他克莫司对肝移植受者外周血T淋巴细胞亚群及共刺激分子表达的影响

目的 探讨他克莫司（FK506）对肝移植受者外周血T淋巴细胞亚群及其表面共刺激分子表达的影响。方法 采用荧光标记单克隆抗体和流式细胞技术，测定术后采用FK506治疗的肝移植受者（FK506治疗组）在用FK506后1、2、3、4周时的外周血T淋巴细胞亚群及其表面共刺激分子CD28、CD152和ICOS分子的表达情况，以健康志愿者（健康对照组）和患终末期肝脏疾病拟行肝移植者（肝病对照组）为对照。结果 CD3^＋T淋巴细胞在各组间的差异均无统计学意义（P〉0．05）。经FK506治疗后，肝移植患者的CD4^＋T淋巴细胞逐渐减少，CD8^＋T淋巴细胞逐渐增加，并恢复至健康对照组水平（P〉0．05）。FK506治疗组T淋巴细胞亚群表面CD28分子和ICOS分子表达逐渐下降，并明显低于健康对照组（P〈0．05），而CD152分子表达增加，且明显高于健康对照组（P〈0．05）；其ICOS分子表达水平的下降晚于CD28分子，CD4^＋CD28^＋T淋巴细胞、CD8^＋CD28^＋T淋巴细胞和CD4^＋ICOS^＋T淋巴细胞均呈现相近的变化规律。结论 FK506能迅速纠正移植受者T淋巴细胞亚群紊乱，并抑制正性共刺激分子CD28和ICOS的表达，促进负性共刺激分子CD152的表达。

Immunoregulatory effect of FK506 on T lymphocytes subgroups and the expression of co-stimulators in allo-liver recipients

Objective To explore the effect of FK506 on T-cell subgroups and the expression of co-stimulators in patients receiving allo-liver transplantation. Methods Fluorescein-labeled monoclonal antibodies and flow cytometry was to determine the T-cell subgroups and the expression of CD28, CD152 and ICOS on peripheral T cells of allo-liver recipients 1, 2, 3 and 4 weeks after treatment with FK506. And health volunteers and patients who suffered severe hepatic diseases and intended to receive hepatic transplantation were used as controls. Results There was no significant difference in CD3~ +T lymphocytes among all the three groups (P> 0.05). After FK506 treatment, the CD4~ +T lymphocytes of the recipients were decreased gradually, CD8~ +T lymphocytes increased gradually, and went back to health-control level (P> 0.05). In the FK506-treated group, the expression of CD28 and ICOS on the surface of T lymphocyte was decreased, and was significantly lower than health-control level (P< 0.05), while the expression of CD152 was increased, and was significantly higher than health-control level (P< 0.05); The decrease of ICOS expression was delayed in contrast to that of CD28, and the expression of CD4~ +CD28~ +T lymphocyte, CD8~ +CD28~ +T lymphocyte and CD4~ +ICOS~ +T lymphocyte changed in the similar pattern. Conclusion FK506 can quickly correct the imbalance of T cell subgroups in the transplantation recipients, inhibit the expression of positive co-stimulatory molecules CD28 and ICOS and at the same time promote the expression of negative co-stimulatory molecule CD152.