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目的 :探讨肾移植受者外周血T细胞CD2 8和CD40共刺激通路相关分子的表达及其与排斥反应的关系。 方法 :采用流式细胞仪检测了 42例肾移植受者外周血CD2 8、CTLA4、CD40及CD40L分子在CD4+ T细胞和CD8+ T细胞表面的表达。病例分为两组 ,排斥反应组 1 8例 ,肾功能正常组 (对照组 ) 2 4例。 结果 :排斥反应组患者外周血CD2 8、CTLA4、CD40和CD40L分子的表达均增强 ,其中CD2 8+ T细胞的增多主要表现在CD4+ T细胞亚群 ,CTLA4分子的表达增强主要为CD8+ T细胞。CD40及CD40L在CD4+ 或CD8+ T细胞上的表达 ,排斥组与非排斥组间无显著差异。 结论 :肾移植排斥反应的发生与CD2 8和CD40共刺激通路的活化有密切关系 ,非T细胞表面CD40及CD40L分子表达的增强在排斥反应中可能也起着重要作用。检测外周血共刺激分子的表达 ,有助于临床排斥反应的诊断
OBJECTIVE: To investigate the expression of CD28 and CD40 costimulatory molecules on peripheral blood T cells in renal allograft recipients and its relationship with rejection. Methods: The expression of CD28, CTLA4, CD40 and CD40L on the surface of CD4 + T cells and CD8 + T cells in 42 renal transplant recipients was detected by flow cytometry. The cases were divided into two groups, 18 cases of rejection group, 24 cases of normal renal function group (control group). Results: The expression of CD28, CTLA4, CD40 and CD40L in peripheral blood of patients with rejection increased. The increase of CD8 + T cells was mainly in the subset of CD4 + T cells. The expression of CTLA4 was mainly CD8 + T cells. CD40 and CD40L expression on CD4 + or CD8 + T cells, no significant difference between rejection group and non-rejection group. CONCLUSION: The rejection of renal allografts is closely related to the activation of CD28 and CD40 co-stimulatory pathways. The enhanced expression of CD40 and CD40L on non-T cells may also play an important role in rejection. Detection of peripheral blood costimulatory molecules, contribute to the diagnosis of clinical rejection