上海交通大学学报（医学版）

›› 2011, Vol. 31 ›› Issue (7): 971-.doi: 10.3969/j.issn.1674-8115.2011.07.022

• 论著（临床研究） • 上一篇    下一篇

CD4+T细胞内ATP含量检测在肾移植受者免疫状态监测中的应用价值

李春景, 周佩军, 徐 达, 王祥慧, 邵 琨   

  1. 上海交通大学 医学院附属瑞金医院泌尿外科, 上海 200025
  • 出版日期:2011-07-28 发布日期:2011-07-27
  • 通讯作者: 周佩军, 电子信箱: peijunzhou@yahoo.com.cn。
  • 作者简介:李春景（1983—）, 男, 硕士生；电子信箱: lichunjing.2007@yahoo.com.cn。
  • 基金资助:

    上海市科委生物医药重点项目（09411952600）

Detection of mass concentrations of ATP in CD4+T cells for immunity monitoring in renal transplant recipients

LI Chun-jing, ZHOU Pei-jun, XU Da, WANG Xiang-hui, SHAO Kun   

  1. Department of Urology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
  • Online:2011-07-28 Published:2011-07-27
  • Supported by:

    Shanghai Science and Technology Committee Foundation, 09411952600

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摘要：

目的 探讨CD4+ T细胞内三磷腺苷（ATP）含量检测对肾移植受者细胞免疫功能状态的评估价值。方法 70例肾移植受者根据临床状态分为感染组（感染受者，n=20）和对照组（非感染受者，n=50），两组均采用以钙调蛋白磷酸酶抑制剂(CNI)环孢素或他克莫司为基础的三联免疫抑制方案治疗。采集受者外周血样本，采用ImmuKnow技术检测外周血CD4+T细胞内ATP含量；流式细胞仪检测外周血T淋巴细胞亚群CD3+、CD4+、CD8+T细胞百分比和CD4+T细胞与CD8+/T细胞比值（CD4+/CD8+）；均相酶免疫分析法测定环孢素和他克莫司的血药浓度。分析外周血CD4+T细胞内ATP含量与其他指标的相关性。结果 与对照组比较，感染组外周血CD4+T细胞内ATP的质量浓度明显降低（P<0.05），外周血CD3+和CD8+T细胞百分比则显著升高（P<0.05）；两组外周血中CD4+T细胞百分比、CD4+/CD8+及环孢素和他克莫司血药浓度比较差异均无统计学意义(P>0.05)。相关性分析结果显示：外周血CD4+ T细胞内ATP含量与外周血CD8+T细胞百分比呈显著负相关（r=-0.299, P=0.041），与CD4+/CD8+呈显著正相关（r=0.324, P=0.026）。结论 与外周血T细胞亚群和CNI血药浓度测定相比，CD4+T细胞内ATP含量检测能更准确地反映感染的肾移植受者的免疫状态，可为免疫抑制剂的调整提供依据。

关键词: 肾移植受者, 感染, CD4+ T细胞, 三磷腺苷, 免疫监测

Abstract:

Objective To investigate the value of detection of mass concentrations of adenosine triphosphate (ATP) in CD4+ T cells in immunity monitoring of renal transplant recipients. Methods Seventy renal transplant recipients were divided into infection group (with infection, n=20) and control group (without infection, n=50) according to the clinical status, and both groups received immunosuppressive therapy based on calcineurin inhibitors of ciclosporin and tacrolimus. Peripheral blood samples were collected from renal transplant recipients. The mass concentrations of ATP in CD4+ T cells in peripheral blood were detected by ImmuKnow method, the percentages of T lymphocyte subset of CD3+ T cells, CD4+ T cells and CD8+ T cells and ratio of CD4+ T cells to CD8+ T cells (CD4+/CD8+) in peripheral blood were determined by flow cytometry, and the plasma mass concentrations of ciclosporin and tacrolimus were measured by homogeneous immunoassay. The correlations of mass concentrations of ATP in CD4+ T cells in peripheral blood with the other parameters were analysed. Results The mass concentration of ATP in CD4+ T cells in peripheral blood in infection group was significantly lower than that in control group (P<0.05), and the percentages of CD3+ T cells and CD8+ T cells in infection group were significantly higher than those in control group (P<0.05). There was no significant difference in percentage of CD4+ T cells and CD4+/CD8+ in peripheral blood, and plasma concentrations of ciclosporin and tacrolimus between two groups (P>0.05). Correlation analysis revealed that the mass concentration of ATP in CD4+ T cells in peripheral blood was significantly negatively related to the percentage of CD8+ T cells in peripheral blood (r=－0.299, P=0.041), and was significantly positively related to CD4+/CD8+ (r=0.324, P=0.026). Conclusion Compared with detection of T lymphocyte subset in peripheral blood and plasma concentrations of CNI, detection of mass concentration of ATP in CD4+ T cells in peripheral blood is more accurate in immunity monitoring of renal transplant recipients, and can serve as guidance for adjustment of immunosuppressants.

Key words: renal transplant recipient, infection, CD4+ T cells, adenosine triphosphate, immunity monitoring