Study On Changes Of T Lymphocyte Subpopulations And Application Of Simulect In The Kidney Transplantation Patients

Objective:Acute rejection is a risk factor for graft survival in kidney transplanted recipeints, activated T cells mediated immune response plays a crucial role in the acute rejection, but CD4+CD25high regulatory T cells (CD4+CD25high Treg) regulate negatively activation and proliferation of T effector cells, which was few reported in kidney transplantation. Therefore, the present study is to investigate the changes of T lymphocyte subpopulations and CD4+CD25high Treg and effect of Basiliximab, which may provide basis for diagnose, monitoring of acute rejection in kidney transplantation.Methods:89 kidney transplantation recipients were divided into kidney function group (n=56) and acute rejection group (n=33),30 health volunteers were as control group. Another 65 kidney transplantation recipients were divided into Basiliximab treatment group (n=33) and control group (n=32). The changes of T lymphocyte subsets, CD4+CD25+ Treg and forkhead box protein P3 (FoxP3) and cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) expression were detected by flow cytometry, the changes of serum IL-2, soluble interleukin-2 receptor (sIL-2R) and IL-10 concentration were detected by enzyme linked immunosorbent assay, acute rejection, adverse effect, serum creatinine and urea nitrogen concentration were observed within two monthes after Basiliximab application in kidney transplantation recipients.Results:(1) Compared with normal control group and kidney function group, there was significant increase in ratio of CD3+ CD4+, CD4+ CD25+ T cells, and decrease in ratio of CD3+CD8+T cells, and also decrease in ratio of CD4+CD25high Treg, CD4+ CD25high FoxP3+ Treg and CD4+CD25high CTLA-4+Treg in the acute rejection group. (2) Compared with normal control group and kidney function group, sIL-2 and sIL-2R concentration all were heightened obviously in the acute rejection group, serum IL-10 concentration in the acute rejection group were higher than that of nomal control group,but were lower than that of kidney function group. (3) Compared with control group, there was a significant decrease in the incidence of acute rejection and adverse effect, serum creatinine, urea nitrogen, IL-2 and sIL-2R concentration were also lowered in 1d～28d, 1d～42d, 1d～28d and 1d～56d after operation in the Basiliximab treatment group respectively. (4) Compared with control group, ratio of CD4+CD25+T cells was lowered obviously in 1d-42d, ratio of CD4+ CD25high Treg, CD4+CD25high FoxP3+Treg and CD4+CD25high CTLA-4+Treg were all lowered in 1d～7d posttransplantaion in the Basiliximab treatment group.Conclusion:(1) Increase of CD4+T cells, sIL-2 and sIL-2R concentration, decrease of CD4+CD25highTreg and IL-10 production may play an important role in acute rejection of kidney transplantation. (2) Simulect may decrease incidence of acute rejection through reduction of CD4+CD25+T cells, decrease of sIL-2 and sIL-2R concentration, transitent effect of activation and proliferation of CD4+CD25high Treg. (3) Detection of peripheral T lymphocyte subsets and serum immunological markers has important diagnostic value on monitoring of acute rejection, Basiliximab is an safe and effective immunosuppressant.