The Application Of Detection Of SCD30 And Th1/Th2 To Evaluate Immune Status Of Patients With Chronic Renal Allograft Dysfunction

Objection: Chronic renal allograft dysfunction( CRAD )is a prelude to the majority of graft failures. The risk factor that can lead to CRAD could be divided into immune injury and nonimmune injury. At present, there is deficiency of effective harmless method to monitor immune status of CRAD patients. The aim of this study is to discuss the implemented value of detection of sCD30 in serum and Th1/Th2 of CD3~+CD8~- T lymphocytes cells in peripheral blood for evaluating immune status of CRAD patients by cross-check analysing the level of sCD30 in serum and the ratio of Th1/Th2 of CD3~+CD8~- T lymphocytes cells in peripheral blood of 3 groups patients in late post-transplantation period.Methods: Through analyzing clinical data and combining core-needle biopsy of allograft, 15 patients with CRAD which mainly caused by immune injury (group A); 15 patients with CRAD which mainly caused by non-immune injury (group B); and 15 patients with normal allograft function (group C) in late post-transplantation period (> 6 month) were selected. The percentage of IFN-γand IL-4 of CD3~+CD8~- T lymphocytes cells in peripheral blood of all patients in 3 groups were measured by FCM. The ratio of IFN-γ/IL-4 was considered as the ratio of Th1/Th2. Meanwhile, the samples of serum of all patients were collected. The level of sCD30 in serum of all patients were measured later by ELISA.Results: There was no difference of the percentage of IFN-γof CD3~+CD8~- T lymphocytes cells in peripheral blood of the patients in 3 groups (P > 0.05). The percentage of IL-4 of CD3~+CD8~- T lymphocytes cells in peripheral blood of the patients in the A group was significantly lower than that in the other two groups(P < 0.01). And the ratio of Th1/Th2 of CD3~+CD8~- T lymphocytes cells in peripheral blood of the patients in the A group was significantly higher than that in the other two groups(P < 0.01). While the percentage of IL-4 and the ratio of Th1/Th2 of CD3~+CD8~- T lymphocytes cells in peripheral blood was no difference between the B group and C group (P > 0.05). The level of sCD30 in serum of the patients in the A group was significantly higher than that in the other two groups(P < 0.01). But there was no difference of the level of sCD30 in serum of the patients between the B group and C group(P > 0.05). ROC curve analysis indicated that when the ratio of Th1/Th2 is at the cut-off value of 1.95, the sensitivity and specificity to identify CRAD which mainly caused by immune injury was 80% and 90% respectively; when the level of sCD30 in serum is at the cut-off value of 10ng/ml, the sensitivity and specificity to identify CRAD which mainly caused by immune injury was 93.3% and 86.7% respectively.Conclusion: Disequilibrium of Th1/Th2 (drift to Th1) and raise of level of sCD30 in serum happened in most of patients with CRAD which mainly caused by immune injury. Disequilibrium of Th1/Th2 (drift to Th1) might be one of pathogenesis of CRAD which mainly caused by immune injury. And the high level of sCD30 in serum indicated the active immune state of body. It was with high sensitivity and specificity to identify CRAD which mainly caused by immune injury based on the ratio of Th1/Th2 of CD3~+CD8~- T lymphocytes cells in peripheral blood and the level of sCD30 in serum. Therefore, they could be used to evaluate the immune status of patients of renal transplantation, identify the etiological factor of CRAD roughly, and instruct us how to adjust immunosuppressive agent.