| Objective：By studying the correlation between Th17/IL-17&IL-21and renal allograftrejection, we wanted to explore the pathogenesis of rejection to provide certaintheoretical basis for clinical diagnosis and treatment of rejection.Methods：1）In accordance with the inclusion criteria strictly，health physical examinationpersonnel (15caess) and kidney transplantation recipients (47caess) were choosed anddivided into four groups: normal group (15cases)，stable renal function group (20cases)，acute rejection group (15cases)，and chronic rejection (12cases). The relativeexpression levels of IL-17mRNA and IL-21mRNA of these four groups in peripheralblood mononuclear cell were detected by real time fluorescence quantitative polymerasechain reaction(RT-PCR). Then differences between four groups were compared and thecorrelations with the serum creatinine and the rejection time were analysised.2）In accordance with the inclusion criteria strictly，twelve renal allografts whichdivided into acute rejection group(6cases) and chronic rejection group(6cases),removed due to terminal rejection, were collected. Fresh normal renal tissue wasobtained from the intact portion of six kidneys removed for renal cancer. IL-17+cellsand IL-21+cells infiltration in renal graft were analysed by HE staining and immuno-histo chemical staining. Then differences between three groups were compared and thecorrelations with graft survival time and resistance index were compared.3） We established the mouse kidney transplantation model, in which theexperimental animals were randomly divided into syngeneic transplantation group andacute rejection group, each group had15pairs. Then intracellular IL-17of CD4+T cells,infiltrated in renal tissue, were detected by flow cytometry.Result： 1. RT-PCR results1.1The normal group was considered as the reference object.Compared with stablegroup, the expression level of IL-17mRNA in acute rejection group didn’t show asignificant difference; the expression level of IL-17mRNA in chronic rejection groupincreased by2.89times, showed a significant difference.1.2The normal group was considered as the reference object.Compared with stablegroup, the expression level of IL-17mRNA in acute rejection group increased by1.92times, in chronic rejection group increased by3.19times, they both showed asignificant difference.1.3In the acute rejection group, compared with serum creatinine throughcorrelation analysis,the correlation coefficient of IL-17mRNA and IL-21mRNA werer=-0.2937and-0.2303, p=0.288and0.409; compared with postoperative rejectiontime,the correlation coefficients were r=-0.2642and-0.1095, p=0.341and0.698; therewere both no significant differences. In the chronic rejection group, compared withserum creatinine through correlation analysis, the correlation coefficient of IL-17mRNAand IL-21mRNA were r=-0.0921and-0.3136, p=0.776and0.321; compared withpostoperative rejection time,the correlation coefficients were r=0.1625and0.4801,p=0.614and0.114; there had no significant differences.2. immunohistochemical staining results2.1The positive expression of IL-17was not found in normal renal tissues; inacute rejection group, the number of IL-17+cells which was expressed on renal allografttissure was (2-11)cells/mm2, the average number was (6.00±2.97) cells/mm2; in chronicrejection group, the number of IL-17+cells was(3-14) cells/mm2, the average numberwas (6.67±3.88) cells/mm2; there had significant differences in the three group.2.2The positive expression of IL-21was not found in normal renal tissues; inacute rejection group, the number of IL-21+cells which was expressed on renal allografttissure was (1-5) cells/mm2, the average number was (2.33±1.75) cells/mm2;in chronicrejection group, the number of IL-21+cells was(4-9) cells/mm2, the average number was(6.83±1.72) cells/mm2; there had significant differences in the three group. 2.3IL-17and IL-21were stained in inflammatory cells, not in renal parenchymacells.2.4In the acute rejection group, compared with graft survival time throughcorrelation analysis,the correlation coefficient of IL-17+cells and IL-21+cells werer=-0.1260and-0.4411, p=0.812and0.381; compared with resistance index throughcorrelation analysis,the correlation coefficient of IL-17+cells and IL-21+cells werer=0.4736and0.3880, P=0.343and0.447; there had no significant differences. In thechronic rejection group, compared with graft survival time through correlationanalysis,the correlation coefficient of IL-17+cells and IL-21+cells were r=0.1494and0.2031, p=0.778and0.700; compared with resistance index through correlationanalysis,the correlation coefficient of IL-17+cells and IL-21+cells were r=0.2042and0.2368, p=0.698and0.651; there had no significant differences.3The results of animal experimentsIn the isograft group, the percentages of Th17cells accounted for infiltrated Tlymphocytes were（0.27±0.08)%；in acute rejection group, the percentages of Th17cells were (1.49±0.37)%, there had significant differences.Conclusions：1. IL-21may be involved in the occurrence and development of rejection.2. IL-17have certain correlation with chronic rejection.3. IL-17and IL-21were stained in inflammatory cells, not in renal parenchymacells, suggesting that they were the product of inflammatory cells.4. The expression level of Th17cells in acute rejection group was higher than inisograft group, suggesting that Th17cells may be involved in the pathogenesis of acuterejection.5. In acute and chronic rejection, compared with serum creatinine, rejection time,graft survival time and resistance index through correlation analysis, IL-17and IL-21didn’t show obvious correlation. |
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