NK受体KIR及其HLA配体对肾移植急性排斥反应的作用

Role of NK Receptors KIRand HLA Ligands in Acute Rejection after Kidney Transplantation

目的探讨杀伤细胞免疫球蛋白样受体(KIR)及其配体人类白细胞抗原(HLA)对肾移植患者术后发生急性排斥反应(AR)的作用。方法随机采集2009年3月-2012年3月实行肾移植的45对供受者,采用PCR-SSP方法进行HLA-Cw和KIR基因分型,然后依据受者移植后移植肾功能恢复状态分为AR组(16例)和非AR组(29例),分析供受者HLA-Cw和KIR基因型、受者KIR/供者HLA-Cw组合型与受者术后肾移植发生AR反应的相关性,籍此研究KIR及配体HLA-Cw对肾移植急性排斥反应的作用。结果在AR组中受者表达KIR2DL2/2DS2明显低于非AR组(P<0.05);非AR组中供受者KIR2DL2/HLA-Cw1、2DL3/HLA-Cw1和2DS2/HLA-Cw1组合型的匹配几率明显高于AR组(P<0.05)。结论特定的KIR基因(2DL2/2DS2)以及供受者KIR2DL2/HLA-Cw1、2DL3/HLA-Cw1和2DS2/HLA-Cw1组合型在异基因移植免疫应答中具有传导抑制信号的作用。

Objective To investigate the contribution of killer cell immunoglobulin - like receptors （KIR） and their human leukocyte antigen （HLA） class I ligands in the pathogenesis of acute rejection （AR） after kidney transplantation. Methods The donors and recipients of 45 kidney transplantations conducted in the Department of Organ Transplantation of Zhujiang Hospi- tal during March 2009 and March 2012 were enrolled in the study. According to the kidney function status of the recipients, the donor- recipient pairs were classfied into two groups, acute rejection group （AR, n= 16） and non- acute rejection group （n= 29）. KIR and HLA- Cw genotyping were performed by polymerase chain reaction - sequence - specific priming （PCR - SSP） method. The possible associations of KIR genotypes and KIR/HLA combinations with acute rejection after kidney transplantation were explored. Results The expression rates of KIR2DL2/2DS2 in the AR group were significantly lower than those in the non- AR group （P 〈 0.05）. The matching probabilities of KIR2DL2/HLA- Cwl, 2DL3/HLA - Cwl and 2DS2]HLA- Cwl combinations in the non - AR group were significantly higher than those in the AR group （P 〈 0.05）. Conclusions Specific KIR genes （2DL2/2DS2） and KIR2DL2/HLA-Cwl, 2DL3/HLA-Cwl and 2DS2/HLA-Cwl combinations can conduct in- hibitory signals in the immune response of allogeneic transplantation.