【摘要】 背景:B细胞活化因子(B cell activating factor belonging to TNF family,BAFF),经与其受体结合,对B细胞分化、成熟、生存和抗体分泌发挥重要作用,在T细胞应答过程中亦可能起着重要作用。BAFF信号是否在同种肾移植排斥反应过程中起作用值得探讨。目的:分析肾移植受者外周血淋巴细胞上BAFF的表达情况及其可能的生物学作用。设计、时间及地点:病例观察,于2006-06/2007-03在苏州大学附属第三医院泌尿外科进行。对象:86例肾移植随访患者,男60例,女26例,年龄12～62岁。患者均为首次肾移植,血肌酐值在65～267μmol/L。方法:取患者外周血,以EDTA-Na2抗凝。收集部分患者的移植肾活检标本。主要观察指标:分析外周血单个核细胞上BAFF+、BAFF-R+、CD4+、CD8+、CD4+CD25+CD127-/low、CD134+、CD4+CD134+和CD19+BAFF-R+的表达率,计算CD4/CD8比值;对活检组织进行病理分析和免疫组织化学分析。结果:肾移植受者外周血单个核细胞上BAFF的表达率在0.18%～76.97%之间。将15%设为临界值,所有数据分成≥15%组和<15%组进行统计分析。在≥15%组,BAFF表达率为36.91%,与CD4/CD8比值、CD4+CD25+CD127-/lowT细胞之间不相关。然而,BAFF+细胞数与CD134+细胞和CD4+CD134+细胞存在显著相关性(分别为P<0.01和P<0.05)。而在<15%组,各指标之间没有显著相关性。病理诊断证实慢性排斥的移植肾组织,BAFF表达于肾小管上皮细胞胞浆/胞膜。结论:BAFF在肾移植受者外周血单个核细胞的异常高表达可能与同种肾移植排斥反应相关。更多还原

【Abstract】 BACKGROUND: B cell activating factor belonging to tumor necrosis factor family (BAFF) is essential to B cell differentiation, maturation, survival, and antibody secretion via binding to its receptors, and may play a role in the development of T cell response. Whether or not BAFF signal participates in the kidney allograft rejection is worthy of studying. OBJECTIVE: To analyze the expression and potential bioactivity of BAFF in the peripheral lymphocytes of kidney transplant recipients. DESIGN, TIME AND SETTING: A case observation was performed at the Department of Urology, Third Affiliated Hospital of Soochow University from June 2006 to March 2007. PARTICIPANTS: Eighty-six kidney transplant recipients comprising 60 males and 26 females, aged 12-62 years old, who received first-time kidney transplantation, were included. The serum creatinine levels ranged between 65-267 μmol/L. METHODS: Peripheral blood of follow-up recipients was taken for anticoagulation using EDTA-Na2. Renal graft biopsy samples of some patients were collected. MAIN OUTCOME MEASURES: The expression rates of BAFF+, BAFF-R+, CD4+, CD8+, CD4+ CD25+ CD127-/low, CD134+, CD4+ CD134+ and CD19+ BAFF-R+ in peripheral mononuclear cells were analyzed, and the ratio of CD4/CD8 was calculated. Biopsy tissue was subjected to pathological and immunohistochemical analyses. RESULTS: BAFF expression rate on the peripheral mononuclear cells was between 0.18%-76.97%. 15% was used as the cut-off value. In the ≥15% group, the mean value of BAFF expression rate was 36.91%; BAFF+ mononuclear cells were not significantly correlated to the ratio of peripheral CD4+/CD8+ and the CD4+ CD25+ CD127-/low T lymphocytes. However, there were significant correlations between BAFF+ mononuclear cells and CD134+ lymphocytes or CD4+ CD134+ lymphocytes (P < 0.01, P < 0.05, respectively). While in the < 15% group, there were no significant correlations among all indices. Pathological diagnosis confirmed that BAFF was expressed in the renal tubular epithelial cell cytoplasm and cytomembrane staining of some chronic rejection sections. CONCLUSION: Abnormal high expression of BAFF in peripheral mononuclear cells may be related to renal allograft rejection.更多还原