Variation and significance of T helper 17 cells in peripheral blood in patients after liver transplantation / 器官移植

ABSTRACT

To study the relationship between T helper (Th) 17 cell [CD4 +interleukin (IL)-17 +T lymphocytes]in peripheral blood and acute rejection in patients after liver transplantation.Methods A total of 76 patients receiving orthotopic liver transplantation (OLT)for benign end-stage liver diseases in Department of Hepatobiliary and Pancreas-Spleen Surgery,Affiliated Beijing Chaoyang Hospital of Capital Medical University from June 2008 to December 2012 were included in this study. According to whether the acute rejection occurred after operation,the patients were divided into rejection group (n=17)and non-rejection group (n=59). All the patients were followed up regularly by routine. The incidence of rejection and the treatment of patients were recorded. Patients in the rejection group received liver biopsy when suffered acute rejection to decide the severity. The percentage of CD4 +IL-17 +T lymphocytes to CD4 +T lymphocytes (CD4 +IL-17 +T%)in peripheral blood in all patients was measured at different time pointspre-OLT,at regular intervals (3-6 months)within 1 year after hospital discharge or before the treatment of acute rejection and after the remission (3-6 months). The CD4 +IL-17 +T% of every time point were compared between two groups.The correlations of CD4 +IL-17 +T% with the rejection activity index (RAI ), blood concentration of immunosuppressor were analyzed.Results The acute rejection occurred in 0.7-12.0 (median2.5 ) months after OLT. The CD4 +IL-17 +T% in the rejection group increased significantly compared with that in the non-rejection group after OLT [(2.56 ±0.43)%vs. (1.79 ±0.44)%,P<0.001]. In the rejection group,the CD4 +IL-17 +T% increased significantly when acute rejection occurred compared with that when acute rejection had not occurred [(2.56 ±0.43)%vs. (1.50 ±0.25)%,P<0.001)]. The variation of CD4 +IL-17 +T%was not obvious at different time points in non-rejection group (P >0.05 ). The CD4 +IL-17 +T% was positively correlated with RAI when acute rejection occurred in the rejection group (r=0.72,P=0.001 ).The blood concentration of tacrolimus,cyclosporin in rejection and non-rejection group were not correlated with CD4 +IL-17 +T% (r=0.21,-0.13;both in P>0.05). Conclusions CD4 +IL-17 +T%in peripheral blood can be used as a monitoring index for deciding and assessing severity of acute rejection after OLT. The increase of CD4 +IL-17 +T% in peripheral blood indicates a severe acute rejection.