混合淋巴细胞培养上清液中细胞因子水平与移植肾急性排斥反应的联系

ALTERATION OF CYTOKINES IN MLC SUPERNATANTS IN PATIENTS WITH ACUTE RENAL ALLOGRAFT REJECTION

目的 :探讨混合淋巴细胞培养 (MLC)上清液中细胞因子水平与肾移植术后急性排斥反应的关系 ,评价肾移植术前检测MLC上清液中细胞因子水平 ,作为预测急性排斥反应指标的临床价值。 方法 : 选取 48例接受同种异体肾移植术的患者为检测对象。在手术当日 ,分离其外周血单个核细胞 (PBMC)与供者单个核细胞进行混合培养 (反应组 ) ,同时以受者单纯自身PBMC进行培养 (对照组 )。在培养第 1、3、5天测MLC上清中IL 2和TNF α水平 ,并观察其分泌动态变化。 结果 : 发生急性排斥反应的患者 ,在 3次时间点上 ,两种细胞因子水平均高于肾功能稳定组 ,差异显著。在发生急性排斥反应和肾功能稳定的两组受者中 ,反应组较对照组细胞因子水平都有增加 ;急排的患者增加量高于肾功稳定的受者 ,差异显著。排斥组与肾功能稳定组两种细胞因子的分泌规律基本一致 ,但排斥组峰值都高于肾功能稳定组。 结论 :检测MLC上清液中细胞因子水平可以作为合理选择供受者、预测急性排斥反应的方法。

To explore the relationship between cytokines in MLC supernatants and acute rejection in renal allograft recipients and to evaluate the clinical value of cytokines determination in MLC donor selection. METHODOLOGY 34 male and 14 female randomly chosen renal allograft recipients were involved in this study.PBMC was separated routinely in donors and recipients.For one way MLC,stimulator PBMC was treated with mitomycin C.Cell concentration was 1 5×10 6/ml.Responder PBMC (recipientsPBMC) was co cultured with either mitomycin C treated autologous PBMC (control cultures) or mitomycine C treated allogenic(stimulated cultures)in duplicates of four.ELISA was used for the determination of IL 2 and TNF α.Samples were collected and measured on day1,3,and 5.RESULTS In 20 patients who suffered acute rejection (RG group),the levels of both cytokines in control and stimulated cultures were significantly higher thanthose of the 28 patients whose renal function was stable(SG group).Either in RG or SG on day 1,3,and 5,both cytokineslevels in stimulated cultures were higher than in control cultures.Cytokines gaps between stimulated and control cultrues were significantly higher in RG than in SG.The kinetics of IL 2 and TNF α in rejection group was similar to stable group. CONCLUSION The increased levels of both IL 2 and TNF α in MLC supernatant are of significance in predicting the occurrence of acute rejection in renal allograft recipients.And they may also be applied in the selection of compatible related and unrelated donors.