巨细胞病毒感染肾移植受者红细胞表面分子CD35、CD58、CD59表达的变化

Changes of erythrocytes surface molecule CD35,CD58 and CD59 expression in recipients infected with cytomegalovirus after renal transplantation

目的探讨巨细胞病毒(CMV)感染肾移植受者红细胞膜表面分子CD35、CD58、CD59表达的变化规律及其意义。方法选择同种异体肾移植术的受者82例,根据外周血CMV-pp65抗原检测定性结果将其分为CMV阴性组(21例)和CMV阳性组(61例),再根据CMV-pp65(+)白细胞计数结果将活动性CMV阳性组分为低活动性感染亚组(55例)和高活动性感染亚组(6例);另外选取健康成人志愿者作为健康对照组(30名)。采用流式细胞术检测CMV-pp65抗原和红细胞膜表面分子CD35、CD58、CD59的表达情况。结果与健康对照组比较,CMV阳性组的肾移植受者红细胞表面分子CD35、CD58、CD59表达水平降低,CMV阴性组的CD35和CD59表达水平降低(均为P<0.05);与CMV阴性组比较,CMV阳性组的红细胞表面分子CD58和CD59表达水平明显降低(均为P<0.05)。高活动性感染亚组的红细胞表面分子CD35和CD59表达水平均低于低活动性感染亚组(均为P<0.05)。结论肾移植术后CMV活动性感染的程度越严重,患者红细胞表面免疫分子CD35、CD58、CD59的表达越低,提示红细胞免疫功能紊乱可能参与了CMV活动性感染。

Objective To investigate the change rules and its significance of erythrocytes surface molecule CD35,CD58 and CD59 expression in recipients infected with cytomegalovirus（ CMV） after renal transplantation. Methods Eighty-two recipients undergoing allogeneic renal transplantation were selected and divided into the negative（ n = 21） and positive CMV groups（ n = 61） based on the qualitative detection of CMV-pp65 antigen in peripheral blood. According to the results of CMV-pp65（ ＋） leucocyte count,all 61 patients in positive CMV group were further divided into low（ n = 55） and high active infection subgroups（ n = 6）. Healthy adults were recruited into the normal control group（ n = 30）. The expression levels of CMV-pp65 antigen,erythrocytes surface molecule CD35,CD58 and CD59 were measured by flow cytometry. Results Compared with normal control group,the expression levels of erythrocytes surface molecule CD35,CD58 and CD59 in the positive CMV group were significantly down-regulated,and the CD35 and CD59 expression in the negative CMV group were considerably down-regulated（ all P〈0. 05）. Compared with negative CMV group,the expression levels of CD58 and CD59 in the positive CMV group were significantly down-regulated（ both P〈0. 05）. The expression levels of CD35 and CD59 in the high active infection subgroup were significantly lower than those in the low active infection subgroup（ both P〈0. 05）. Conclusions The more severe active CMV infection after renal transplantation,the lowerexpression of erythrocytes surface molecule CD35,CD58 and CD59,hinting that red cell immune dysfunction is probably involved with active CMV infection.