抗CD_(25)单克隆抗体对肾移植受者末梢血淋巴细胞的影响

Effect of anti-CD_(25) monoclonal antibody on the lymphocyte in the peripheral blood of the recipients of kidney transplantation

目的 探讨抗CD2 5单克隆抗体 (舒莱 )对肾移植受者末梢血活化T细胞的抑制作用。 方法 4 6例肾移植受者随机分为舒莱治疗组 ( 2 3例 )和对照组 ( 2 3例 )。免疫抑制剂方案为新山地明胶囊 (Neoral)、硫唑嘌呤 (Aza)和泼尼松 (Pred) ,舒莱治疗组术前 2h和术后 4d各静脉滴注舒莱 2 0mg。应用流式细胞仪对 4 6例受者手术前后末梢血中不同表型淋巴细胞进行连续动态观察。 结果 与对照组比较 ,舒莱组活化T细胞 (CD+2 5)在用药后 2 4h明显下降 ,从用药前的 ( 17.0 0± 3.70 ) %降至 ( 3.30± 2 .4 3) % ,1周后降至 ( 2 .5 2± 1.0 9) % ,并在整个观察过程中呈低水平表达 (P <0 .0 1) ;淋巴细胞总数和T细胞 (CD+3 CD-19)总数无明显变化 ;B淋巴细胞 (CD-3 CD+19)、NK细胞 (CD-3 CD+16CD+56)和非HLA限制性细胞毒性T细胞 (CD+3 CD+16CD+56)未见明显升高。 结论 舒莱对活化T细胞有明显抑制作用 。

Objective To study the inhibition effect of anti-CD 25 monoclonal antibody (Simulect) to the activated T cells in the recipients of kidney transplantation. Methods Forty-six recipients of renal transplantation were randomly divided into therapeutic group with simulect (23 cases) and control group (23 cases).All recipients in both groups received immunosuppressive therapy with neoral,azatheoprine and predonine conventionally.The recipients in simulect group received additionally 20 mg simulect at 2h preoprative and 4d postoperative,respectively.Several phenotypes of lymphocyte in the peripheral blood of all recipients were observed sequentially with flow cystometer. Results Compared with the control group,the number of activated T cells(CD + 25 ) decreased significantly within 24h after the first dose in the patients who received simulect,and the level of the cells that expressed CD 25 was significantly lower than that of control during the whole observation( P <0.01).The total numbers of lymphocytes and T cells(CD + 3CD - 19 ) were unchanged;the numbers of B cells (CD - 3CD + 19 ),NK cells (CD - 3CD + 16 CD + 56 ) and non HLA restricted cytotoxic T cells (CD + 3CD + 16 CD + 56 ) were not increased. Conclusions Simulect inhibits the activated T cells effectively.The mechanism of inhibition is the clonal blockage rather than deletion.