天津医药

天津医药 ›› 2017, Vol. 45 ›› Issue (2): 172-175.doi: 10.11958/20161259

• 临床研究 • 上一篇    下一篇

肝移植术后半年内外周血 Th1/Th2 细胞因子变化

李亚光 1， 王凯 1,2△， 刘凯 1， 周春雷 1， 吴斌 1,2， 高伟 1,2   

  1. 1 天津医科大学一中心临床学院 （邮编 300192）； 2 天津市第一中心医院移植外科
  • 收稿日期:2016-11-02 修回日期:2016-12-16 出版日期:2017-02-15 发布日期:2017-02-14
  • 通讯作者: △通讯作者 E-mail：wang-kai1978@hotmail.com E-mail:wang-kai1978@hotmail.com
  • 作者简介:李亚光 （1990）， 男， 硕士研究生， 主要从事肝脏移植研究
  • 基金资助:
    国家自然科学基金资助项目 （81570592）

Changes of serum Th1/Th2 cytokines in peripheral blood pre- and post-liver transplantation

LI Ya-guang1, WANG Kai1,2△, LIU Kai1, ZHOU Chun-lei1, WU Bin1,2, GAO Wei1,2   

  1. 1 First Center Hospital Clinic Institute, Tianjin Medical University, Tianjin 300192, China; 2 Department of Transplantation, Tianjin First Center Hospital
  • Received:2016-11-02 Revised:2016-12-16 Published:2017-02-15 Online:2017-02-14
  • Contact: △Corresponding Author E-mail: wang-kai1978@hotmail.com E-mail:wang-kai1978@hotmail.com

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摘要： 目的 探讨成人肝移植术后 6 个月内外周血 Th1 与 Th2 类细胞因子的变化趋势。方法 选取在天津市第一中心医院接受肝移植的患者 23 例作为患者组， 男 21 例、 女 2 例， 年龄 37~63 岁， 平均 （52.7±7.6） 岁。20 名来自本院的健康成年职工作为对照组， 男 15 例、 女 5 例， 年龄 22~42 岁， 平均 （31.0±6.1） 岁。患者组术后长期服用他克莫司为主要免疫抑制剂， 于术前（T0）、 术后 1 个月（T1）、 3 个月（T3）和 6 个月（T6）时采集静脉血。对照组仅采血 1 次作为对照。酶联免疫吸附试验（ELISA）法检测外周血中白细胞介素-2（IL-2）、 干扰素-γ（IFN-γ）、 白细胞介素-10 （IL-10） 和转化生长因子-β （TGF-β） 的浓度。结果 （1） 患者组 IL-2 浓度表现为持续升高趋势， T1 时较 T0 增高不明显， 至 T3 时浓度进一步增高且高于 T0， T6 时浓度均高于 T0 和 T1； 患者组 T0~T3 时浓度与对照组差异无统计学意义， 至 T6 时浓度高于对照组。（2）患者组 IFN-γ 浓度经历了从术前到术后 1 个月的短暂下降后开始升高， 并于术后 3 个月达到高峰， 随后又开始下降的趋势。T0 与 T1~T6 浓度无差异， T3 时浓度高于 T1， 至 T6 时浓度低于 T3； 与对照组相比， 仅 T3 时点的浓度在其水平之上。（3） IL-10 在患者组不同时点浓度无差异， 且不同时点与对照组差异亦无统计学意义（均 P＞0.05）。（4）患者组 TGF-β 浓度在术后呈现缓慢下降的趋势， 至 T6 时达到最低浓度， 低于 T0~T3 时点； 与对照组相比， T0、 T1 时下降不明显， 至 T3 和 T6 时点的浓度降低（P＜0.05）。结论 肝移植术后 6 个月内， Th1 类细胞因子表达呈上升趋势， Th2 类细胞因子中 TGF-β 呈下降趋势， 这种变化可能与肝移植术后的自身免疫反应及服用免疫抑制剂有关。

关键词: 肝移植, 细胞因子类, Th1 细胞, Th2 细胞, 白细胞介素 2, 白细胞介素 10, 转化生长因子 β, 干扰素Ⅱ型

Abstract: Objective To explore the trend of changes of Th1 and Th2 cytokines within 6 months after adult liver transplantation (LT). Methods Twenty-three patients from Tianjin First Center Hospital were chosen as the patient group with an average age of (52.7±7.6), range from 37 to 63 years old, including 21 males and 2 females. Twenty healthy staffs from Tianjin First Center Hospital formed the control group (C) with 15 males and 2 females whose average age was (31.0 ± 6.1) ranged from 22 to 24 years old. The patient group was treated with tacrolimus after LT as main immunosuppressive drug. The peripheral blood at time points before (T0) and 1 month (T1), 3 months (T3), 6 months (T6) after LT at 9:00 AM were collected. The blood sample was also collected form control group but only one time. Levels of IL-2, IFN-γ, IL-10 and TGF- β were detected by ELISA. Results (1) The concentration of IL-2 showed a continuous up-going trend, which was not such obvious between T1 and T0, and until T3 reached a higher concentration than T0. The concentration at T6 was higher than T0 and T1. There were no significant differences in concentrations of T0 to T3 between patient group and control group, while T6 reached a higher concentration in patient group than that of the control group. (2) The concentration of IFN- γ experienced a shortly down-going trend from T0 to T3, and started rising, reached the peak at 3 months after the operation, then started its down-going trend. There were no significant differences in the concentrations of IFN-γ from T1 to T6, and T3 reached a higher concentration than T1 while T6 was lower than T3. Only at T3, the concentration of IFN-γ was higher in patient group than that of control group. (3) There were no significant differences in the concentrations of IL-10 at various time points in patient group, and there were no significant differences in the concentrations of IL-10 at different time points between two groups (P＞0.05). (4) The concentration of TGF-β showed a gradual decline after the operation, and reached its bottom at T6, and which was lower than T0 to T3. Compared with the control group, the down- going trend was not such obviously at T0 and T1, and the concentration was down at T3 and T6（P＜0.05） . Conclusion Our results suggest that there is a tendency of an increasing Th1 cytokine expression at early stage in post-transplantation, while the TGF-β of Th2 cytokine is a decreasing trend. This tendency may associate with the autoimmunity response caused by LT and the immunosuppressive drugs.

Key words: liver transplantation, cytokines, Th1 cells, Th2 cells, interleukin-2, interleukin-10, transforming growth factor beta, interferon type Ⅱ