Evaluation Of The Immune Status Of Long-term Survival Recipients(＞20 Years) After Kidney Transplantation

Objective: To analyze the proportion of some immune cell subsets and the changes of some cytokines in serum of long-term（>20 years）and short-term（1-2 years）stable recipients of renal transplantation and the healthy population,and to comprehensively evaluate the immune status of long-term survival recipients after kidney transplantation.Methods: 28 long-term recipients after kidney transplantation were selected as the study subjects,15 recent renal transplant recipients with recent stable renal function and 15 healthy subjects as the control group.Peripheral blood T lymphocyte subsets（including CD3⁺T cells,CD4⁺T cells,CD8⁺T cells,CD4⁺CD25⁺CD127-T cells（Tregs））,B lymphocyte subsets(including CD19⁺B cells,CD19⁺CD24^hiCD38^hiB cells,CD19⁺CD24^hiCD27⁺B cells)and Myeloid-Derived Suppressor Cells（MDSCs）were detected by flow cytometry.The serum levels of IL-2、IL-4、IL-10、IL-17 A and IFN-γ were detected by Cytometric Bead Array（CBA）,and the serum levels of TGF-β1 were detected by Enzyme-linked Immunosorbent Assay（ELISA）.And the clinical data of renal function and anti-hla antibody were also analyzed.Results:Among immune cells,Treg/CD4⁺T cells,CD19⁺B cells and CD19⁺CD24^hiCD38^hiB cells in long-term and recent renal transplant recipients were lower than those in the healthy control group（P<0.05）,showing a statistically significant difference.Among the cytokines,the level of serum IFN-γ in the long-term survival patients was significantly ^higher than that in the postoperative stable renal transplantation group and the healthy control group（P<0.05）;Serum TGF-β1 level was significantly lower in the long-term survival group than in the short-term postoperative group and the healthy control group（P<0.05）,with statistical difference.In the long-term survival group,43% of the recipients were positive for urinary protein and 50% were positive for HLA antibody.Conclusion: In long-term survival recipients,the relevant indicators of immune response were increased,w^hile those related to immunosuppression were not significantly increased. Long-term survival recipients with stable renal function may be in an immune equilibrium state where immunosuppression and rejection coexist under the action of low-intensity immune agents.If immunosuppressive agents are reduced or even removed,rejection may occur.