人类白细胞抗原G在肾移植受者外周血的表达探讨

Expression of human leucocyte antigen G in peripheral blood of kidney transplantation recipients

目的探讨人类白细胞抗原（HLA）G的膜型HLA—G（mHLA—G）、胞内HIJA—G（iHLA—G）和可溶型HLA—G（sHLA—G）在。肾移植受者外周血的表达及其与术后临床相关性。方法研究对象为2000年2月至2006年6月解放军第三零九医院全军器官移植中心行肾移植的175例受者，根据4周内是否发生排斥反应分为急性排斥反应组（36例）、功能稳定组（139例），30例健康供者作为对照组。应用流式细胞术检测外周血mHLA-G1、iHLA—G1的表达，酶联免疫吸附法检测血浆sHLA-G5的含量．结果T淋巴细胞CD4^＋mHlA—G1’、CD8^＋mHLA—G1^＋、CD4^＋iHLA—G1^＋、CD8^＋iHLA—G1^＋平均表达率在对照组分别为0．43％±0．19％、1．23％4-0．41％、27％±13％、36％±14％，急性排斥反应组分别为：0．57％±0．34％、1．31％±0．56％、26％±8％、37％±17％，功能稳定组分别为0．61％±0．43％、1．39％4-0．47％、26％±9％、37％±17％，3组间比较差异均无统计学意义（均P〉0．05）。外周血浆sHLA—G5表达在对照组为（25±14）ng／ml；急性排斥组术前为（24±15）ng／ml，术后为（34±21）ng／ml；功能稳定组术前为（25±11）ng／ml，术后为（56±32）rig／ml；急性排斥组和功能稳定组术前与健康组比较，差异无统计学意义（P〉0．05），术后功能稳定组明显高于急性排斥组（P〈0．05）。结论肾移植受者外周血存在一群比率较低的HLA—G^＋T淋巴细胞，mHLA—G1和iHLA—GI的表达与肾移植术后的排斥反应发生无关，sHLA—G5的高表达与排斥反应发生的减少有关。

Objective To investigate the expression of non-classical major histocompatibility complex（ MHC）-I molecule, human leucocvte antigen （HLA） G, including membrane-bound HLA-G （mHI,A-G）, intracellular HI,A-G （iHLA-G） and soluble HLA-G （sHLA-G）, in peripheral blood of surviving kidney transplantation recipients and understand the relevance between HLA-G and the function of transplanted organ, as well as the onset of acute rejection. Methods A longitudinal study was performed on 175 kidney transplantation recipients. Three groups were involved in this study, including acute rejection group （n = 36）, function stable group （n = 139） and healthy control group （n = 30）. The expression of mHLA-GI and iHLA-G1 in the T lymphocytes of peripheral blood was detected by flow cytometry analysis and the sHLA-G5 level detected by ELISA. Results The average rate of CD4^＋ mHLA-G1^＋ , CD8^＋ mHLA- G1^＋ , CD4^＋ iHLA-G1^＋ , CD8^＋ iHLA-G1^＋ in T lymphocytes of healthy control group was 0. 43% ±0. 19%, 1.23% ±0.41% , 27% ± 13% and 36% ± 14% respectively. That of acute rejection group was 0.57% ± 0.34%, 1.31% ±0.56%, 26% ±8% and 37% ± 17%; that of function stable group was 0.61% ± 0. 43% , 1.39% ±0. 47% , 26% ± 9% and 37% ± 17% respectively. There was no signifieant difference among the three groups （ all P 〉 0. 05 ）. The average of sHLA-G5 levels in plasma of eontrol group was （25 ± 14） ng/ml, acute rejection group （24 ±15） ng/ml （pre-operative） and （34± 21 ） ng/ml （post-operative） , function stable group （ 25 ± 11 ） ng/ml （pre-operative） and （ 56 ± 32 ） ng/ml （post-operative）. There was no signifieant difference among the three groups （pre-operative, P 〉 0. 05 ）. The average of sHLA-G5 levels in plasma of function stable group was higher than that of acute rejection group （post-operative, P 〈 0.05 ） . Conclusion There is a subset of CD4^＋ HLA-G1^＋ and CD8^＋ HLA-G1^＋ T lymphocytes with low percentage in peripheral blood of those surviving kidney transplantation recipients. The expressions of mHLA-G1 and iHLA-G1 have no relevance with the onset of acute rejection, sHLA-G5 is correlated with acute rejection in peripheral blood of surviving transplantation recipients.