调节性T细胞亚群在肝移植中的作用及临床应用进展

Role of regulatory T cell subsets in liver transplantation and progress in clinical application

背景:肝移植后的免疫排斥反应严重影响患者的生存质量,而调节性T细胞在抑制肝移植排斥反应及免疫耐受方面发挥着重要作用。目的:综述调节性T细胞在肝移植术中的作用及其在临床上的应用进展,为调节性T细胞在肝移植及其他器官移植方面的研究及临床应用提供思路。方法:第一作者于2021年2月应用计算机在PubMed和中国知网数据库检索1970年1月至2021年2月相关文献,以“regulatory T cells,liver transplantationg”为英文检索词,以“调节性T细胞、肝移植”为中文检索词,最终纳入49篇文献进行分析。结果与结论:①调节性T细胞是一类控制体内自身免疫反应性的T细胞亚群,又称抑制性T细胞,调节性T细胞可分为天然产生的自然调节性T细胞和诱导产生的适应性调节性T细胞,自然调节性T细胞主要为CD4^(+)CD25^(+)T细胞,占外周血及脾脏CD4^(+)T细胞的5%-10%,调节性T细胞在抑制肝移植排斥反应及维持免疫耐受方面发挥着重要作用。②肝移植后,受者受到移植肝的刺激,调节性T细胞的数量及活性增加,同时叉状头转录因子的表达量增多。③肝移植后发生排斥反应时受者体内调节性T细胞的数量及活性较低。④肝移植后免疫耐受者体内调节性T细胞的数量及活性较高,并且调节性T细胞能够诱导及维持免疫耐受。⑤向肝移植后受者输注调节性T细胞能够减轻移植后的排斥反应,延长移植肝的存活时间。

BACKGROUND:The immune rejection after liver transplantation seriously affects the quality of life of patients.Regulatory T cells play an important role in inhibiting the rejection and maintaining immune tolerance.OBJECTIVE:To review the role of regulatory T cells in liver transplantation and its clinical application,so as to provide ideas for the research and clinical application of regulatory T cells in liver transplantation and other organ transplantation.METHODS:The first author searched the relevant articles published from January 1970 to February 2021 in PubMed and CNKI by computer in February 2021.The Chinese and English key words were“regulatory T cells,liver transplantation”.Finally,49 articles were included and analyzed.RESULTS AND CONCLUSION:(1)Regulatory T cells are a subgroup of T cells that control the autoimmune response in vivo,also known as inhibitory T cells.Regulatory T cells can be divided into naturally occurring natural regulatory T cells and induced adaptive regulatory T cells.Natural regulatory T cells are mainly CD4^(+)CD25^(+)regulatory T cells,accounting for about 5%-10%of CD4^(+)T cells in peripheral blood and spleen.Regulatory T cells play an important role in inhibiting liver transplantation rejection and maintaining immune tolerance.(2)After liver transplantation,the number and activity of regulatory T cells and the expression of transcription factor forkhead box P3 were increased when the recipient was stimulated by the transplanted liver.(3)The number and activity of regulatory T cells were low in the recipients of rejection after liver transplantation.(4)The number and activity of regulatory T cells were higher in immunotolerant patients after liver transplantation,and regulatory T cells could induce and maintain immune tolerance.(5)Infusion of regulatory T cells into the recipient after liver transplantation can reduce the rejection and prolong the survival time of the transplanted liver.