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目的 探讨混合淋巴细胞培养 (MLC)中细胞因子水平与急性排斥反应的关系。方法随机选取 2 4例接受同种异体肾移植术的患者为检测对象。在其接受手术当日 ,分离其外周血单个核细胞 (PBMC)与供者单个核细胞进行混合白细胞培养 (反应组 ) ,同时以单纯自身PBMC进行培养 (对照组 )。在培养第 1、3、5d测MLC上清中IL 2、IL 6和TNF α水平 ,并观察其分泌动态变化。结果 发生急性排斥反应的患者 ,在 3次时间点上 ,细胞因子水平均高于肾功能良好组 ,差异达到显著水平。反应组较对照组细胞因子水平有增加 ,急排的病人增加量高于肾功能良好的受者 ,差异达到显著水平。排斥组与肾功能良好组 3种细胞因子的分泌规律基本一致 ,但峰值都有增高。结论 检测MLC中细胞因子水平可以作为合理选择供受者、预测急性排斥的方法。并启发利用抗细胞因子抗体逆转急性排斥反应。
Objective To investigate the relationship between cytokine levels and acute rejection in mixed lymphocyte culture (MLC). Methods Twenty-four patients undergoing allogeneic kidney transplantation were randomly selected as the test subjects. On the day of their surgery, peripheral blood mononuclear cells (PBMCs) and donor mononuclear cells (PBMCs) were isolated and cultured in mixed leukocytes (reaction group), while cultured in PBMC alone (control group). The levels of IL-2, IL-6 and TNF-alpha in MLC supernatants were detected on the 1st, 3rd, 5th day after culture, and their secretion dynamic changes were observed. Results In patients with acute rejection, the levels of cytokines were higher than those in the renal function group at 3 time points, and the difference reached significant level. Response group than the control group cytokine levels increased, patients with acute discharge increased higher than those with good renal function, the difference was significant. Exclusion group and good renal function of the three kinds of cytokines secreted law is basically the same, but the peak has increased. Conclusions The detection of cytokines in MLC can be used as a reasonable choice of donor and prognosticator of acute rejection. And inspired the use of anti-cytokine antibodies to reverse acute rejection.