论文部分内容阅读
目的探讨Th17细胞及相关因子白细胞介素-17(IL-17)在肝移植急性排斥反应中的变化及意义。方法收集2011年1月至2012年12月大连医科大学附属第二医院肝移植手术患者28例,根据移植肝组织穿刺活检病理诊断结果将肝移植的28例患者分为急性排异反应组6例和无排斥反应稳定组22例,15名健康体检者作为对照组。急性排斥组及稳定组在移植术后3 d和7 d,行肝穿刺活检病理检查;同时检测受检者外周血Th17细胞,受检者血清中IL-17水平。结果移植肝穿刺活检病理诊断显示急性排斥组随着移植时间延长,排斥反应逐渐增强。肝组织出现典型的细胞免疫性病理损伤,术后7 d肝脏汇管区、肝实质、小静脉壁、胆管上皮内及小叶间胆管被大量的淋巴细胞及嗜中性粒细胞包绕及浸润,胆管上皮细胞内空泡形成、上皮细胞凋亡。病理改变明显比术后3 d严重;急性排斥组患者术后3 d和7 d外周血Th17细胞比例及血清中IL-17含量较稳定组和对照组均明显增多(P<0.05),且Th17细胞及IL-17在术后急性排斥期7 d值均明显高于3 d(P<0.05)。结论 Th17细胞及IL-17在肝移植急性排斥反应的发生、发展中可能起着促进作用,外周血Th17细胞及IL-17的检测有可能成为肝移植急性排斥反应的早期诊断指标。
Objective To investigate the changes and significance of Th17 cells and related factors interleukin-17 (IL-17) in acute rejection after liver transplantation. Methods Twenty-eight patients undergoing liver transplantation at the Second Affiliated Hospital of Dalian Medical University from January 2011 to December 2012 were enrolled. According to the results of pathological diagnosis of transplanted liver biopsy, 28 patients with acute liver transplantation were divided into acute rejection group 22 cases of stable group without rejection and 15 healthy subjects as control group. The acute rejection group and stable group were examined by liver biopsy on the 3rd and 7th day after transplantation. The levels of IL-17 in sera of the peripheral blood of Th17 cells and the sera were also detected. Results The pathological diagnosis of transplanted liver biopsy showed that the rejection increased with the prolongation of transplantation in the acute rejection group. The hepatic tissue showed the typical cellular immunity pathological injury. The hepatic portal area, liver parenchyma, small vein wall, biliary epithelium and interlobular bile duct were surrounded and infiltrated by a large number of lymphocytes and neutrophils on the 7th day after operation. Epithelial cells within the formation of vacuoles, epithelial cell apoptosis. The pathological changes were significantly more severe than those on the 3rd postoperative day. Th17 cells in peripheral blood and levels of IL-17 in serum of the acute rejection group were significantly increased (P <0.05) on the 3rd and 7th day after operation compared with those in the stable and control groups (P <0.05) The acute rejection of cells and IL-17 at 7 days was significantly higher than that of 3 days (P <0.05). Conclusion Th17 cells and IL-17 may play an important role in the development of acute rejection in liver transplantation. The detection of Th17 cells and IL-17 in peripheral blood may be an early diagnostic indicator of acute rejection in liver transplantation.