排斥反应时血清可溶性白细胞相关免疫球蛋白样受体1的水平及意义

Role of an inhibitory receptor LAIR-I expression in graft rejection

目的探讨可溶性白细胞相关免疫球蛋白样受体1（sLAIR1）与移植物排斥反应的相关性。方法采用双抗体夹心酶联免疫吸附试验测定23例肝移植、139例肾移植患者的血清sLAIR-1水平，并以健康志愿者为对照。结果健康志愿者的血清sLAIR-1水平为（4．3±2．3）μg／L，移植器官功能正常者（肝移植11例，肾移植87例）的sLAIR-1为（6．3±3．7）μg／L，二者比较，差异无统计学意义（P〉0．05）。肝移植后发生急性排斥反应的6例患者，其血清sLAIR-1水平为（47．2±25．9）μg／L；肾移植后后发生急性排斥反应的20例患者，其血清sLAIR-1水平（36．3±14．7）μg／L；移植肾功能丧失的5例患者，其血清sLAIR-1水平为（28．8±9．4）μg／L，上述三者的血清sLAIR-1水平均明显高于移植物功能正常者和健康志愿者（P〈0．01）。移植肝重度排斥反应的1例，其血清sLAIR-1高达117．3μg／L．为正常人的27倍。移植肝慢性排斥反应者（5例）和移植肾慢性排斥反应者（27例）的血清sL-AIR-1水平分别为（16．1±6．4）μg／L和（13．1±5．5）μg／L，也明显高于移植物功能正常者和健康志愿者（P〈0．05）。结论发生排斥反应者的血清sLAIR-1水平升高，其水平的升高可能是发生排斥反应的重要风险因素。

Objective To investigate the relationship between the soluble LAIR-1 （sLAIR-1） in the serum from recipients after transplant and graft rejection. Methods Serum sLAIR-1 level was de termined by double mAb sandwich enzyme linked immunosorbent assay on 23 cases of liver transplantation and 139 eases of kidney transplantation. Results In healthy volunteers and 98 recipients with normal graft function,sLAIR-1 was detected at low level [（4. 3 ± 2.3） μg/L and （6. 3 ±3.7） μg/L], with the difference being not significant. In 6 cases of liver acute rejection,20 cases of kidney acute rejection and 5 cases of graft loss, serum sLAIR-1 levels were increased remarkably at high levels [（47. 2 ± 25.9） μg/L, （36. 3 ± 14. 7） μg/L and （28.8 ± 9. 4） μg/L respectively] as compared with the two groups of healthy volunteers and the recipients with normal graft function,even peaked at 117. 3 μg/L in one case of severe liver rejection. Meanwhile,in 5 cases of liver chronic rejection,27 cases of kidney chronic rejection and 6 cases under dialysis treatment, the levels of sLAIR-1 were （16. 1 ±6. 4） μg/L, （13.1 ± 5.5） μg/L and （11.2 ± 4. 6） μg/L respectively, significantly higher than those of the healthy volunteers and the recipients with normal graft function. Conclusion sLAIR 1 was detected at high level in the recipients suffered graft acute or chronic rejection and might be a promising monitor of rejection after transplantation.