输供体骨髓对可溶性Fas的影响

Effect of Donor Bone Marrow Infusion on Soluble Fas Value in Renal Recipients

目的 通过测定病人血清中 sFas 的含量，观察输供体骨髓对肾移植前后 sFas 含量变化的影响，探讨 sFas与输供体骨髓(DBM)之间的关系及意义。方法：80例肾移植病人分为四组，第一组术前用免疫抑制剂霉酚酸酯(MMF)+输供体骨髓；第二组术前用免疫抑制剂；第三组术前输供体骨髓；第四组术前 MMF 与 DBM 均不使用。分别在术前、术后6月和12月采血测 sFas 含量。结果：第一组与第二组、第四组相比有极显著差异，第三组与第二、第四组相比有明显差异；第一、第三组术后6月、12月与术前相比有明显差异，但术后6月和12月相比无显著差异。结论：受者体内血清中 sFas 水平升高可能与输供体骨髓能持续提供抗原刺激有关，受者 CTL 及 TH_1被抗原激活后表达 Fas 及 FasL 而发生凋亡，起到抑制排斥反应的作用。

Objective To investigate the relationship between soluble Fas(sFas)and donor bone marrow infusion and itsmeanings in the renal recipients.Methods The 80 renal recipients were divided into four groups:1.Receiving an immunosuppres-sor,MMF before the operation and being infused with donor bone marrow;2.Only receiving MMF;3.Only being infused with donorbone marrow;4.Blank control.The blood sFas contents in the renal recipients were measured respectively before the operation,and6 and 12 months after the operation.Results The blood sFas content in group 1 was very significantly higher than those in groups 2and 4,and the blood sFas content in groups 3 was significantly higher than those in groups 2 and 4 after the operation.In groups 1and 3,the sFas contents were significantly higher after the operation than those before the operation,and there is insignificant differ-ence in the sFas content between 6 and 12 months after the operation.Conclusions The increase in the sFas content in the recipi-ents' blood suggests that the donor bone marrow infusion can continuously provide the antigen excitation.The recipients are forced toexpress Fas and FasL since the CTL and THI of recipients are activated by the antigen.The rejection reactions can be restrained be-cause the recipients' T-cells recognizing the donors' CTL-cells by the way of Fas are killed.