Cosimi A B, Colvin R B, Burton R C, Rubin R H, Goldstein G, Kung P C, Hansen W P, Delmonico F L, Russell P S
N Engl J Med. 1981 Aug 6;305(6):308-14. doi: 10.1056/NEJM198108063050603.
Using monoclonal antibodies and flow cytometry, wer serially monitored lymphocyte subpopulations in renal-allograft recipients treated with either conventional immunosuppression or a monoclonal antibody. In 29 patients given conventional suppression, highly significant correlations between changes in T-cell subsets and rejection were noted. Normal or elevated ratios of OKT4 (helper/inducer) to OKT8 (suppressor/cytotoxic) cells were associated with rejection unless the donor was HLA identical or the total number of T cells was extremely low. In patients with low ratios, rejection seldom occurred. Two patients treated with OKT3 monoclonal antibody for acute rejection had rapid disappearance of OKT3-reactive cells from the peripheral blood and prompt reversal of rejection. The use of monoclonal antibodies allows the precise determination of changes in T-cell subsets and promises the development of therapeutic protocols that can be designed to manipulate selected lymphocyte populations.
利用单克隆抗体和流式细胞术，我们对接受传统免疫抑制治疗或单克隆抗体治疗的肾移植受者的淋巴细胞亚群进行了连续监测。在29例接受传统免疫抑制治疗的患者中，发现T细胞亚群变化与排斥反应之间存在高度显著的相关性。OKT4（辅助/诱导）细胞与OKT8（抑制/细胞毒性）细胞的比例正常或升高与排斥反应相关，除非供者与受者HLA相同或T细胞总数极低。比例较低的患者很少发生排斥反应。两名因急性排斥反应接受OKT3单克隆抗体治疗的患者外周血中OKT3反应性细胞迅速消失，排斥反应迅速逆转。单克隆抗体的应用能够精确测定T细胞亚群的变化，并有望开发出可用于调控特定淋巴细胞群体的治疗方案。
