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他克莫司(Tacrolimus)是一种强效免疫抑制剂,现已广泛应用于肾脏、肝脏及心脏移植,有效减低了排异反应的发生,提高了移植受者的存活率。但是他克莫司个体药代动力学差异大,不同个体对其血药浓度的敏感性及耐受性有差异,故单纯依靠血药浓度监测不能有效反映移植受者的免疫状态。因此如何了解移植受者的免疫状态,指导免疫抑制剂的个体化应用,在免疫抑制不足及免疫过度之间寻找平衡,成为困扰移植医生的问题。NK细胞(natruralkiller cell)是天然免疫系统的主要效应细胞。近年研究表明,NK细胞在移植免疫中起重要作用,可促使移植物排斥反应的发生[1]。NKT细胞(natrural killerT cell)是一类表达NK细胞表面特有标志的特殊T细胞亚群,参与机体免疫调节,是连接固有免疫和适应性免疫应答的桥梁[2],研究发现它对于器官移植免疫耐受的产生和维持具有重要作用[3]。本研究通过测定肾移植受者术后外周血NK细胞及NKT细胞的动态变化,研究他克莫司对NK细胞及NKT细胞表达的影响,探讨外周血NK、NKT细胞的表达能否作为体现肾移植受者免疫状态的一个指标,可否作为免疫抑制药物调整的依据之一。
Tacrolimus is a potent immunosuppressive agent that has been widely used in kidney, liver and heart transplantation to effectively reduce rejection and improve survival of transplant recipients. However, the individual pharmacokinetics of tacrolimus vary greatly. Individuals have different sensitivity and tolerability to their plasma concentrations. Therefore, the monitoring of plasma concentration alone can not effectively reflect the immune status of transplant recipients. Therefore, how to understand the immune status of transplant recipients and guide the individualized application of immunosuppressive agents to find the balance between immunosuppression and over-immunization has become a problem plaguing transplant doctors. NK cells (natruralkiller cells) are the main effector cells of the innate immune system. In recent years, studies have shown that NK cells play an important role in graft immunity, can promote the occurrence of graft rejection [1]. NKT cells (natrural killerT cells) is a group of special T cell subsets that express NK cell surface specific markers, involved in the immune regulation of the body, is a bridge between the innate and adaptive immune response [2], found that it is immune to organ transplantation Tolerance to produce and maintain has an important role [3]. In this study, by measuring the dynamic changes of NK cells and NKT cells in peripheral blood after renal transplantation recipients to study the impact of tacrolimus on NK cells and NKT cells, to explore whether the expression of NK and NKT cells in peripheral blood can reflect the changes of renal An indicator of immune status of transplant recipients can serve as a basis for the adjustment of immunosuppressive drugs.