血液透析对转化生长因子β1及补体调节蛋白CD59基因表达的影响

Effects of hemodialysis on transforming growth factor-β1 and expression of complement regulatory protein CD59

目的 研究不同透析膜对维持性血液透析 (MHD)患者外周血转化生长因子 β1及补体调节蛋白CD5 9活性表达的影响。方法 通过流式细胞术和酶联免疫吸附法测定长期采用铜仿膜 (CU)与聚砜膜 (PSU)透析患者外周血TGF β1水平及CD5 9活性表达。结果 MHD患者血浆TGF β1水平明显增加 (P <0 .0 5 ) ,其中CU组为 (81.7± 8.7)ng mL ;PSU组为 (6 4 .3±8.3)ng mL ,与正常对照组 (49.3± 6 .1)ng mL相比均有显著差异 (P <0 .0 1,P <0 .0 5 ) ;而PSU组与CU组相比 ,外周血TGF β1水平明显下降 (P <0 .0 5 )。CD5 9在正常人外周血单个核细胞中无表达 ,而在尿毒症未透析组及血透组均有表达 ,其中未透析组表达较低 ,而血透组表达较高 ,CU膜血透组较PSU血透组表达要高 (P <0 .0 5 )。经相关分析结果显示 :CU组与PSU组内TGF β1水平与CD5 9表达均呈现良好的相关性 (r=0 .6 4 0 9与 0 .5 83,P <0 .0 5 )。 结论 血液透析通过血液 透析膜间相互反应可活化补体 ,诱导外周血单个核细胞 (PBMC)合成TGF β1增多 ,而增高的TGF β1水平可上调CD5 9基因表达 ,抑制补体异常活化造成的细胞破坏 ,对机体具有代偿性保护意义。然而不同透析膜如CU和PSU对MHD患者TGF β1与CD5 9的影响有所不同 。

Objective To investigate the effect of different dialysis membranes on peripheral blood transforming growth factor-β1(TGF-β1) and the expression of complement regulatory protein CD59 in maintenance hemodialysis patients(MHD).Methods The levels of peripheral blood TGF-β1 and the expression of CD59 were measured by ELISA and flow cytometry in patients with Cuprophone (CU) and Polysulfone (PSU).Results As compared with normal control group TGF-β1(49.3±6.1) ng/mL, the levels of TGF-β1 in MHD patients were significantly increased, but the levels of TGF-β1in PSU group(64.3±8.3)ng/mL were significantly decreased than that in CU group(81.7±8.7) ng/mL (P<0.01). The activity of CD59 was not expressed in the peripheral blood mononuclear cell of normal person, but it did so in the hemodialysis and non-dialysis group of uremia. CD59 activity was lower in the non- dialysis group, while it was higher in the dialysis group. In CU group it was significantly increased than that in PSU group(P<0.05). There is a positive correlation between TGF-β1 levels and CD59 expression in CU group and PSU group.Conclusion Hemodialysis may activate complement through reaction between blood and dialysis membrane, in- ducing peripheral blood mononuclear cells to synthesize more TGF-β1, while abnormally increased TGF-β1 could increase the activity of CD59, inhibit cells damage caused by abnormal complement activation to protect human body. But different dialysis membrane such as CU and PSU has different effect on TGF-β1 and CD59 in MHD patients. All of these changes are associated with the biocompatibility of the dialysis membrane.