上海交通大学学报（医学版）

›› 2013, Vol. 33 ›› Issue (3): 290-.doi: 10.3969/j.issn.1674-8115.2013.03.007

• 论著（临床研究） • 上一篇    下一篇

终末期肾病维持性血透患者树突状细胞分化成熟能力的研究

吴俊逸, 张 薇   

  1. 上海交通大学 医学院附属第九人民医院肾脏内科, 上海 200011
  • 出版日期:2013-03-28 发布日期:2013-03-29
  • 通讯作者: 张 薇, 电子信箱: dongzhang.1087@yahoo.com.cn。
  • 作者简介:吴俊逸（1984—）, 男, 住院医师, 学士； 电子信箱: jackwuprivate@hotmail.com。
  • 基金资助:

    上海市科委科研计划项目（10411964300）

Differentiation and maturation of dendritic cells in patients with end-stage renal disease undergoing maintenance hemodialysis

WU Jun-yi, ZHANG Wei   

  1. Department of Nephrology, the Ninth People´s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200011, China
  • Online:2013-03-28 Published:2013-03-29
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 10411964300

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摘要：

目的 研究终末期肾病（ESRD）患者外周血中树突状细胞（DC）分化成熟能力的变化，探讨ESRD患者免疫功能低下的可能机制。方法 采集接受维持性血液透析治疗的ESRD患者（ESRD组，n=20）外周血，利用粒-巨噬细胞集落刺激因子(GM-CSF)、白介素4 (IL-4)和脂多糖（LPS）联合培养体系体外诱导培养DC，经流式细胞仪检测DC表面分子CD40、CD80、CD86、CD83、CCR7和HLA-DR的表达，采用酶联免疫吸附法（ELASA）测定DC细胞培养上清液中细胞因子IL-12的含量。设立正常对照组（n=20）。结果 与正常对照组比较，ESRD组DC表面分子CD40、CD80、CD86、CD83、CCR7和HLA-DR的表达率显著降低，组间比较差异均有统计学意义（P<0.05和P<0.01）；同时，ESRD组DC培养上清液中IL-12的含量显著高于正常对照组（P<0.01）。结论 ESRD患者外周血单核细胞源性的DC发育不成熟，其趋化迁移功能以及外源性抗原递呈能力下降，免疫激活能力降低，可能导致T细胞功能缺陷，从而最终诱导机体特异性的免疫耐受。

关键词: 终末期肾病, 维持性血液透析, 树突状细胞, 表面分子, 细胞因子

Abstract:

Objective To investigate the changes of capacity of differentiation and maturation of dendritic cells (DC) in peripheral blood in patients with end-stage renal disease (ESRD) undergoing maintenance hemodialysis, and explore the possible mechanism of impaired immune responses of patients with ESRD. Methods The peripheral blood samples of patients with ESRD undergoing maintenance hemodialysis (ESRD group, n=20) were collected, and in vitro culture with granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin-4 (IL-4) and lipopolysaccharide (LPS) was conducted. The expression of CD40, CD80, CD86, CD83, CCR7 and HLA-DR on the surface of DC was detected by flow cytometry, and the level of interleukin-12 (IL-12) in the culture supernatant of DC was determined by enzyme-linked immunosorbent assay (ELISA). Besides, normal control group was established (n=20). Results The expression of CD40, CD80, CD86, CD83, CCR7 and HLA-DR on the surface of DC in ESRD group was significantly lower than that in normal control group (P<0.05, P<0.01). The level of IL-12 in the culture supernatant of DC in ESRD group was significantly higher than that in normal control group (P<0.01). Conclusion Peripheral blood monocyte-derived DC of patients with ESRD are immature, with the decrease in chemotactic function, migration ability and exogenous antigen-presenting capacity. The reduction of immune activation capacity of DC is likely to further participate in the immune dysfunction of T cells, and ultimately induces specific immune tolerance.

Key words: end-stage renal disease, maintenance hemodialysis, dendritic cells, surface molecules, cytokines