低表明免疫反应性发生了改变。对这些具有功能同种异体移植的长期糖尿病受者的免疫监测表明，持续降低的OKT4/OKT8比值的观察结果可能（1）有助于预测同种异体移植的持续功能，（2）促使更快地将类固醇药物减少至维持剂量，因为这种模式可能表明存在亚临床病毒感染。
