外周血淋巴细胞穿孔素的表达及在肾移植排斥与耐受中的临床意义

Perforin expression in peripheral blood lymphocytes and clinical implication of rejection and tolerance in kidney transplantation recipients

目的 测定细胞内穿孔素 (P + )及细胞表面抗原的表达 ,探讨其与移植肾急性排斥和长期存活的关系。方法 用流式细胞仪测定 2 2例患者外周血细胞毒T淋巴细胞和自然杀伤细胞亚群穿孔素的表达。结果 排斥组淋巴细胞穿孔素的表达高于非排斥组 ,排斥反应与CD4 +P+下调和CD8+P+上调有关。冲击治疗可引起P+T细胞亚群和CD5 6+P+NK细胞的降低。CD4 +P+及CD8+P+细胞的下调和CD5 6+P+上调在移植长期存活中多见。结论 观察外周血穿孔素的改变可以较早预测排斥反应 ,可作为评估移植肾长期存活的标志物。

Objective\ To detect the expression of intracellular perforin and cell surface antigens simultaneously to predict the relationship between acute kidney transplant rejection and long term survival. Methods\ By using flow cytometry (FCM), the expression of porforin in peripheral cytotoxic T lymphocyte subsets and natural killer cell subsets was detected. Results\ In the rejection group, the expression of perforin in lymphocytes was higher than in non rejection group. The rejection was related with CD4+P+ down regulation and the high expression of CD8+P+. Intensive therapy could resulted in the decrease of P+T cell subset and CD56+P+NK cells. CD4+P+ and CD8+P+ cell down regulation and CD56+P+ up regulation were mainly found in long term survival tranplant kidney. Conclusion\ The changes in peripheral blood perforin could earlier predict rejection and could be used as a marker to evaluate long term survival of the transplant kidney.