肾移植微嵌合体与免疫耐受相关性研究

目的　探讨肾移植术后受者微嵌合体与免疫耐受的相关性。方法　采集接受男性供体肾脏移植术后女性受者不同生存期外周血及尿沉渣标本 ,采用Y染色体 3对引物SRY1、DYZ11st和DYZ12nd,应用PCR和RT PCR方法检测标本中微嵌合体特异性标志Y染色体DNA和mRNA的表达 ,同时测定移植肾功能。结果　在 130例肾移植受者中 ,检测到嵌合阳性者 98例 ,占 75 .39% ,嵌合阴性者 32例 ,占 2 4 .6 1%。嵌合阳性与阴性两组比较 ,移植肾平均存活时间分别为 8.7± 3.5年和 5 .4± 3.3年 ;嵌合阳性者发生过排斥反应者 11例 ,占 11.2 2 % ,而嵌合阴性者9例 ,占 2 8.13% ;血清肌酐在嵌合阳性者为 74 .3μmol L±32 .5 μmol L ,而嵌合阴性者为113.6 μmol L±37.8μmol L。结论　受者体内嵌合阳性比阴性者具有更好的移植肾功能和低排斥率 ;受者生存期愈长 ,嵌合阳性率愈高 ;体内的嵌合状态与免疫耐受具有相关性

Relationship between Microchimerism and Immunologic Tolerance after Kidney Transplantation

Objective To explore the relationship between the microchimerism and immunologic tolerance after kidney transplantation.Methods Collect the peripheral blood and urinary sediments of female patients at different survival stages after undergoing transplantation of kidney from male donors for detecting the Y chromosome DNA and expressed mRNA, both representing microchimerism specifically, by PCR and RT-PCR using 3 pairs of primers SRY1, DYZ11st and DYZ12nd in Y chromosome. Examine the functions of transplanted kidneys at the same time.Results Of the 130 patients undergoing kidney transplantation, 98 (75 39%) were microchimerism positive, and the rest 32 (24.61%) were negative. The mean survival time of transplanted kidneys of microchimerism positive and negative patients were 8.7±3.5 and 5.4±3.3 years respectively (p<0.05). Rejection occurred in 11 microchimerism positive (11.22%) and 9 negative ((28.13%)) patients (p<0.05). The serum creatinine levels were (74.3±32.5) μmol/L and (113.6±(37.8)) μmol/L in microchimerism positive and negative patients respectively (p<0.05).Conclusion Compared with those of microchimerism negative patients, the functions of transplanted kidney of microchimerism positive patients were good, and the rejection rates of them were low. The longer the survival time was, the higher the microchimersim positive rate was.It showed a relationship between the state of microchimerism and immunologic tolerance.