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背景:细胞毒性T淋巴细胞相关抗原4是新近发现的共刺激分子,在肿瘤及自身免疫性疾病中研究较多,在肾移植领域缺少研究。目的:探讨细胞毒性T淋巴细胞相关抗原4在肾移植排斥反应中的作用。方法:纳入肾移植患者50例,根据移植后肾功能分为2组,急性排斥组20例,移植肾功能稳定组30例。同时选择30例健康查体者作为健康对照组。分别抽取外周静脉血,采用ELISA法及流式细胞术检测观察对象血清及外周血淋巴细胞中的细胞毒性T淋巴细胞相关抗原4水平。结果与结论:细胞毒性T淋巴细胞相关抗原4在肾移植后急性排斥组、肾功能稳定组及健康对照组血清中的表达水平差异有显著性意义(F=70.008 1,P=0.000 0)。肾功能稳定组显著低于健康对照组(P=0.000 0),急性排斥组显著低于健康对照组(P=0.000 0),急性排斥组显著低于肾功能稳定组(P=0.000 0)。细胞毒性T淋巴细胞相关抗原4在肾移植后急性排斥组、肾功能稳定组及健康对照组淋巴细胞中的表达水平差异无显著性意义(F=1.865 6,P=0.161 7)。提示细胞毒性T淋巴细胞相关抗原4在肾移植患者发生排斥反应时血清中表达减低,具有一定的相关性,可能参与了排斥反应的发生。
BACKGROUND: Cytotoxic T-lymphocyte-associated antigen 4 is a recently discovered costimulatory molecule that has been studied more frequently in oncology and autoimmune diseases and has been lacking in the field of kidney transplantation. Objective: To investigate the role of cytotoxic T lymphocyte-associated antigen 4 in renal allograft rejection. Methods: Fifty cases of renal allograft were enrolled in this study. They were divided into two groups according to renal function after transplantation, 20 cases with acute rejection group and 30 cases with stable graft function. At the same time, 30 healthy people were selected as healthy control group. Peripheral venous blood was drawn respectively, and the levels of cytotoxic T lymphocyte-associated antigen 4 in serum and peripheral blood lymphocytes were detected by ELISA and flow cytometry. RESULTS AND CONCLUSION: The expression level of cytotoxic T lymphocyte associated antigen 4 in acute rejection group, stable renal function group and healthy control group after renal transplantation was significantly different (F = 70.008 1, P = 0.000 0). The stable renal function group was significantly lower than that of the healthy control group (P = 0.000 0), the acute rejection group was significantly lower than the healthy control group (P = 0.000 0), and the acute rejection group was significantly lower than the stable renal function group (P = 0.000 0). There was no significant difference in the expression level of cytotoxic T lymphocyte-associated antigen 4 in acute rejection group, stable renal function group and healthy control group (F = 1.865 6, P = 0.1617). It is suggested that the expression of cytotoxic T lymphocyte-associated antigen 4 in serum after rejection in renal transplant recipients has a certain correlation, which may be involved in the rejection.