| 王 泳,张汝霖,康 玫,王 杨,邱建新.长期肾移植受者外周血B淋巴细胞亚群分布特征[J].,2021,(13):2451-2459 |
| 长期肾移植受者外周血B淋巴细胞亚群分布特征 |
| Peripheral B Lymphocyte Phenotype Analysis in Long-term Survival Allograft Kidney Transplant Recipients |
| 投稿时间：2020-12-28 修订日期：2021-01-23 |
| DOI：10.13241/j.cnki.pmb.2021.13.011 |
| 中文关键词: 肾移植 长期存活受者 B淋巴细胞亚群 |
| 英文关键词: Allograft kidney transplant Long term survival B lymphocyte phenotype |
| 基金项目:上海市卫生健康委员会面上项目（20114245）；上海交通大学STAR计划项目（Trans-med Awards Research） |
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| 中文摘要: |
| 摘要 目的：观察移植肾功能稳定的长期受者（>10年）外周血B细胞亚群分布特征及其相关因素。方法：54名肾移植受者接受流式细胞仪检查，测算外周血总B细胞、未转化记忆B细胞、转化记忆B细胞、双阴性B细胞（CD19+CD27-IgD-）比例及数量（个/微升）。患者均服用包括环孢霉素的免疫抑制治疗。术后时间16.33±5.98年，GFR：91.63±11.28 mL/min/1.73 m2。结果：1长期肾移植患者外周血B细胞中幼稚B细胞最多（37.92% ± 22.06%），未转化记忆B细胞最少(16.23% ± 11.10%)。B细胞亚群数量与白细胞总数、中性粒细胞比例等相关。2 以上述条件为控制因素行相关分析，转化记忆B细胞比例和GFR相关（r=-0.279，P=0.045），双阴性B细胞数量和环孢霉素浓度相关（r=-0.300，P=0.029）。线性回归显示双阴性B细胞数目与环孢霉素浓度相关（R2=0.123，P=0.049）。3按GFR将患者分为肾功能减退组（GFR<90 mL/min/1.73 m2，n=19）和肾功能正常组（GFR≥90 mL/min/1.73 m2，n=35）。前者转化记忆B细胞比例显著升高（23.61% ± 10.96% vs.17.48%±8.91%，P=0.030）。按环孢霉素谷浓度将患者分为低浓度组（<64 mmol/L，n=28）和高浓度组（≥64 mmol/L，n=26），前者双阴性B细胞数量显著升高（13.74±10.70 vs. 8.14±6.72/μL，P=0.027）。转化记忆B细胞比例与GFR分组相关（r=-0.326，P=0.018），双阴性B细胞数量和环孢霉素浓度分组相关（r=-0.350，P=0.01）。结论：移植肾功能稳定的长期存活受者（>10年）外周血幼稚B细胞较多。转化记忆B细胞增多与移植肾功能减退相关，增多的双阴性B细胞和低孢霉素浓度治疗相关。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the peripheral B lymphocyte phenotype in long-term survival allograft kidney transplant recipients. Methods: Peripheral B lymphocyte phenotype was detected in 54 Allograft kidney transplant recipients. The number (/μL) and percentage of total B cell, unswitched memory B cell, switched B cell, double negative B cell （CD19+CD27-IgD-）were recorded, respectively. The average estimated Glomerular Filtration Rate (GFR) was 91.63±11.28 mL/min/1.73 m2. The average time(years) after kidney transplant was 16.33±5.98years. All patients had the same immunosuppressant treatment including cyclosporine. Results: 1 Na?ve B cells predominated in the peripheral B lymphocytes(37.92%±22.06%), while unswitched B cells were the least(16.23%±11.10%). The number of B lymphocytes subtypes correlated with the number of peripheral leukocytes and the percentage of neutrophils. 2 Correlation analysis indicated that, the percentage of switched B cells related to GFR(r=-0.279, P=0.045). Besides, the number of double negative B cells related to the trough level of cyclosporine(r=-0.300, P=0.029). Linear regression analysis indicated that the number of double negative B cells correlated with cyclosporine(R2=0.123, P=0.049). 3 Patients in the impaired allograft function team(GFR<90 mL/min/1.73 m2, n=19) had higher percentage of switched memory B cells(23.61%±10.96% vs.17.48%±8.91%, P=0.030) than the normal allograft function team(GFR≥90 mL/min/1.73 m2，n=35). Patients with lower cyclosporine trough level (<64 mmol/L, n=28) had more double negative B cells (13.74±10.70 vs. 8.14±6.72/μL, P=0.027) than the higher cyclosporine trough level patients(≥64 mmol/L, n=26). The percentage of switched memory B cells correlated with the normal/impaired allograft function team(r=-0.326, P=0.018). The number of double negative B cells correlated with the higher/lower cyclosporine team(r=-0.350, P=0.01). Conclusion: In the long-term survival kidney transplant patients with stable allograft function, na?ve B cells predominated in the peripheral B lymphocytes. Switched memory B cells correlate with impaired allograft kidney function. Increased double negative B cells correlate with low cyclosporine trough level. |
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