共查询到20条相似文献,搜索用时 15 毫秒
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Objective To evaluate the immune status of acute rejection recipients, and to improve the short-term and long-term survival rate of renal transplant recipients and grafts, and to investigate dynamically the changes in the immune repertoire of patients with acute rejection. Methods Combined multiplex PCR amplification technique and high throughput sequencing technique, the TCR β chain complementarity determining region 3 (CDR3) diversity and repertoire characteristics at different time points during renal transplantation were analyzed, in order to reveal the immunological characteristics of T lymphocytes in patients with acute rejection. Results The diversity of TCR CDR3 in acute rejection patients was reduced to the lowest one day after surgery. The diversity of TCR CDR3 before acute rejection was higher than before. The acute rejection-related up-regulated TCR CDR3 amino acid sequences were screened out. In addition, TCR beta chain V and J subfamily showed the phenomenon of advantage usage in pre-acute rejection, which may be due to T cell recognition of transplanted kidney antigens in vivo. Conclusions The immune diversity of patients with acute rejection is significantly lower. In addition, TCR beta chain V and J subfamily show the phenomenon of advantage usage. 相似文献
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Analysis of AHG-PRA and ELISA-PRA in kidney transplant patients with acute rejection episodes 总被引:2,自引:0,他引:2
Kaufman A de Souza Pontes LF Queiroz Marques MT Sampaio JC de Moraes Sobrino Porto LC de Moraes Souza ER 《Transplant immunology》2003,11(2):175-178
Many centers determined a significant correlation between post-transplant anti-HLA antibodies production and clinical outcome. In order to confirm this correlation and ascertain the sequential appearance of anti-HLA antibodies, we compared the ELISA (ELISA-PRA) and the anti-human globulin enhanced complement-dependent lymphocytotoxicity panel-reactive antibodies test (AHG-PRA) with the occurrence of acute rejection episodes. Thirty patients who underwent kidney transplantation between December 1998 and October 1999 were assayed. One pre-transplant and 10 post-transplant serum samples were tested from each recipient except from one of them who lost his graft on the 1 week post-transplant. The diagnosis of acute rejection episode was based on classical criteria (fever, graft swelling and tenderness, oliguria, weight gain) and a rapid rise in serum creatinine levels, confirmed by an allograft biopsy graded by the Banff working classification. The 322 pre- and post-transplant serum specimens were tested by AHG-PRA methodology and 298 of them by the ELISA-PRA. The agreement coefficient (kappa) for both methodologies was 0.63. There were 27 acute rejection episodes in 19 patients. AHG-PRA results were significantly correlated (Hazard ratio=10.06; P=0.006) with this occurrence. These data were not confirmed with the ELISA-PRA procedure. Our results suggest that a routine post-transplant AHG-PRA test offers an early risk assessment of acute rejection episodes and may be a useful method for monitoring the kidney transplant evolution. 相似文献
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Tan JC Wadia PP Coram M Grumet FC Kambham N Miller K Pereira S Vayntrub T Miklos DB 《Transplantation》2008,86(1):75-81
BACKGROUND: Human minor histocompatibility antigens (mHA) and clinically relevant immune responses to them have not been well defined in organ transplantation. We hypothesized that women with male kidney transplants would develop antibodies against H-Y, the mHA encoded on the Y-chromosome, in association with graft rejection. METHODS: We tested sera from 118 consecutive transplant recipients with kidney biopsies. Antibodies that specifically recognized the recombinant H-Y antigens RPS4Y1 or DDX3Y were detected by IgG enzyme-linked immunosorbent assay and western blotting. Immunogenic epitopes were further identified using overlapping H-Y antigen peptides for both the H-Y proteins. RESULTS: In the 26 female recipients of male kidneys, H-Y antibody development posttransplant (1) was more frequent (46%) than in other gender combinations (P<0.001), (2) showed strong correlation with acute rejection (P=0.00048), (3) correlated with plasma cell infiltrates in biopsied kidneys (P=0.04), and (4) did not correlate with C4d deposition or donor-specific anti-human leukocyte antigen (HLA) antibodies. Of the two H-Y antigens, RPS4Y1 was more frequently recognized (P=0.005). CONCLUSION: This first demonstration of a strong association between H-Y antibody development and acute rejection in kidney transplant recipients shows that in solid organ allografts, humoral immune responses against well defined mHA have clear clinical correlates, can be easily monitored, and warrant study for possible effects on long-term graft function. 相似文献
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Pawlik A Domanski L Rozanski J Florczak M Dabrowska-Zamojcin E Dutkiewicz G Gawronska-Szklarz B 《Transplantation proceedings》2005,37(5):2041-2043
INTRODUCTION: Proinflammatory cytokines have been implicated in the pathogenesis of acute kidney allograft rejection. The aim of the study was to examine the association between interleukin (IL)-2 -330 and tumor necrosis factor (TNF)-alpha -308 promoter polymorphisms and acute kidney allograft rejection. METHODS: The study included 72 patients with long-term stable graft function, and 57 diagnosed with acute kidney allograft rejection. RESULTS: Patients with acute kidney allograft rejection showed a prevalence of subjects with TNF-alpha T2 allele (P < .05). The risk of acute kidney allograft rejection diagnosis was 2.5-fold greater among carriers of the T2 allele than those homozygous for T1T1 (OR 2.53, 95% CI 1.19 to 5.37, P < .05) There was no statistically significant difference in the distribution of IL-2 genotypes between patients with stable graft function and acute kidney allograft rejection. CONCLUSION: The results suggest that TNF-alpha-308 promoter polymorphism is a risk factor for acute kidney allograft rejection. 相似文献
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Obata F Yoshida K Ikeda Y Ohkubo M Saito T Takeuchi Y Shinohara N Endo T Baba S 《Transplant immunology》2004,13(3):233-237
The clonality of T-cell populations mediating acute and chronic rejection (AR and CR, respectively) of kidney allografts was ascertained by investigating the diversity of TCRBV genes expressed by allograft-infiltrating T cells. Both oligoclonality and polyclonality cases were found in biopsy specimens of AR as well as CR. These results indicated that the T-cell clonality in each specimen did not correlate directly with the mode of rejection. When AR and CR specimens were compared, however, the CR specimen group was significantly more polyclonal (or less oligoclonal) than the AR group. This result may reflect the higher chance of epitope spreading in the more slowly progressing CR than in AR. 相似文献
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Hypercholesterolemia is associated with increased kidney graft loss caused by chronic rejection in male patients with previous acute rejection 总被引:6,自引:0,他引:6
BACKGROUND: Whereas acute rejection is the main risk factor for the occurrence of chronic rejection, mechanisms in addition to the donor-specific immune response probably contribute to late allograft failure. In this study, we investigated the possible role of hypercholesterolemia in the incidence of chronic kidney graft loss. METHODS: By using the actuarial method, we retrospectively analyzed the long-term loss of cadaveric kidney grafts in patients who had a functioning graft at 1 year and had received a transplant and undergone cyclosporin A therapy in our center between 1983 and 1997. RESULTS: As observed previously, patients with acute rejection during the 1st posttransplant year (n=198) had significantly higher actuarial graft loss at 10 years compared with those free of acute rejection (n=244). In patients free of acute rejection at 1 year, hypercholesterolemia (> or =250 mg/dl) had no impact on graft loss at 10 years. On the contrary, in patients with previous acute rejection, those with hypercholesterolemia (n=59) had a higher immunological (36.0% vs. 19.2%; P<0.01) and overall (50.0% vs. 25.3%; P<0.01) graft loss at 10 years compared with patients with serum cholesterol <250 mg/dl (n=139). Among patients with 1st year acute rejection, hypercholesterolemia was associated with a significant increase in graft loss in male but not in female recipients. Multivariate analysis confirmed that hypercholesterolemia was an independent risk factor for chronic graft loss in male patients (P<0.05). CONCLUSION: Hypercholesterolemia is an independent risk factor for kidney graft loss from chronic rejection in male patients with previous acute rejection. Correction of hypercholesterolemia could help to reduce kidney graft loss caused by chronic rejection in this category of patients. 相似文献
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目的 研究肾移植受者术前血清抗内皮细胞抗体(AECA)的水平对术后6个月内发生急性排斥(AR)的预测作用。 方法 将1998年12月至2003年8月在本中心行同种异体肾移植并存有血标本的495例受者纳入研究。回顾总结术后6个月内AR发生情况及相关资料。健康对照(阴性对照)40例。采用细胞-ELISA法,以EA.hy926细胞(人脐静脉内皮细胞株)为底物检测血清AECA水平。结果采用比值表示,P(患者)/N(阴性对照)=(A患者标本-A空白对照)/(A阴性对照-A空白对照)。P/N大于健康对照组均值加2个标准差者为阳性。 结果 495例患者血清中,AECA阳性93例(18.8%)。维持血透时间大于12个月患者血清AECA水平(1.43±0.37)显著高于未透析患者(1.27±0.32,P = 0.013)及维持血透时间≤12个月患者(1.31±0.32,P = 0.029)。血清AECA水平与透析时间呈正相关(r = 0.218,P = 0.018)。AECA阴性、阳性患者术后6个月内AR发生率分别为23.4%、38.7%,差异有统计学意义(P = 0.002)。AECA阳性患者细胞性AR、体液性AR的发生率均显著升高(P = 0.035,P = 0.002)。多元Logistic回归分析显示AECA阳性、群体反应性抗体(PRA)≥10%、高淋巴毒反应为发生AR的独立危险因素,优势比(OR)分别为2.056、1.751、1.764(P值分别为0.004、0.029、0.050)。 结论 肾移植受者术前血清AECA阳性预示术后发生急性排斥反应的风险增加。术前血清AECA水平随透析时间延长而升高。 相似文献
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Wiśniewski A Kusztal M Magott-Procelewska M Klinger M Jasek M Łuszczek W Nowak I Kosmaczewska A Ciszak L Frydecka I Górski A Kuśnierczyk P 《Transplantation proceedings》2006,38(1):56-58
Cytotoxic T-lymphocyte antigen 4 (CTLA-4) molecule is an important inhibitor of T-lymphocyte response. Polymorphisms in the CTLA-4 gene have been described to be associated with numerous autoimmune diseases. However, similar studies in solid organ transplantation have been scarce. Therefore, we examined the distribution of three single nucleotide dimorphisms, namely, −1147T/C, −318C/T, and +49A/G, in two groups of allogeneic kidney graft recipients: (1) those with at least one acute rejection episode (“rejectors”; n = 38) and (2) those with no signs of acute rejection (“nonrejectors”; n = 53). Allele frequencies in both groups of patients were similar in two positions, −1147T/C and +49A/G. However, rejectors showed slight differences from nonrejectors for allele and genotype frequencies in position −318. The −318T allele was two times less frequent among rejectors than nonrejectors, a difference that was close to statistical significance (P = .039; P corrected = .0583), and may reach it when greater numbers of patients are tested. 相似文献
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直肠癌病人外周血NK细胞和T淋巴细胞亚群数目的变化及其临床意义 总被引:5,自引:1,他引:5
目的 探讨直肠癌病人外周血NK细胞和T淋巴细胞亚群的变化及临床意义。方法 分别应用同位素及流式细胞仪法检测26例正常人(无肿瘤)和35例直肠癌患者(包括术前术后)外周血NK细胞和T淋巴细胞亚群数目。结果 NK细胞,CD3,CD4,CD4/CD8比值在直肠癌组与对照组差异显著性(P<0.05)。直肠癌患者随Dudes分期增高而NK细胞,CD3,CD4,CD4/CD8比值逐渐下降,差异均有极显著性(P<0.01)。根治术和姑息性切除术后NK细胞CD3,CD4,CD4/CD8升高,CD8回落接近对照组。肿瘤未切除组术后NK细胞,CD3,CD4/CD8则进一步下降,差异有显著性(P<0.05)。结论 直肠癌患者NK细胞等各项免疫指标大大降低,这种疫紊乱状态在不同病情又有显著差别,根治术和姑息性切除术可明显改善病人的免疫状态。 相似文献
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Experimental studies have demonstrated the cardinal role played by the mononuclear phagocyte system in the removal of antigen-antibody complexes. To assess the functional capacity of phagocytes in patients with renal disease, 33 normal subjects, 10 patients with mesangial proliferative glomerulonephritis, 8 patients with membranous nephropathy, and 8 patients with moderately severe chronic renal failure were studied by an in vitro assay, measuring the ability of isolated monocytes to ingest sheep erythrocytes coated with IgG antibody and to phagocytize latex beads. Monocytes from four patients with mesangial proliferative glomerulonephritis and one patient with membranous nephropathy exhibited a subnormal capacity to ingest the antibody-coated erythrocytes. Additionally, monocytes from two of the four patients with mesangial proliferative glomerulonephritis and a defect in ingesting sensitized erythrocytes had a subnormal capacity to phagocytize latex beads. The results are interpreted in the context of a hypothesis which suggests that patients with immune nephritis show various forms of immune deficit. 相似文献
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Individualized T cell monitored administration of ATG versus OKT3 in steroid-resistant kidney graft rejection 总被引:1,自引:0,他引:1
Midtvedt K Fauchald P Lien B Hartmann A Albrechtsen D Bjerkely BL Leivestad T Brekke IB 《Clinical transplantation》2003,17(1):69-74
Acute steroid-resistant rejection episodes are recommended to be treated with set doses of anti-thymocyte globulin (ATG) or anti-CD3 monoclonal antibody (OKT3). Individualized T cell monitoring has been proposed as a tool for dose finding. A randomized study comparing the efficacy and safety of ATG (n = 27) with OKT3 (n = 28) in the treatment of biopsy verified acute steroid-resistant rejection (ASRR) when both drugs were administered on the basis of daily individualized T cell measurements. A drop to below 50 cells/mm3 CD2+ T cells was considered adequate and used to guide the dose of ATG/OKT3. Demographic, clinical and histopathological severities of rejections were equal in the two groups. During the 10 days of T cell monitoring and antibody treatment, 13 patients were in need of dialysis (ATG = 7/OKT3 = 6). Two grafts did not respond to antibody treatment and were lost due to rejection (ATG = 1/OKT3 = 1). There were 26 biopsy verified re-rejections (ATG = 12/OKT3 = 14) within the first 3 months following antibody treatment. Mean serum creatinine (micromol/L) was similar in the two groups (ATG/OKT3: before rejection 157 +/- 72/151 +/- 88, at start of antibody treatment 308 +/- 125/330 +/- 94, end of antibody treatment 254 +/- 122/246 +/- 144 and at follow-up after a mean of 32 months 166 +/- 55 (n = 24)/164 +/- 57(n = 23)). To keep the T cell count below 50 cells/mm3, average dose ATG given was 354 +/- 151 mg (2.3 administrations, range 1-4) and average OKT3 was 32.5 +/- 6.8 mg in 10 doses. In conclusion, individualized T cell monitored administration of ATG and OKT3 is safe and seems as effective as a standard set dose in treatment of ASRR. Tailoring the dose for each individual patient lowers the cost. 相似文献
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Aquino-Dias EC Joelsons G da Silva DM Berdichevski RH Berdichewski RH Ribeiro AR Veronese FJ Veronose FJ Gonçalves LF Manfro RC 《Kidney international》2008,73(7):877-884
Delayed graft function (DGF) often occurs in kidney transplants from deceased donors. We wanted to provide studies giving more accurate non-invasive tests for acute rejection (AR). Using real-time PCR, we examined the expression of cytolytic molecules such as perforin, granzyme B, and fas-ligand along with serpin proteinase inhibitor-9. We also measured the expression of FOXP3, a characteristic gene of T-regulatory cells known to be involved in AR. These studies were conducted on peripheral blood monocytes, urinary cells, and 48 surveillance kidney biopsies taken from a total of 35 patients with DGF. Of these patients, 20 had a histopathological diagnosis of AR, whereas other 28 had characteristics of acute tubular necrosis (ATN). Expression of cytolytic and apoptotic-associated genes in the biopsy tissue, peripheral blood leukocytes, and urinary cells was significantly higher in patients with AR than that in patients with ATN. Diagnostic parameters associated with FOXP3 gene expression were most accurate in peripheral blood leukocytes and urine cells with sensitivity, specificity, positive and negative predictive values, and accuracy between 94 and 100%. Our study shows that quantification of selected genes in peripheral blood leukocytes and urinary cells from renal transplant patients with DGF may provide a useful and accurate non-invasive diagnosis of AR. 相似文献