Beik A I, Morris A G, Higgins R M, Lam F T
Department of Surgery, Walsgrave Hospital, Coventry, UK.
Clin Transplant. 1998 Feb;12(1):24-9.
We examined changes in the circulating T-cell subsets and their activation to see if consistent changes occur following renal transplantation, during acute rejection episodes (ARE), cytomegalovirus (CMV) infection, and cyclosporine (CsA) nephrotoxicity. Serial blood samples were taken from 28 patients on standard triple immunosuppresion therapy. Using two-colour flow cytometric analysis, the percentages of CD3+, CD4+, and CD8+ T-cells were determined, and coexpression of CD25, HLA/DR, and CD45 isoforms used to define their activation status. During ARE and CMV infection, increased levels of circulating CD4+ CD25+, CD8+ HLA/DR+, CD4+ CD45RO+, CD8+ CD45RO+ were observed. The increased levels of CD45RO+ T-cells were associated with a significant decrease in the percentages of CD45RA+ of both CD4+ and CD8+ T-cells. No significant changes were seen during CsA nephrotoxicity. The pattern of marker expression seen during ARE and CMV infection was similar to that seen in Con-A stimulated T-lymphocytes from 22 normal controls. We conclude that, the increase in the levels of these surface markers do not differentiate between lymphocyte activation indicative of rejection or infection, but clearly distinguish episodes of CsA nephrotoxicity. These results could be useful in the differential diagnosis of renal allograft dysfunction.
我们检测了循环T细胞亚群及其激活情况的变化，以观察肾移植后、急性排斥反应（ARE）期间、巨细胞病毒（CMV）感染以及环孢素（CsA）肾毒性时是否会出现一致的变化。对28例接受标准三联免疫抑制治疗的患者采集系列血样。采用双色流式细胞术分析，测定CD3⁺、CD4⁺和CD8⁺T细胞的百分比，并使用CD25、HLA/DR和CD45异构体的共表达来定义其激活状态。在ARE和CMV感染期间，观察到循环CD4⁺CD25⁺、CD8⁺HLA/DR⁺、CD4⁺CD45RO⁺、CD8⁺CD45RO⁺水平升高。CD45RO⁺T细胞水平的升高与CD4⁺和CD8⁺T细胞中CD45RA⁺百分比的显著降低相关。在CsA肾毒性期间未观察到显著变化。ARE和CMV感染期间观察到的标志物表达模式与22名正常对照者经刀豆蛋白A刺激的T淋巴细胞中所见模式相似。我们得出结论，这些表面标志物水平的升高并不能区分指示排斥或感染的淋巴细胞激活，但能清楚地区分CsA肾毒性发作。这些结果可能有助于肾移植功能障碍的鉴别诊断。
