Notch1受体表达水平在移植肾排斥反应诊断中的意义

目的 探讨肾移植受者外周血单个核细胞(PBMC)上Notch1受体表达水平与移植肾排斥反应之间的关系.方法 肾移植受者40例均采用环孢素A(或他克莫司)、吗替麦考酚酯和糖皮质激素预防排斥反应.根据移植肾穿刺活检结果(Banff'97标准)将受者分成3组,其中急性排斥反应组11例,钙调磷酸酶抑制剂(CNI)中毒组16例,肾功能稳定组13例,抽取血液样本;急性排斥反应组中有8例于排斥反应逆转后再次抽取血液样本;另取11名正常人的血液样本作为对照.常规提取样本中PBMC,用流式细胞仪间接荧光法检测Notch1的表达水平.结果 急性排斥反应组受者外周血PBMC上Notch1的荧光强度明显高于CNI中毒组、肾功能稳定组和正常对照组(P<0.05).CNI中毒组、肾功能稳定组和正常对照组荧光强度的差异无统计学意义(P>0.05).40例受者外周血PBMC上Notch1的荧光强度为2.60±2.37,血肌酐为(241.2±137.1)μmol/L,二者之间存在相关性(r=0.358,P<0.05).急性排斥反应组受者排斥反应逆转后的Notch1的荧光强度低于排斥反应期间,差异有统计学意义.结论 肾移植受者急性排斥反应期间外周血PBMC上Notch1受体表达水平增高.Notch1可做为监测肾移植受者免疫状态的指标,其表达水平与同期肌酐水平有相关性,可在一定程度上反映排斥反应对肾功能的损害程度.

A new candidate as predictor of acute renal allograft rejection: Notch receptor-1

Objective To determine the relationship between Notch receptor-1 (Notch1) and ongoing immune processes within the graft. Methods Flow cytometry (FCM) was performed to detect Notch1 expression in peripheral blood mononuclear cells ( PBMCs) of 40 recipients post-transplantatioa Results The Notch1 expression level was higher in PBMCs of patients with ongoing acute rejection episodes proven by histologically thanCNI toxicosis group (1. 66±0. 64),control group (1. 36 ± 0. 50) and stable graft function group (1. 67 ± 0. 45) (P<0. 05). Most importantly,elevated levels of Notchl levels were correlated with the serum creatinine levels. Conclusion These data reveal a correlation between elevated Notch1 expression in PBMCs post-transplantation and intragraft immune activation that leads to acute rejection. Notch1 may be a good predictor of acute renal allograft rejection and long-term survival.