终末期肾病患者外周血T细胞凋亡及Bcl-2、Fas表达的研究

Expression of Bcl-2 and Fas and Apoptosis of T Lymphocyte in the Peripheral Blood of Patients with End-stage Renal Diseases

目的研究终末期肾病(ESRD)患者外周血T细胞的凋亡、Fas、Bcl-2的表达以及不同透析膜对其的影响。方法应用流式细胞术检测10例ESRD未透析(ND)患者、45例维持性血液透析患者分别采用醋酸纤维素膜(CA)、低通聚砜膜(PS-LF)、高通聚砜膜(PS-HF)、以及8例健康对照组(HC)的外周血T细胞经植物血球凝集素刺激培养24h后的凋亡率,免疫组化检测T细胞Bcl-2、Fas的表达。结果ESRD患者各组T细胞的凋亡率高于HC组(P<0.01),各透析组以CA组最高,PS-HF组最低(P<0.05);ESRD患者各组T细胞Bcl-2的表达低于HC组(P<0.01),各透析组以PS-HF组最高,CA组最低(P<0.01),Bcl-2与T细胞凋亡呈负相关(r=-0.83,P<0.01);ESRD患者各组T细胞Fas的表达高于HC组(P<0.01),各透析组以CA组最高,PS-HF组最低(P<0.01),Fas与T细胞凋亡呈正相关(r=0.81,P<0.01)。结论ESRD患者存在外周血T细胞凋亡加速,凋亡途径与Fas表达上调、Bcl-2表达下调有关。维持性血液透析患者T细胞凋亡不仅与透析膜的生物相容性有关,还与透析膜的通透性有关。

Objective To investigate the expression of Bcl-2 and Fas and the apoptosis of T lymphocyte in the peripheral blood of patients with end-stage renal diseases; and to test the impact of various dialysis membranes on the apoptosis of T lymphocyte. Methods T lymphocyte was cultured with the stimulation of Phytohemagglutinin （PHA） for 24 h. The apoptosis of T lymphocyte was measured by flow cytometry. The expression of Bcl-2 and Fas was measured with immunohistochemical approach. A total of 10 non-dialyszed （ND） patients, 45 maintenance hemodialysis patients with cellulose acetate （CA） membrane, low-flux （PS-LF） and high-fluxpolusulfone （PS-HF） membrane, and 8 healthy volunteers （HC） participated in the study. Results The patients with end-stage renal diseases had greater apoptosis of T lymphocyte than healthy volunteers （P〈0.01）. The patients undergoing hemodialysis with CA membrane had greater apoptosis of T lymphocyte than those with PS-LF and PS-HF membranes （P〈0. 05）. The expression of Bcl-2 in T lymphocyte of patients with end-stage renal diseases was lower than that of healthy valunteers （P 〈 0. 01）. The apoptosis of T lymphocyte was negatively correlated with the expression of Bcl-2 （r=-0.83,P〈0.01）. The expression of Fas in T lymphocyte of patients with end-stage renal diseases was greater than that of healthy valunteers （P〈0.01）. The apoptosis of T lymphocyte was positively correlated with the expression of Fas （r=0.81,P〈0. 01）. Conclusion Patients with end-stage renal diseases may experience accelerated apoptosis of T lymphocyte, which is associated with the high expression of Fas and low expression of Bcl-2 in T lymphocyte. The apoptosis of T lymphocyte is also influenced by the permeability of the dialysis membranes.