The Dynamic Change Of Peripheral Treg Cell And Th17 Cell In RTRs

Objective To investigate the dynamic changes of CD4+CD25+Foxp3+ regulatory T cell(Treg cell)and T helper cell 17(Th17 cell)as well as T lymphocyte subsets in peripheral blood of renal transplant recipients(RTRs).Methods The prospective study method was used to select the recipients with kidney transplantation in transplant center from April 2016 to September 2016.Flow cytometric frequencies of circulatory Treg cells and Th17 cells as well as CD4+ T and CD8+ T cells were measured before transplantation and 1,2,3 weeks and 1,2,3,4,5,6 months after transplantation.The above indexes were repeatedly detected when occurred PCP,and the clinical data were collected.At the same time,healthy subjects,who matched the gender and age with patients,were selected as the control.Software Flowjo7.6 was used for flow cytometric analysis,SPSS17.0 for statistical analysis and Graphpad6.0 for graphics drawing.One-way ANOVA and Student-Newman-Keuls test were used for the normal distribution data.Rank sum test was used to compare non-normal data.The statistical results were expressed as “Mean±standard error(x-±SE)”,and “P<0.05” indicated a statistically significant difference.Results A total of 65 patients were followed up.1,The mean proportion of peripheral Treg cells decreased 2 weeks after transplantation in RTRs.The lowest-proportion of Treg occurred in 2m post-transplantation,which decreased by 69.1% compared with pre-transplantation status.Proportion of Treg cells gradually gained back to baseline at 6m post-transplantation.The percentage of Th17 cells within 3 weeks post-transplantation was significantly higher than that of the control and baseline,and dropped to a lower value at 6m when compared with control.The ratio of Th17 / Treg was significantly higher than that of the control group during the period from 1w to 3m(P <0.05),and dropped to a lower value at 6m when compared with control.2,The percentage of lymphocytes dropped to the lowest in 1week after transplantation,which decreased by 21.9%-39.2% of baseline,and rapidly rose back at 3w.The same trend of change can be seen in proportion of CD3+T cells.3,The proportion of CD4+T lymphocytes in RTRs at different phase did not change acutely,so did CD8+ T cells.But the opposite change trend could be found between them.The proportion of neither CD4+ T nor CD8+ T cells fluctuated significantly,but the opposite trend of change could be found between them.The ratio of CD4+/CD8+ T cells fluctuated between 1.90 and 2.56 with no significant differences at every phase.4,During the observation period,4 cases of PCP occurred,and the incidence density of PCP post-transplantation was 1.83%.5,Compared with baseline,the proportion of Treg was significantly lower in PCP,the former was(8.51±1.40)%,the latter was(3.02±0.99)%.Both the percentage of Th17 and the ratio of Th17 / Treg did not change significantly.6,The percentage of Treg in cyclosporine-a treatment RTRs demonstrated the lowest level(2.00±0.22)% at 2m,which decreased by 69.1% compared with 0d.However,the valley percentage of Treg(1.30 ± 0.23)% at 3w in tacrolimus-treated group was 79.2% lower than that of baseline.Conclusion 1,The influence of immunosuppressive agents on RTRs is decrease in the proportion of Treg and rise in the Th17 / Treg ratio.2,Both tacrolimus and cyclosporine inhibit the proliferation of Treg cells after renal transplantation.3,The proportion of Treg cells decreases significantly in PCP after renal transplantation.