同种异体手移植术后细胞因子的动态观察

目的 探讨同种异体手移植患者术后血清细胞因子水平的变化和意义。方法 采用酶联免疫方法动态检测2例同种异体手移植患者血清中血清白细胞介素-2（IL-2）,白细胞介素-10（IL-10）,γ-干扰素（IFN-γ）,肿瘤坏死因子（TNF-α）水平。结果 IL-2、IFN-γ、TFN-α血清水平术后1周内降低。1周后恢复至术前水平,随后逐渐降低并维持在低水平,IL-10在术后1周内明显升高,随后逐渐降低并维持在低水平,5个月后又中度升高。结论 同种手移植术后细胞因子谱系由Th1向Th2的转换提示术后免疫抑制方案十分有效。同种异体手移植后患者无明显的排斥反应与临床观察相符,提示细胞因子的监测有助于同种异体手移植预后的判断和排斥反应的诊断。

Dynamic observation of serum cytokines in patients receiving hand transplantation

OBJECTIVE: To investigate the changes of serum levels of cytokines in patients receiving hand transplantation. METHODS: The serum levels of IL-2, IL-10, TNF-alpha, and IFN-gamma in 2 hand transplant recipients were measured by enzyme-linked immunosorbent assays (ELISA). RESULTS: The serum levels, IL-2, TNF-alpha, and IFN-gamma in the 2 patients decreased significantly during the first posttransplant week, then increased gradually to the pretransplant levels, and finally decreased and maintained the low level. The serum level of IL-10 in the patients increased significantly during the first posttransplant week, and decreased gradually to the low level. At 5 posttransplant months, the serum level of IL-10 increased moderately again. CONCLUSION: The predominance of Th2 over Th1 confirms the efficiency of immunosuppressive drug regimens, which contribute to the survival of hand transplant. Hand transplantation does not elicit significant immune rejection. The dynamic determination of cytokines helps judge the prognosis and diagnosis of rejection in hand transplantation.