| Objective: To observe the dynamics of Th1 (IFN-γ,IL-12) /Th2 (IL-4,IL-10) cytokines and T subsets (CD3+, CD4+, CD8+, CD4+/CD8+, CD69+) after early renal transplantation, and to explore their clinical application and distribution in vivo. Methods: It was a prospective cohort study, the dynamic trends of T subsets (CD3+, CD4+, CD8+, CD4+/CD8+, CD69+),Th1 (IFN-γ,IL-12) and Th2 (IL-4,IL-10) were detected in three groups, non-rejection group, acute rejection group,severe pulmonary infection group (as infection group) . Flow cytometer and ELISA (Enzyme-linked immunosorbent assay) were used to check out the expression of serum cytokines and T subsets in four time-points, including day 0, 3, 7, 14 of renal post-transplantation. Repeated to check these index, in day 28 after transplantation when acute rejection happened, or in day 2 after admission when severe pulmonary infection happened. Results: From July 2006 to January 2009, there were 32 complete cases, non-rejection group was 16, acute rejection group was 11, infection group was 5.The postoperative non-rejection group was kept stably, in Th1 (IFN-r, IL-12), Th2 (IL-4, IL-10) and T subsets (CD4+/CD8+, CD69+) , during 14 days after operation.In preoperative rejection group, IFN-γ(65.89±4.51) and IL-12 (498.57±46.19) were more than them in preoperative non-rejection group (35.58±1.37vs454.76±19.34) , the two groups got significant differences (P<0.05);IL-4 (28.87±3.34) and IL-10 (16.32±23.21) were lower than them in non-rejection group (35.32±7.87 vs 35.32±10.22), the two groups got significant differences (P<0.05);The average time when acute rejection happened in this group was day 19±14.1. After transplantation in rejection group, IFN-r and IL-12 got obviously advanced, reached the peak value (72.21±5.93vs543.12±46.23) before acute rejection, then turned down;IL-4 and IL-10 got gradually advance before acute rejection, their peak values were still lower than them in non-rejection group.In preoperative infection group, IFN-γ(43.43±2.87) and IL-12 (467.22±43.32) were more than them in non-rejection group (35.58±1.37 vs 65.89±4.51), lower than them in rejection group (454.76±19.34 vs 498.57±46.19), IL-4 (58.34±9.12) and IL-10 (76.23±15.4) were obviously more than them both in non-rejection group and rejection group, the statistical differences were significant (P<0.05).The average time when infection happened in this group was day 67.2±25.4, IFN-γand IL-12 got peak values (57.81±3.22 vs 527.28±43.53)when infection happened, lower than them in rejection group;IL-4 and IL-10 (72.50±7.43 vs 92.35±18.76) were obviously more than them both in rejection group and non-rejection group, the statistical differences were significant (P<0.05).Before operation, CD4+/CD8+ was shown up high-expression (2.47±0.32) in rejection group, and was shown up low-expression (0.43±0.21) in infection group.CD4+/CD8+ got peak value (2.65±0.41) when acute rejection happened, then turned down after inversion;CD4+/CD8+ got advance when infection happened, the peak value still lower than it in rejection group, the two groups got significant differences (P<0.05). CD69+ both in rejection group and infection group (13.57±3.28 vs 9.43±3.21), were more than it in non-rejection group (3.10±1.02) before transplantation. When rejection or infection happened, CD69+ got advance (19.34±3.12 vs 12.54±3.65) each. Conclusion: Single cytokine or T subset couldn't reflect then immune status in vivo after early renal transplantation, Th1 (IFN-γ,IL-12), Th2 (IL-4, IL-10) and T subsets (CD4+/CD8+) can represent it。It prompts that: In rejection group, Th1 (IFN-γ, IL-12) and CD4+/CD8+ are shown up high-expression before transplantation, then get peak values before rejection;In infection group, Th2 (IL-4, IL-10) are shown up high-expression, CD4+/CD8+ is shown up low-expression, Th2 (IL-4, IL-10) get peak values when infection happens; Th1/Th2 cytokines keep stable state in non-rejection group;Both rejection and infection can make CD69+ to advance. |
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