终末期肾病患者Th1/Th2型细胞因子的特征与外周血T细胞凋亡的关系

目的:研究终末期肾病(ESRD)患者Th1/Th2型细胞因子的特征及其与外周血T细胞凋亡的关系,并探讨不同透析膜对T细胞凋亡的影响。方法:应用流式细胞术检测10例ESRD未透析(ND)患者,维持性血液透析的患者45例,分别采用醋酸纤维素膜(CA)、低通聚砜膜(PS-LF)、高通聚砜膜(PS-HF)进行透析,以及8例健康对照组(HC)的外周血T细胞,经PHA刺激培养24h后锚定蛋白(AnnexinV)的表达。用ELISA法检测细胞培养上清IFN-γ及IL-4的水平。结果:ESRD患者未透析组及3种膜透析组T细胞AnnexinV的表达高于健康对照组(P<0.05)。各透析组患者T细胞AnnexinV的表达以CA组最高,PS-HF组最低,组间比较具有统计学意义(P<0.05);ESRD患者各组IFN-γ的水平均低于健康对照组(P<0.05),与AnnexinV的表达呈负相关;IL-4的水平高于健康对照组(P<0.05),与AnnexinV的表达呈正相关。结论:ESRD患者存在Th型细胞因子的失衡,呈Th2型细胞因子占优势,T细胞的凋亡增加。

The characterization of Th1 /Th2 profile in end-stage renal disease patients and the correlation with the apoptosis of T lymphocyte

AIM: To investigate the characterization of Th1/Th2 profile in patients with end-stage renal disease (ESRD) and the correlation with the apoptosis of the peripheral blood T cells; and to study the influence of different dialysis membranes on the apoptosis of T lymphocyte. METHODS: T cells from 10 non-dialyzed (ND) patients, 45 maintenance hemodialysis patients with cellulose acetate (CA) membrane, low-flux (PS-LF) and high-flux polusulfone (PS-HF) membrane, and 8 healthy volunteers (HC) were separated and stimulated with PHA for 24 hours in vitro. Then the apoptosis of T cells and supernatants levels of IFN-gamma and IL-4 were detected by Flow cytometry (FCM) and ELISA. RESULTS: In ESRD patients, the expression of Annexin V in T lymphocyte was higher than that of group HC (P<0.05), group CA was higher than group PS-HF and PS-LF (P<0.05). The level of IFN-gamma of ESRD patients was decreased significant compared with that in group HC (P<0.05), and there was negative correlation. between the Annexin V and IFN-gamma. IL-4 was increased in ESRD patients (P<0.05) and it was positive correlated with Annexin V. CONCLUSION: ESRD patients showed suppressed secretion of IFN-gamma, increased secretion of IL-4 and apoptosis of T lymphocytes.