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目的探讨术前受者外周血抗原特异性单个效应细胞频数与肾移植后急性排斥反应的关系。方法采用酶联免疫斑点实验方法,检测8名健康志愿者及25例肾移植受者术前外周血淋巴细胞经同种异体抗原刺激后分泌特异性细胞因子(γ干扰素、白细胞介素2、白细胞介素4和白细胞介素5)的单个效应细胞频数,并对25例受者肾移植后的情况进行随访,时间至少为半年。结果8名健康志愿者外周血中分泌γ干扰素(INFγ)的细胞的频数最高,为15/500000～120/500000,其频数在连续4个月内相对稳定。受者术前体内存在的供者特异性的、分泌INFγ的细胞频数与供、受者间HLA配合情况无关;25例肾移植受者中,21例移植术后均未发生急性排斥反应,其术前供者特异性的、分泌INFγ的细胞频数除2例外,均低于40/500000;4例术后发生急性排斥反应,术前供者特异性的、分泌INFγ的细胞频数分别为86/500000、104/500000、128/500000及264/500000。结论移植术前测定受者体内供者特异性的、分泌INFγ的细胞频数可以作为评估受者针对供者的特异性免疫反应能力的方法之一,并为术后急性排斥反应的防治提供参考。
Objective To investigate the relationship between the frequency of antigen-specific single effector cells in peripheral blood and acute rejection after renal transplantation in preoperative recipients. Methods Immunocytochemistry was used to detect the expression of specific cytokines (IFN-γ, IL-2, IL-6, IL-6 and IL-10) in peripheral blood mononuclear cells of 8 healthy volunteers and 25 renal transplant recipients after stimulation with alloantigens Interleukin-4 and Interleukin-5) and follow-up of 25 recipients after renal transplantation for at least six months. Results The frequency of INFγ secreted by peripheral blood of 8 healthy volunteers was the highest from 15/500000 to 120/500000, and its frequency was relatively stable in 4 consecutive months. The frequency of donor-specific IFNγ-secreting cells in preoperative recipients was not related to the HLA matching between donors and recipients. Of the 25 renal transplant recipients, no acute rejection occurred in 21 of the 25 transplant recipients The frequencies of preoperative donor-specific and IFNγ-secreting cells were all lower than 40/500 000 in 2 cases. Four cases had acute rejection, the frequency of preoperative donor-specific and IFNγ-secreting cells were 86 / 500000, 104/500000, 128/500000 and 264/500000. Conclusion The frequency of donor-specific IFNγ-secreting cells in donor recipients prior to transplantation can be used as a measure of recipient-specific immunoreactivity and provide a reference for the prevention and treatment of postoperative acute rejection.