天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (7): 727-731.doi: 10.11958/20190386

• 临床研究 • 上一篇    下一篇

肾移植急性排斥受者外周血OX40 mRNA和Th1的变化及意义

左娅薇，莫春柏，李光，耿洁，王玉亮   

  1. 天津医科大学肿瘤医院检验科，天津医科大学肿瘤医院，国家肿瘤临床医学研究中心，天津市“肿瘤防治”重点实验室，天津市恶性肿瘤临床医学研究中心（邮编 300060）
  • 收稿日期:2019-02-13 修回日期:2019-05-13 出版日期:2019-07-15 发布日期:2019-08-01
  • 通讯作者: 王玉亮 E-mail:wang_yu_l@163.com

Changes and significance of OX40 mRNA and Th1 in peripheral blood of acute rejection recipients after renal transplantation

ZUO Ya-wei,MUO Chun-bai,LI Guang,GENG Jie,WANG Yu-liang   

  1. Department of Clinical Laboratory Medicine, Tianjin Medical University Cancer Institute and Hospital, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin，s Clinical Research Center for Cancer, Tianjin 300060, China
  • Received:2019-02-13 Revised:2019-05-13 Published:2019-07-15 Online:2019-08-01
  • Contact: WANG Yuliang E-mail:wang_yu_l@163.com

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摘要： 目的 探讨外周血单个核细胞 OX40 mRNA和外周血 CD3+CD8- T辅助细胞（Th）1、Th2检测用于评估肾移植术后急性排斥的应用价值。方法 收集 2016年 1月—2017年 1月天津市第一中心医院器官移植中心行肾移植手术的 40例肾移植受者及 20名健康志愿者纳入研究，肾移植受者分为急性排斥组 20例和肾功能稳定组 20例。应用TaqMan实时荧光定量聚合酶链式反应（RT-PCR)定量检测 3组外周血单个核细胞（PBMCs）中 OX40 mRNA水平，应用流式细胞术检测外周血 CD3+CD8-T淋巴细胞中 IFN-γ（Th1）和 IL-4（Th2）表达率。ROC曲线评价 OX40和 Th1对预 测急性排斥的诊断价值。结果 肾移植术后急性排斥组 PBMCs 中 OX40 mRNA水平明显高于肾功能稳定组以及健康对照组（P＜0.01），肾功能稳定组 PBMCs 中 OX40 mRNA水平与健康对照组差异无统计学意义（P＞0.05）。急性排斥组 Th1 表达率明显高于肾功能稳定组和正常对照组（P＜0.01），3 组 Th2 表达率差异无统计学意义（P＞0.05）。OX40 mRNA 诊断急性排斥反应的 ROC 曲线下面积（AUC）为 0.903（95%CI：0.825~0.980）；Th1 的 AUC 为 0.731（95%CI：0.587~0.874）；两者联合诊断的 AUC 为 0.930（95%CI：0.859~1.001）。结论 监测肾移植受者外周血 OX40mRNA及 Th1细胞可以预测急性排斥反应。

关键词: 肾移植, 移植物排斥, 受体, OX40, Th1细胞, Th2细胞

Abstract: Objective To investigate the significance of determining OX40 mRNA and Th1, Th2 of CD3+CD8- T helper lymphocytes in peripheral blood for evaluating renal acute rejection. Methods A total of 40 recipients with renal transplantation and 20 healthy volunteers were enrolled and divided into acute rejection group (n=20) and stable renal allograft function group (n=20) according to the inclusion criteria. The levels of OX40 mRNA in peripheral blood mononuclear cells (PBMCs) were measured by TaqMan real-time reverse transcriptase-polymerase chain reaction (RTPCR) assays. The expression percentages of IFN-γ and IL-4 of CD3+CD8- T lymphocytes (Th1 and Th2) in peripheral blood were determined with flow cytometry. Receiver operating characteristic (ROC) curve was used to evaluate the prediction value. Results The level of OX40 mRNA in PBMCs significantly elevated in acute rejection group compared with that in stable renal allograft function group and normal control group (P＜0.01). There were no significant differences in OX40 mRNA levels between stable renal allograft function group and normal control group (P＞0.05). The expression percentage of Th1 in peripheral blood was significantly higher in acute rejection group compared with that in stable renal allograft function group and normal control group (P＜0.01). No significant difference was found in the expression percentage of Th2 in peripheral blood between the three groups (P＞0.05). The area under ROC curve (AUC) in the diagnosis of acute rejection was 0.903 (95% CI 0.825-0.980) for OX40 mRNA. The AUC of Th1 was 0.731 (95%CI：0.587-0.874). The AUC of combined diagnosis was 0.930 (95% CI: 0.859-1.001). Conclusion The monitoring of OX40 mRNA and Th1 after renal transplantation can predict acute renal allograft rejection.

Key words: renal transplantation, acute rejection, OX40, T helper lymphocytes