重组人生长激素对慢性肾衰竭患者T淋巴细胞的免疫调节作用

Regulation effect of recombinant human growth hormone on immune function of T lymphocyte in patients with chronic renal failure

目的探讨重组人生长激素对慢性肾衰竭患者外周血T淋巴细胞免疫功能的调节作用。方法选择45例慢性肾衰竭患者(根据肾小球滤过率水平分为CKD2-3期、CKD4期、CKD5期共3组),以及15例健康对照,抽取外周血,分离得到淋巴细胞,加入植物血凝素和不同浓度的重组人生长激素(0,0.1,10,100 ng/ml)进行培养,于培养第3天收集细胞及上清。抽提细胞RNA,RT-PCR检测细胞内IFN-γ、IL-4的mRNA水平,用双抗体夹心ABC-ELISA法检测培养上清中IFN-γ、IL-4的浓度。结果培养3 d后,重组人生长激素浓度为0 ng/ml时,CKD4、5期组IFN-γ/IL-4水平显著低于正常对照组;加用不同浓度重组人生长激素后,各组IFN-γ/IL-4水平均有不同程度升高,以rhGH浓度为0.1 ng/ml时升高明显,但CKD2-3、4、5期组IFN-γ/IL-4水平仍低于正常对照组。结论慢性肾衰竭患者Th1/Th2平衡可能偏向Th2;重组人生长激素可使慢性肾衰竭患者Th1/Th2平衡向Th1偏移。

Objective To investigate the effect of recombinant human growth hormone on immune function of T lymphocyte in patients with chronic renal failure. Methods The peripheral blood lymphocyte cell was collected from 15 healthy controls and 45 chronic re- nal failure patients. Patients were divided into CKD2 - 3, CKD4 and CKD5 groups according to the glomerular filtration rate. The periph- eral blood lymphocyte ceils were co-cuhured with phytohemagglutinin and different concentrations of recombinant human growth hor- mone （0,0.1,10,100 ng/ml）, respectively, and then the supernatant was collected at day 3. The mRNA of IFN-γ and IL4 was detec- ted by semiquantitative PT-PCR, and the expression of IFN-γ/and IL4 was determined by double antibody sandwich ABC-ELISA tech- nique. Results The levels of IFN-γ/IL-4 in patients with CKIM, 5 were significantly lower than that of healthy controls at 3 d after culture without recombinant human growth hormone. However, the level of IFN-γ/IL-d increased after cultured with recombinant human growth hormone at the concentrations of 0. 1,10,100 ng/ml. It was worth noting that the levesl of IFN-γ/IL-4 increased most obviously when cultured with 0. 1 ng/ml recombinant human growth hormone. Anyway,the levels of IFN-γ/IL-4 in patients with CKD2 - 3, 4, 5 were lower than that of healthy controls. Conclusion There is Th2-polarized disbalance in patients with chronic renal failure, and the recombinant human growth hormone could regulate Th1/Th2 disbalance toward Thl-polarized disbalance.