摘要
目的探讨HLA_G的表达水平与肾移植术后急性排斥反应（AR）和巨细胞病毒（CMV）活动性感染的相关性。方法根据术后是否发生AR或CMV活动性感染，将132例初次肾移植受者分为肾功能稳定组、AR组和CMV组。另选择41例健康供者作为对照组。采用流式细胞术、酶联免疫吸附试验、蛋白质印迹法以及实时定量聚合酶链法检测各组HLA_G及其mRNA的表达，并采用免疫组织化学法观察移植肾组织中HLA-G的表达。结果肾移植前后各组膜结合型HLA_G1（mHLA-G1）的表达均处于较低水平，仅术后CMV组mHLA-G1’的中性粒细胞出现显著升高（P〈O．05）。术前可溶性HLA—G5（sHLA—GS）的表达水平肾功能稳定组显著高于对照组（P〈0．05）；术后sHLA-G5的表达水平CMV组显著高于肾功能稳定组（P〈0．05），而肾功能稳定组均高于对照组和AR组（P〈0．05），AR组与对照组的差异无统计学意义（P〉0．05）。术后CMV组sHLA-G5mRNA的表达水平最高（P〈0．05），肾功能稳定组次之，对照组和AR组均较低。21例AR组移植肾组织活检样本中，17例HLA-G表达呈阴性，3例呈阳性，1例呈弱阳性；9例CMV组移植肾组织活检样本的HLA-G表达均为阳性。132例受者中，28例CMV感染者的AR发生率为7．1％（2／28），104例非CMV感染者的AR发生率为25．0％（26／104），二者间AR发生率的差异有统计学意义（P〈O．05）。结论sHLA-G5可作为预测AR和CMV感染的生物标志分子；CMV感染和AR与受者体内的免疫平衡状况相关。
Objective To study the correlation of HLA-G levels with acute rejection and CMV active infection post-kidney transplantation. Methods A total of 132 initial kidney transplantation recipients were divided into kidney function stable group （F）, acute rejection group （AR）, CMV group according to whether they had active CMV infection and acute rejection. Forty-one healthy donors served as control group （H）. HLA-G levels and mRNA expression were analyzed by using flow cytometry, ELISA, RT-PCR and Western blotting. Immunohistochemical staining was used to detect the HLA-G expression in kidney biopsies. Results The expression levels of mHLA-G1 were low in all 4 groups pre-transplantation. Only CMV group had significantly more CD14~ mHLA-G1 ＋cells post-transplantation （P〈0. 05）. sHLA-G5 levels were higher in F group than in H group （P〈0. 05）, but there was no significant difference among other groups pre-transplantation （P〉0. 05）. sHLA-G5 levels were increased significantly in CMV group as compared with F group （P〈0. 05）, and those in F group were higher than in H and AR groups （P〈0. 05）. Renal tissue biopsies from 21 renal transplantation recipients with AR indicated that HLA-G5 was expressed negatively in 17 patients, positively in 3 patients and 1 weakly positively. HLA-G was positive in the kidney tissue of9 patients out of 9 patients with active CMV infection. In total 132 recipients, AR incidence was significantly lower in CMV （ ＋ ） group （7. 1%, 2/28） than that in CMV （ - ） group （24. 0 %, 25/ 104-）. Conclusion The sHLA-G5 may contribute to predict AR and CMV active infection; AR and CMV active infection may be correlation with immune balance in kidney transplantation recipients.
出处
《中华器官移植杂志》
CAS
CSCD
北大核心
2011年第10期584-587,共4页
Chinese Journal of Organ Transplantation
基金
基金项目：军队“十一五”计划第二批科技攻关课题（部门计划,08G133）
