ABSTRACT
Objective To investigate the effects of commonly used inductive agents on peripheral blood monocytic myeloid-derived suppressor cells (M-MDSCs) in renal transplantation recipients and to discuss their possible mechanism.Methods The enrolled patients received rabbit anti-thymocyte globulin (rATG) or basiliximab for induction therapy,with the maintenance immunosuppressive regimen of tacrolimus,mycophenolate mofetil and steroid.The number of CD11 b + CD33 + HLA-DR-CD14 + CD1 5-M-MDSCs and cytokine levels in peripheral blood,including interferon-γ(IFN-γ),interleukin-2 (IL-2),IL-4 and IL-6,were measured by flow cytometry before and 1 week,2 weeks,1 month,2 months,3 months after operation.Results A total of 47 recipients (29 given rATG 29,and 18 given basiliximab) were included in this study.Compared to the patients with basiliximab,asignificant increase in the frequency of M-MDSCs was observed in the rATG group at 2nd month after operation (5.5％ ± 2.8％ vs.3.8％ ± 1.6％,P＜0.001) and at 3rd month after operation (7.0 ％ ± 3.1％vs.4.1％ ± 2.3 ％,P＜ 0.001),while there was no significant difference in the cell number between the two groups.In the cytokine detection,levels of IL-2 and IL-4 in the rATG-treated recipients were significantly higher at 2nd weekpostoperation (Pr2 =0.032,and PIL-4 =0.019)and 1st month postoperation (PIL-2 =0.024,PIL-4 ＜0.001) than the basiliximab group.Conclusions ATG promotes the expansion of M-MDSCs,which is associated with the secretion of IL-2 and IL-4 due to the lymphocytes depletion.The synergistic immunosuppressive effect may contribute to the induction of immune tolerance.
ABSTRACT
Objective To evaluate the efficiency of treatment of iliac-femoral venous thrombus(I-FVT)via double femoral veins.Methods Eighteen patients with I-FVT were treated with implantation of inferior vena caval filter,catheter-directed cut,balloon-directed extend and drag.Some patients were treated with ATD or OASIS catheter.After operation,the catheter was kept in iliac-femoral veins for one to six days.Meanwhile,strict anti-coagulation was necessary.Results The treatment was successful in seventeen patients,the iliac-femoral veins were patent after the opration.Swollen symptom of lower limb and pain disappeared in fifteen patients,swollen symptom of lower limb became better in two patients.The treatment was fail in one patient.Follow-up study showed no pulmonary embolization or recrudescence in all eighteen patients.Conclusion The treatment of I-FVT via double femoral veins is a safe and effective method,there are no serious complications.