肾移植患者血清中可溶性B7-H3水平的变化及其临床意义

目的 检测肾移植患者移植前后血清中可溶性B7-H3(sB7-H3)水平变化,并探讨其临床意义.方法 34例肾移植患者于移植前及移植后3、6、12个月采集外周血,用酶联免疫吸附试验(ELISA)检测血清中的sB7-H3,取11例健康志愿者为正常对照.用Luminex检测人白细胞抗原(HLA)和主要组织相容性Ⅰ类相关链A位点(MICA)抗体并分为术前抗体阳性组及阴性组.随访组根据术后1年内基本情况分为肾功能稳定组和不稳定组.结果 肾移植组术前血清sB7-H3水平(27.10±13.61)μg/L,n=34]高于正常对照组(11.61±3.77)μg/L,n=11],两组比较差异有统计学意义(P＜0.01),且术前抗体阳性组血清sB7-H3水平高于阴性组(34.96±17.37)μg/L,n=11比(23.34±9.75)μg/L,n=23,P＜0.05].肾移植术后肾功能稳定组各时间点血清sB7-H3水平与正常对照组比较差异无统计学意义(P＞0.05),肾功能不稳定组未排斥时血清sB7-H3和肌酐(Cr)水平与正常对照组比较差异亦无统计学意义(P＞0.05),而排斥时其血清sB7-H3水平(20.63±4.28)μg/L,n=12;(18.95±2.98)μg/L,n=6;(28.36±19.83)μg/L,n=10]和Cr均明显升高,与肾功能稳定组及正常对照组比较差异有统计学意义(P＜0.01).结论 慢性肾炎患者血清sB7-H3水平增高,且术前抗体阳性组增高更明显;肾移植术后血清sB7-H3水平与肾功能变化一致.术后监测sB7-H3动态变化,可间接了解患者机体免疫状态,对肾移植术后的疗效观察和预后判断有参考价值.

Abstract：

Objective To detect the serum soluble B7-H3 (sB7-H3) in patients before and after renal transplantation, and to investigate the clinical significance. Methods The serum level of sB7-H3 in 34 patients were determined before and 3, 6, 12 months after renal transplantation. Besides, 11 health adults were elected as controls. These 34 patients were divided into two groups according to HLA and/or MICA antibodies using Luminex before operation. After transplantation, all the patients were divided into two groups according to their conditions; group Ⅰ with rejection; group S with stable renal function and no rejection. Results The serum level of sB7-H3 in all 34 patients before operation was significantly higher than health controls (27. 10 ± 13. 61) μg/L,n = 34 vs (11.61 ±3.77) μg/L,n = 11 ,P ＜0. 01], and significantly higher in patients with antibodies than in those without before operation (34. 96 ± 17. 37) (μ/L, n = 11 vs (23. 34 ± 9. 75) (μg/L, n = 23, P ＜ 0. 05]. There was no significant difference in the serum level of sB7-H3 between control group and S group after operation (P ＞0. 05). In group Ⅰ, the serum level of sB7-H3 was increased obviously when rejection occurred (20. 63 ±4. 28) μg/L,n = 12; (18. 95 ±2.98) μg/L,n=6; (28.36 ±19. 83) μg/L,n = 10] , as compared with group S and control group (P＜0. 01), while at the time without rejection, there was no difference among them (P ＞0. 05). Conclusion Monitoring serum sB7-H3 after renal transplantation would be clinically useful in indicating therapeutic effect and outcome of the patients.

Change of serum soluble B7-H3 in renal transplantation receptor and its clinical significance

Objective To detect the serum soluble B7-H3 (sB7-H3) in patients before and after renal transplantation, and to investigate the clinical significance. Methods The serum level of sB7-H3 in 34 patients were determined before and 3, 6, 12 months after renal transplantation. Besides, 11 health adults were elected as controls. These 34 patients were divided into two groups according to HLA and/or MICA antibodies using Luminex before operation. After transplantation, all the patients were divided into two groups according to their conditions; group Ⅰ with rejection; group S with stable renal function and no rejection. Results The serum level of sB7-H3 in all 34 patients before operation was significantly higher than health controls (27. 10 ± 13. 61) μg/L,n = 34 vs (11.61 ±3.77) μg/L,n = 11 ,P ＜0. 01], and significantly higher in patients with antibodies than in those without before operation (34. 96 ± 17. 37) (μ/L, n = 11 vs (23. 34 ± 9. 75) (μg/L, n = 23, P ＜ 0. 05]. There was no significant difference in the serum level of sB7-H3 between control group and S group after operation (P ＞0. 05). In group Ⅰ, the serum level of sB7-H3 was increased obviously when rejection occurred (20. 63 ±4. 28) μg/L,n = 12; (18. 95 ±2.98) μg/L,n=6; (28.36 ±19. 83) μg/L,n = 10] , as compared with group S and control group (P＜0. 01), while at the time without rejection, there was no difference among them (P ＞0. 05). Conclusion Monitoring serum sB7-H3 after renal transplantation would be clinically useful in indicating therapeutic effect and outcome of the patients.