Clinical Correlation Between Procalcitonin And Th22 And Th17 Cells After Renal Transplantation

Background:Though the use of immunosuppressive agents can prevent transplant rejection,it increases the risk of infection in transplant recipients,which could affect the long-term survival of the grafts and even threaten recipients’life.Therefore,early diagnosis and effective intervention of infection after renal transplantation are particularly important.Studies have shown that procalcitonin(PCT)has higher sensitivity and specificity than that of the traditional indicators in assessing infection status,and it has gradually been applied in the clinic after transplantation.Besides,we need consider comprehensively the immunomodulatory factors,which play important roles after renal transplantation,to meet the accurate requirements of anti-infection and anti-rejection.Previous reports have shown that helper T cells play a key role in the immune regulation after renal transplantation.In particular,Th17 and Th22 play important biological functions in both transplantation and infection immunity.Therefore,it is important to integrate PCT,immunomodulatory factors such as T helper cell subsets,and related cytokines in recipients after renal transplantation,to further explore the correlation of each index based on clinical samples.Until now,there is no report shown that the clinical correlation between PCT and T helper cell subsets.Objective:To study the clinical association between PCT and T helper cell subsets(including Th17 cells and Th22 cells)in peripheral blood of early renal transplant recipients.It will provide a clinical reference for the refined diagnosis and treatment of infections after transplantation.Methods:Clinical data and peripheral blood of kidney transplant recipients were collected.The frequencies of Th22,IL22~+Th17 and Th17 cells in peripheral blood of recipients were detected by flow cytometry.The levels of IL-22,IL-17A,IL-6 and TNF-αcytokines in plasma were detected by enzyme-linked immunosorbent assay(ELISA).The expressions of clinical conventional infection indexes,the distribution characteristics of T helper cell subsets,and relevant cytokines were analyzed between the PCT-high and PCT-low groups.Results:(1)The conventional infection indexes in the PCT-high group were significantly increased(P<0.05);and the evaluation of renal function status indexes were also significantly increased(P<0.05);(2)The frequencies of Th22 and IL22~+Th17cells in the PCT-high group were significant increased,while there was no significant difference in Th17 cells;(3)The expression of IL-22,TNF-α,and IL-17A in the PCT-high group(P<0.05)were increased significantly,while IL-6 not;(4)IL-22 expression were positively correlated with the Th22 cells in the PCT-high group,while TNF-αnot.What’s more,there was no significant association between IL22~+Th17 cells and IL-22expression.Conclusion:Th22 cells and IL-22 have significant clinical correlation with PCT level in recipients after renal transplantation.It indicated that integration of relevant indicators may be beneficial for the accurate evaluation of infection after renal transplantation,which may provide new ideas for further study of the immune regulation mechanism of T helper cell subsets in the infection after renal transplantation.