CD95、CD95L mRNA在肾移植、肝移植以及肝肾联合移植受者外周血中表达的意义

检测肾移植、肝移植以及肝肾联合移植受者外周血淋巴细胞CD95、CD95L mRNA的表达水平,评估其预测移植术后急性排斥反应(acute rejection,AR)的价值.方法 采用SYBR 荧光实时定量逆转录聚合酶链反应(RT-PCR)法检测132例肾移植受者、59例肝移植受者以及18例肝肾联合移植受者外周血T淋巴细胞CD95、CD95L mRNA的表达水平.根据术后1个月内有否出现AR将209例受者分为排斥组和无排斥组.对两组受者外周血T淋巴细胞CD95、CD95L mRNA的表达情况进行分析.结果 在肾移植组、肝移植组以及肝肾联合移植组中,发生AR的移植受者的外周血CD95、CD95L mRNA表达水平均显著升高(均为P<0.01),且时间早于患者出现临床症状以及实验室指标异常,提前(2.5±0.9)d.结论 CD95、CD95L mRNA表达升高与肾移植、肝移植以及肝肾联合移植术后发生AR密切相关,并且早于患者出现实验室指标异常.SYBR 荧光实时定量RT-PCR法检测外周血T淋巴细胞CD95、CD95L mRNA,方法准确、易行,可作为移植器官发生AR的预测和诊断指标.

Expressions of CD95 and CD95L mRNA of peripheral blood in kidney, liver and liver-kidney transplantation

Objective To detect the expression of CD95 and CD95L mRNA in recipients undergoing kidney, liver and liver-kidney transplantation after operation and to evaluate the predictive value of CD95 and CD95L mRNA in acute rejection （AR）. Methods The expressions of CD95 and CD95L mRNA of peripheral blood T lymphocyte from 132 kidney, 59 liver and 18 combined liver-kidney transplant recipients were examined using SYBR RT-PCR. A total of 209 patients were divided into Group AR and Group Non-AR according to AR episodes experienced in the first month post transplant. The expressions of CD95 and CD95L mRNA of these two groups were analyzed and compared respectively. Results CD95 and CD95L mRNA levels in the recipients with AR were significantly higher at time of rejection （ all in P 〈 0. 01 ）, and the elevation occurred （2. 5 ±0. 9） days earlier than related symptom and abnormal labs did. Conclusion CD95 and CD95L mRNA are related to AR. Their expression will be significantly increased at time of AR for kidney, liver and liver-kidney transplantation. CD95 and CD95L mRNA measurement may serve as an indicator for prediction and diagnosis of AR episodes.