| Objective: To study the CD4+CD25+Foxp3+regulatory T lymphocytes (Treg) changes in the peripheral blood of pediatric liver transplantation patients.Methods: During January2012to March2013collected48pediatric liver transplantation surgery patients and follow-up patients in Tianjin First Central Hospital Organ Transplant Center our single liver transplant group, as well as collected20healthy children cases from Tianjin First Central Hospital out-patient, all of them were get peripheral blood samples. The study samples were divided into healthy controls, continuous observation after liver transplantation (within6months after liver transplantation operation), stable group after liver transplantation (liver transplant recipients survived12months or more)3groups, ages, sex, height, weight and so on of each group were in proper proportion. Observed the peripheral blood leucocyte cells count (x109/L), absolute neutrophil count (x109/L), lymphocyte count(xl09/L) changes before and after transplant surgery; observed the proportion of CD4+T cells in lymphocytes (CD4+T/T,%) of pediatric liver transplant patients in the early postoperative (within6months after surgery), and the variation trend of the proportion of CD4+CD25+Foxp3+Treg cells in CD4+T cells (Treg/CD4+T,%) at different time points after surgery (1month,3months,6months after surgery); and compare the relationship between immunosuppressant tacrolimus (FK506) trough concentration and the ratio of CD4+T/T, Treg/CD4+T in pediatric patients.Results:(1) by comparing liver transplantation group and the healthy control group in the peripheral blood leukocytes, neutrophils, lymphocytes and other testing indicators, it showed that after liver transplantation in pediatric patients white blood cells, neutrophils and lymphocytes decrease compared with the control group, but there was no significant difference (P>0.05);(2) the ratio of CD4+T/T in the time point of1month,3month,6month after surgery in patients that in continuous observation after liver transplantation group were showed no significant difference (P>0.05), and compare6months after surgery in continuous observation group with stable group (12month after surgery) showed no significant difference (P>0.05); the ratio of Treg/CD4+T in the time point of1month and3month after surgery in continuous observation group showed no significant difference (P>0.05), but3months after surgery vs.6months in continuous observation group,6months after surgery in continuous observation group vs. stable group postoperative (12month after surgery) were showed significant difference (P<0.05);(3) according to the FK506trough concentrations, divided the liver transplant pediatric patients who in steady state into low concentrations group (FK506trough concentrations<7.0ng/mL) and high concentrations group (FK506trough concentrations=7.0ng/mL). The mean concentration of low concentrations group was3.48±1.83ng/mL, and in the high concentration group, the average concentration was8.64±0.72ng/mL. By analyzed the relationship between CD4+T/T, Treg/CD4+T and the concentration of FK506, conducted the linear correlation analysis between Treg/CD4+T, CD4+T/T ratio and the different FK506trough concentrations showed that according to different trough concentrations of FK506, CD4+T/T in low concentration and high concentration group had no significant difference (P=0.787), but Treg/CD4+T had significant difference (P=0.003), and in high concentrations group Treg/CD4+T, CD4+T/T ratio were both lower than the low dose group (P<0.05), there was no linear correlation between the concentration of FK506trough Treg/CD4+T, its associated coefficient r=0.260, P=0.209, there was also no linear correlation between the FK506trough concentration and CD4+T/T, the correlation coefficient r=0.109, P=-0.604.Conclusions:(1) In the early stage of children liver transplant recipients after surgery(within3months), due to the effection of varietious immunosuppressive drugs, proportion of Treg cells in the CD4+T cells of recipients’peripheral blood did not change significantly, with the gradual withdrawal of steroids, FK506as single immunosuppressive drug effect gradually Treg/CD4+T, and it showed a gradual downward trend, we believed that with prolonged postoperative time, the ratio of Treg/CD4+T magbe stay steady.(2) Steady state liver transplantation pediatric recipients’peripheral blood Treg/CD4+T related with FK506tough concentration. Low levels Treg/CD4+T ratio higher, while high concentration was on the contrary... |
PDF Full Text Request