肝移植受者外周血调节性T细胞中CD39的表达及意义

Expression and significance of CD39 on regulatory T cells in the peripheral blood of patients following liver transplantation

目的 检测肝移植患者急性排斥时外周血CD39在CD4＋CD25＋调节性T细胞中的表达与免疫抑制功能的变化.方法检测76例肝移植患者外周血CD39占CD4＋CD25＋T细胞百分比.对发生急性排斥反应的患者在检测CD39＋T细胞水平的同时行肝穿活检,另选取20例健康人为对照.分别选取急性排斥反应和无排斥反应患者各10例,检测CD4＋CD25＋CD39＋T细胞的免疫抑制功能.结果 发生急性排斥反应的患者CD39占CD4＋CD25＋T细胞的百分比较无排斥反应患者明显降低（P＜0.05）,且与排斥活动指数呈负相关（r=-0.86,P＜0.05）;外周血CD39＋调节性T细胞抑制率较无排斥反应患者明显降低（P＜0.05）.结论 外周血CD4＋CD25＋CD39＋调节性T细胞在肝移植急性排斥过程中明显降低且与排斥程度呈负相关.发生急性排斥的患者外周血CD4＋CD25＋CD39＋调节性T细胞的免疫抑制功能也明显降低.

Objective To study the clinical significance of CD39 on regulatory T （Treg） cells in the peripheral blood （PB） of patients following liver transplantation and to evaluate the relationship between the levels of CD39＋ Treg cells in the PB and acute rejection.Methods A prospective study was conducted to compare the CD39＋ Treg cells from 76 liver transplant patients with those coming from 20 age-matched healthy individuals.The PB samples were collected within one year at different time points post-transplant.Blood samples and liver biopsies were collected at the time when acute rejection was diagnosed.The percentages of CD39 within the CD4＋ CD25＋ T cells were measured by using flow cytometry.The liver transplant patients were classified into two groups：the rejection group which consisted of 17 patients who an episode of acute rejection,and the non-rejection group consisted of the remaining 59 patients who had no acute rejection episodes.The percentages of CD39 within the CD4 ＋ CD25 ＋ T cells and the inhibition function of the CD39＋ Treg cells were compared between the two liver transplant groups.Results The percentages of CD39 within the CD4＋ CD25＋ cells were significantly lower in the rejection group during acute rejection as compared to the non-rejection group （P 〈 0.05）.The percentages of CD39 within the CD4 ＋ CD25 ＋ cells were negatively correlated with the Rejection Activity Index （r =-0.86,P 〈 0.05）.The inhibition rate regarding the CD4＋ CD25＋ CD39＋ Treg cells in patients with acute rejection was significantly lower than those without rejection （P 〈 0.05）.Conclusions The percentages of CD39 within the CD4＋ CD25＋ T cells were significantly lower in the rejection group during acute rejection and were negatively correlated with the RAI.The inhibition rate regarding the CD4＋ CD25＋ CD39＋ Treg cells in patients with acute rejection was significantly lower than those without rejection.