胸腺内注射供体BMSCs对同种异体腹部皮瓣移植排斥的影响

目的:将供体骨髓间充质干细胞(bone marrow mesenchymal stem cells,BMSCs)胸腺内注射(intrathymic injection,IT)至受体胸腺,探讨其对同种异体腹部皮瓣移植排斥的影响及机制。方法:全骨髓贴壁培养法培养并纯化BN大鼠BMSCs,流式细胞术对其表型进行鉴定。受体Lewis鼠随机分为A组(空白对照组)、B组(BMSCs组)、C组(60Coγ射线4Gy全身照射组)、D组(全身照射+BMSCs组),每组6只。各组大鼠第0天进行同种异体腹部皮瓣移植,A组移植前14天IT PBS,B组移植前14天IT供体BMSCs,C组移植前15天给予60Coγ射线4Gy全身照射,移植前14天IT PBS,D组除移植前15天4Gy全身照射外,移植前14天IT供体BMSCs。大体观察移植皮瓣存活情况并绘制生存曲线,排斥终点流式检测脾细胞调节性T细胞(Treg)比例变化,体外混合淋巴细胞反应检测受体脾淋巴细胞对供体抗原反应性变化。结果:全骨髓贴壁培养法能够很好培养出BMSCs,其P3代流式细胞术表型鉴定结果为CD11b/c、CD45阴性,CD29、CD90阳性。B组的移植皮瓣存活时间与A组相比无明显差异(P>0.05),而D组的移植皮瓣平均存活时间较C组延长3.4天,差异具有统计学意义(P<0.01),脾细胞Treg比例显著增高(P<0.01),脾淋巴细胞对供体抗原反应性显著降低(P<0.05)。结论:IT供体BMSCs联合60Coγ射线4Gy全身照射通过上调受体脾细胞Treg比例能有效降低受体脾淋巴细胞对供体抗原的反应性,显著延长同种异体腹部皮瓣移植物存活时间。     

供体特异输注及FK506对同种异体小鼠心脏移植急性排斥反应的影响

目的:探讨供体特异输注(donor-specific transfusion,DST)及不同剂量FK506对同种异体小鼠心脏移植的影响.方法:应用显微外科技术制作颈部移植心脏急性排斥反应小鼠模型,将移植受体小鼠分为4组:对照组(单纯移植组,未加DST),DST 移植组,DST 移植 FK506(2meg/(kg·d))组,DST 移植 FK506(0.3mg/(kg·d))组,比较各组移植心脏生存时间,心肌病理改变及外周血血清细胞因子水平:血清IL-2,IL-4,IL-10和IFN-γ水平.结果:术前1天应用DST与连续应用较小剂量FK506可显著延长移植物存活.术后第七天病理检查发现联合应用DST和FK506的两组移植物急性免疫排斥反应明显比其他两组减轻.血清中IL-2和IFN-γ水平在联合应用DST和FK506的两组明显低于其它两组,IL-4和IL-10水平在联合应用DST和FK506的两组高于对照组和DST 移植组.结论:术前DST及持续应用较小剂量FK506可有效抑制同种异体小鼠颈部心脏移植术后急性排斥反应,显著延长移植物的生存时间.     

诱导性调节性T细胞抑制移植排斥反应的作用研究

目的:通过体外诱导的方法将幼稚CD4+T细胞(na觙ve CD4+T cell)转化为调节性T细胞(RegulatoryT cells,Tregs),并验证其在小鼠异体皮片移植模型上对移植排斥反应的抑制作用。方法:分选na觙ve CD4+T细胞并在体外诱导其转化为Tregs,流式检测细胞确定其转化率。将诱导性Treg(induced Treg,iTreg)与效应T细胞(Effective T cells,Teffs)以不同比例共同培养检测其对T细胞增殖的抑制能力。建立C57bl/6到Balb/c小鼠的异体皮片移植模型,植皮术后将iTreg经由股静脉输注入受体(Balb/c小鼠)体内,观察皮片存活情况,绘制皮片存活曲线。同时于皮片移植术后11天对皮片进行病理切片,观察移植排斥反应状况。结果:体外诱导na觙ve CD4+T细胞转化为iTreg的比例约44%,在iTreg:Teff比例大于1:4时,iTreg具有明显地抑制Teff增殖的作用,且这种抑制作用具有剂量依赖性。植皮小鼠输注iTreg后皮片存活时间较对照组延长约2.4天,病理切片显示排斥反应减轻,但皮片在14天左右时仍被排斥。结论:体外诱导的iTreg能够在体外抑制Teff增殖,且能有效抑制小鼠异体皮片移植后排斥反应。     

供体来源ImDex联合抗原特异性Treg保护大鼠肝脏移植物的研究

目的:探讨供体来源低剂量未成熟树突状细胞外来体(immature dendritic cells exosome,im Dex)联合供体抗原特异型调节性T细胞(regulatory t cells,Tregs)对于肝脏移植物的保护作用。方法:以BN-Lewis大鼠为供受体,建立大鼠原位肝移植模型。利用超高速梯度离心法获得im Dex,采用流式细胞术鉴定该im Dex的表型。不同剂量im Dex用于本移植模型,生存分析探究其对肝脏移植物的保护作用及该作用与剂量的相关关系。利用磁珠分选技术获得Treg,混合淋巴细胞培养获得供体抗原特异性Treg,将不同性质的Treg用于移植受体,验证抗原特异性Treg保护肝脏移植物。进一步探究两者联合使用的效果,应用免疫荧光、流式细胞术研究Treg在移植受体中的分布。结果:超高速梯度离心法分选出的im Dex具有im DC表型,其保护肝脏移植物的最佳作用剂量为20μg,Treg发挥保护移植物作用具有抗原特异性。两者联合应用组生存时间长于对照组(P0.05)。病理显示,输注的Treg分布于受体移植物。结论:Im Dex联合抗原特异性Treg可以有效保护大鼠肝脏移植物。     

CD4^＋CD25^＋Foxp3^＋调节性T细胞的体外扩增及其在移植物抗宿主病中的应用

同种异基因造血干细胞移植是急、慢性白血病及其他恶性血液病重要的治疗方法,但急慢性移植物抗宿主病（graft—versus-host disease,GVHD）作为异基因造血干细胞移植的主要并发症严重影响移植患者的存活率,阻碍移植的临床推广。很多研究发现,高表达Foxp3的CD4^＋CD25^＋调节性T细胞（regulatory T cells,Treg）不仅能控制急慢性GVHD的发生,而且不影响移植物抗白血病效应（graft-versusleukemia,GVL）,在急慢性GVHD发生发展及治疗方面有重要的作用。但Treg细胞在体内的数量很少,不能满足临床应用需求。目前应用外源的IL-2联合TCR、CD28信号通路共同刺激以及运用树突状细胞（dendritic cell,DC）刺激均能达到体外有效扩增Treg细胞的目的。这些扩增的Treg细胞在控制造血干细胞移植过程中急慢性GVHD的发生及防治自身免疫性疾病和移植排斥等方面具有明显作用,在疾病控制和临床应用中具有广阔前景。     

骨髓间充质干细胞在移植免疫方面的研究进展

骨髓间充质干细胞(Mesenchymal stem ells,MSCs)是存在于骨髓中一类低免疫原性的非造血成体干细胞,体外研究表明MSCs能够通过抑制混合淋巴细胞反应抑制抗原呈递细胞分化成熟及功能发挥、抑制CTL形成、抑制NK细胞活性、增加调节性T细胞比例等途径发挥免疫调节作用。体内实验证明,MSC输注能够延长狒狒异体皮肤移植的存活时间,而在小鼠心脏移植的模型中,体外诱导免疫耐受的MSCs在活体内反而加速了小鼠的排斥反应,临床上输注MSCs可缓解移植物抗宿主病(GVHD)。本文对MSCs的免疫学特性及免疫调控功能的研究进展作一综述。     

天然调节T 细胞与诱导调节T 细胞的生物学特性

CD4+CD25+FOXP3+的调节T细胞(regulatory T cells,Treg)在维持机体免疫平衡方面起着重要的作用。体外扩增Treg细胞用于治疗自身免疫病、哮喘及诱导器官移植免疫耐受引起人们极大的兴趣。Treg细胞可分为2个亚群,分别为nTreg和iTreg,两者有不同的生物学特性。nTreg在特定条件下,可以分泌具有促进炎症的IL-17;iTreg在体内可丢失FOXP3,失去其免疫抑制功能。Treg细胞用于临床治疗,还有许多问题需要研究解决。     

zVAD-fmk对未成熟树突状细胞诱导初始性CD4＋T细胞分化为调节性T细胞影响的体外研究

目的 研究 Caspase 通路在未成熟树突状细胞（imDC）诱导同种异体 CD4＋ T 细胞转化为调节性 T 细胞（Treg）中的作用及探讨免疫耐受机制建立可能的分子机制.方法 将人外周血分离、培养出的imDC 与健康胎儿脐血中分离CD4＋ T 细胞混合培养,同时加入zVAD-fmk,以流式细胞仪检测CD4＋CD25＋ T 细胞（Treg 细胞）转化率.结果 （1）imDC 的鉴定：外周血经诱导后分离的imDC,以流式细胞仪检测细胞表面分子,imDC 表面分子表达的结果：CD80（7.27 ± 0.13）、CD83（3.53 ± 0.35）、CD1a（4.29 ± 0.27）;（2）混合培养后CD4＋CD25＋T细胞的转化率结果为：空白组（1.78 ± 0.11）﹪、对照组（22.23 ± 0.77）﹪、低浓度zVAD-fmk 组（21.63 ± 0.82）﹪、中浓度zVAD-fmk 组（12.24 ± 0.54）﹪、高浓度zVAD-fmk 组（12.20 ± 0.96）﹪,结果对照组和低浓度组、中浓度组和高浓度组间比较,P 〉 0.05,其余各组间比较,P 〈 0.05.加入zVAD-fmk 并与imDC 细胞混合培养的T 细胞转化率相对于未加入阻断剂的T 细胞较低,同时Caspase 信号通路对zVAD-fmk 无浓度依赖性.结论 imDC 可以诱导同种异体初始性CD4＋ T 细胞分化为Treg.Caspase 信号通路特异性的阻断剂zVAD-fmk 可以部分抑制Treg 的转化,说明Caspase 信号通路在诱导免疫耐受中可能起了较为重要的作用.     

转hCTLA4-IgG基因小鼠移植皮肤在糖尿病大鼠创面存活的延 长

CTLA4-IgG是呈分泌性表达的CTLA4胞外区与人IgG恒定区的融合分子 ,可有效阻断T细胞B7-CD28共刺激信号通路,从而抑制T细胞活化、延长移 植物存活.糖尿病溃疡创面难愈合是其高致病力和高致残率的主要原因,而 及时有效的封闭创面是创面愈合的关键.异种（异体）皮肤是应用广泛的创 面覆盖物,但免疫排斥反应是移植皮肤存活的主要障碍.通过建立糖尿病大 鼠溃疡创面模型,研究表达人CTLA4-IgG蛋白的转基因小鼠皮肤在糖尿病大 鼠溃疡创面的存活及对创面愈合的影响.结果发现：糖尿病大鼠溃疡创面的 自然愈合时间显著长于正常大鼠(41.7±7.4 d vs 18.5±6.9 d, P <0.01),说明糖尿病大鼠及其溃疡模型已建立;在糖尿病大鼠创面,转 基因皮肤存活时间为22.2±5.8 d,显著长于野生型皮肤(8.2±1.8 d, P<0.01);在转基因皮肤移植后27d,糖尿病大鼠创面已完全愈合, 显著快于其自然愈合过程;在供、受体混合淋巴细胞反应（MLR）中,转基 因皮肤移植受体的淋巴细胞对供体抗原的应答能力与野生型皮肤移植受体无 显著差异.上述结果表明,移植皮肤表达人CTLA4-IgG蛋白可显著延长其在 糖尿病大鼠创面的存活时间,进而促进创面愈合,并对受体免疫系统无显著 的全身性影响     

CD4~+CD25~+ Treg细胞与移植免疫耐受

诱导器官移植受者对供者抗原的免疫耐受是防治同种异型移植排斥反应的最理想途径。目前认为,免疫耐受形成的主要机制包括:胸腺及骨髓阴性选择引起的克隆清除(Clonal deletion)、组织特异性自身抗原低表达引起的克隆忽视(Clonal ignorance)、阻断T细胞共刺激信号引起的克隆无能(Clonal anergy)、嵌合体(Chimerism)的形成、调节性T细胞(Regulatory Tcell,Treg)介导的克隆抑制(Clonal suppression)等。近年来CD4+CD25+ Treg细胞的研究已成为免疫学界的热门课题之一。已知CD4+CD25+ Treg细胞存在于小鼠、大鼠和人体中,是机体自然存在的具有主动调节活性的T细胞,对维持自我耐受和控制自身免疫病发挥着重要作用。本文着重就CD4+CD25+ Treg细胞的免疫调节机制及其在诱导移植免疫耐受方面的研究进展做一综述。     

PD-1/PD-L1抑制剂对肺鳞状细胞癌患者调节性T细胞及其亚型的影响

摘要 目的：探讨PD-1/PD-L1抑制剂对肺鳞状细胞癌（鳞癌）患者调节性T细胞（Regulatory T cell，Treg细胞）及其亚型的影响。方法：2019年1月至2020年12月来我院就诊的肺鳞癌初诊患者纳入本项研究；患者均接受Nivolumab治疗，根据治疗效果不同，将患者分为缓解组（n=20）和无效组（n=20）；流式细胞术检测外周血总Treg细胞、PD-1+Treg细胞、CD150+Treg细胞、CTLA-4+Treg细胞、LAG-3+Treg细胞的比例。结果：缓解组外周血总Treg细胞、CTLA-4+Treg细胞和LAG-3+Treg细胞的比例分别为4.052±0.231%、1.616±0.099%和0.328±0.021%，无效组的比例分别为5.532±0.395%、3.277±0.224%和0.857±0.108%，差异均具有显著的统计学意义（t=3.239，P=0.009；t=6.776，P＜0.001；t=4.807，P＜0.001）；缓解组外周血PD-1+Treg细胞和CD150+Treg细胞的比例分别为0.195±0.016%和1.530±0.113%，无效组的比例分别为0.203±0.018%和1.787±0.157%，差异均不具有统计学意义（t=0.318，P=0.757；t=1.329，P=0.214）。结论：PD-1/PD-L1抑制剂治疗无效的肺鳞癌患者外周血总Treg细胞、CTLA-4+Treg细胞和LAG-3+Treg细胞的比例均显著升高。     

CD25+CD4+ regulatory T cells prevent graft rejection: CTLA-4- and IL-10-dependent immunoregulation of alloresponses.

Specific and selective immunological unresponsiveness to donor alloantigens can be induced in vivo. We have shown previously that CD25+CD4+ T cells from mice exhibiting long-term operational tolerance to donor alloantigens can regulate rejection of allogeneic skin grafts mediated by CD45RB(high)CD4+ T cells. In this study, we wished to determine whether donor-specific regulatory cells can be generated during the induction phase of unresponsiveness, i.e., before transplantation. We provide evidence that pretreatment with anti-CD4 Ab plus a donor-specific transfusion generates donor-specific regulatory CD25+CD4+ T cells that can suppress rejection of skin grafts mediated by naive CD45RB(high)CD4+ T cells. Regulatory cells were contained only in the CD25+ fraction, as equivalent numbers of CD25-CD4+ T cells were unable to regulate rejection. This pretreatment strategy led to increased expression of CD122 by the CD25+CD4+ T cells. Blockade of both the IL-10 and CTLA-4 pathways abrogated immunoregulation mediated by CD25+ T cells, suggesting that IL-10 and CTLA-4 are required for the functional activity of this population of immunoregulatory T cells. In clinical transplantation, the generation of regulatory T cells that could provide dynamic control of rejection responses is a possible route to permanent graft survival without the need for long-term immunosuppression.     

PDIA3 mRNA expression and IL-2, IL-4, IL-6, and CRP levels of acute kidney allograft rejection in rat

Kidney transplantation to treat end-stage renal disease has evolved rapidly from the first successful transplantations to the current widespread use of grafts from both cadaveric and living donors. But acute rejection is still a strong risk factor for chronic rejection in recipients of renal grafts. To investigate possible mechanisms, we describe a comparison between differentially proteins expression and immune markers profile (IL-2, IL-4, IL-6, and CRP) of acute rejection and the controls. Through quantitative real-time RT-PCR confirmation, PDIA3 mRNA and protein expression levels in serum and transplanted kidney in experiment group was significantly (P < 0.05) higher than that in control group. Immunity analysis showed that plasma IL-2, IL-4, IL-6, and CRP levels were higher in experimental rats than those in control rats. Our data thus indicate that PDIA3 might be potentially involve into the occurence and development of acute rejection response in renal transplantation and increased plasma IL-2, IL-4, IL-6, and CRP levels play an important role to prevent acute kidney allograft rejection in rats.     

Total body irradiation of donors can alter the course of tolerance and induce acute rejection in a spontaneous tolerance rat liver transplantation model

Liver transplantation is an established therapy for end-stage liver diseases. Graft rejection occurs unless the recipient receives immunosuppression after transplantation. This study aimed to explore the mechanism of acute rejection of liver allografts in rats pre-treated with total body irradiation to eliminate passenger lymphocytes and to define the role of CD4⁺CD25⁺ regulatory T cells in the induction of immunotolerance in the recipient. Male Lewis rats were used as donors and male DA rats were recipients. Rats were randomly assigned to the following four groups: control group, homogeneity liver transplantation group, idio-immunotolerance group and acute rejection group. After transplantation, the survival time of each group, serum alanine aminotransferase, total bilirubin levels, number of Foxp3⁺CD4⁺CD25⁺ regulatory T cells, expression of glucocorticoid-induced tumor necrosis factor receptor on T cell subgroups, histopathology of the hepatic graft and spleen cytotoxic T lymphocyte lytic activity were measured. In the acute rejection group, where donors were preconditioned with total body irradiation before liver transplantation, all recipients died between day 17 and day 21. On day 14, serum alanine aminotransferase increased significantly to (459.2±76.9) U L^?1, total bilirubin increased to (124.1±33.7) ??mol L^?1 (P<0.05) and the ratio of Foxp3⁺CD4⁺CD25⁺ regulatory T cells decreased significantly to 1.50%±0.50% (P<0.05) compared with the other groups. Analysis of the T cell subpopulations in the acute rejection group varied from the other groups. Histological analysis showed typical changes of acute rejection in the acute rejection group only. Preconditioning of the donors with total body irradiation eliminated passenger lymphocytes of the liver graft, and thus affected the course of tolerance and induced acute rejection after liver transplantation.     

CD4 + CD25<Superscript>high</Superscript> Regulatory T Cell Numbers and FOXP3 mRNA Expression in Patients with Advanced Esophageal Cancer Before and After Chemotherapy

We evaluated the changes in CD4 + CD25^high regulatory T (Treg) cells and FOXP3 mRNA expression in patients with advanced esophageal cancer as well as its clinical significance. For this purpose, the frequencies of peripheral blood Treg cells in 68 patients with advanced esophageal cancer and 40 healthy controls were determined by flow cytometry, and FOXP3 mRNA expression in Treg cells of 40 patients was determined by RT–PCR. The data show that Treg cell numbers were significantly higher (P < 0.01) in esophageal cancer patients (1.82 ± 0.54% of CD4 + T cells) as compared with healthy controls (1.52 ± 0.70% of CD4⁺ T cells). Treg cell numbers in the patients were significantly higher (P < 0.05) before chemotherapy (1.82 ± 0.54% of CD4 + T cells) than after chemotherapy (1.66 ± 0.58% of CD4 + T cells). Expression of the FOXP3 mRNA in the patients was significantly lower (P < 0.05) after chemotherapy (0.266 ± 0.028% of CD4 + T cells) than before chemotherapy (0.318 ± 0.027% of CD4 + T cells). It was, therefore, concluded that Treg cell numbers as well as FOXP3 mRNA expression in advanced esophageal cancer patients were significantly decreased after chemotherapy. Notably, FOXP3 gene may thus be involved in regulating the numbers and function of Treg cells in advanced esophageal cancer patients receiving chemotherapy.     

IL-17A and IL-2-Expanded Regulatory T Cells Cooperate to Inhibit Th1-Mediated Rejection of MHC II Disparate Skin Grafts

Several evidences suggest that regulatory T cells (Treg) promote Th17 differentiation. Based on this hypothesis, we tested the effect of IL-17A neutralization in a model of skin transplantation in which long-term graft survival depends on a strong in vivo Treg expansion induced by transient exogenous IL-2 administration. As expected, IL-2 supplementation prevented rejection of MHC class II disparate skin allografts but, surprisingly, not in IL-17A-deficient recipients. We attested that IL-17A was not required for IL-2-mediated Treg expansion, intragraft recruitment or suppressive capacities. Instead, IL-17A prevented allograft rejection by inhibiting Th1 alloreactivity independently of Tregs. Indeed, T-bet expression of naive alloreactive CD4+ T cells and the subsequent Th1 immune response was significantly enhanced in IL-17A deficient mice. Our results illustrate for the first time a protective role of IL-17A in CD4+-mediated allograft rejection process.     

Skin graft rejection elicited by beta 2-microglobulin as a minor transplantation antigen involves multiple effector pathways: role of Fas-Fas ligand interactions and Th2-dependent graft eosinophil infiltrates

Beta(2)-microglobulin (beta(2)m)-derived peptides are minor transplantation Ags in mice as beta(2)m-positive skin grafts (beta(2)m(+/+)) are rejected by genetically beta(2)m-deficient recipient mice (beta(2)m(-/-)). We studied the effector pathways responsible for the rejection induced by beta(2)-microglobulin-derived minor transplantation Ags. The rejection of beta(2)m(+/+) skin grafts by naive beta(2)m(-/-) mice was dependent on both CD4 and CD8 T cells as shown by administration of depleting mAbs. Experiments performed with beta(2)m(-/-)CD8(-/-) double knockout mice grafted with a beta(2)m(+/+) MHC class I-deficient skin showed that sensitized CD4 T cells directed at beta(2)m peptides-MHC class II complexes are sufficient to trigger rapid rejection. Rejection of beta(2)m(+/+) grafts was associated with the production of IL-5 in vitro, the expression of IL-4 and IL-5 mRNAs in the grafted tissue, and the presence within rejected grafts of a considerable eosinophil infiltrate. Blocking IL-4 and IL-5 in vivo and depleting eosinophils with an anti-CCR3 mAb prevented graft eosinophil infiltration and prolonged beta(2)m(+/+) skin graft survival. Lymphocytes from rejecting beta(2)m(-/-) mice also displayed an increased production of IFN-gamma after culture with beta(2)m(+/+) minor alloantigens. In vivo neutralization of IFN-gamma inhibited skin graft rejection. Finally, beta(2)m(+/+) skin grafts harvested from B6(lpr/lpr) donor mice, which lack a functional Fas molecule, survived longer than wild-type beta(2)m(+/+) skin grafts, showing that Fas-Fas ligand interactions are involved in the rejection process. We conclude that IL-4- and IL-5-dependent eosinophilic rejection, IFN-gamma-dependent mechanisms, and Fas-Fas ligand interactions are effector pathways in the acute rejection of minor transplantation Ags.     

Adipose Tissue-Derived Mesenchymal Stem Cells Increase Skin Allograft Survival and Inhibit Th-17 Immune Response

Adipose tissue-derived mesenchymal stem cells (ADSC) exhibit immunosuppressive capabilities both in vitro and in vivo. Their use for therapy in the transplant field is attractive as they could render the use of immunosuppressive drugs unnecessary. The aim of this study was to investigate the effect of ADSC therapy on prolonging skin allograft survival. Animals that were treated with a single injection of donor allogeneic ADSC one day after transplantation showed an increase in donor skin graft survival by approximately one week. This improvement was associated with preserved histological morphology, an expansion of CD4⁺ regulatory T cells (Treg) in draining lymph nodes, as well as heightened IL-10 expression and down-regulated IL-17 expression. In vitro, ADSC inhibit naïve CD4⁺ T cell proliferation and constrain Th-1 and Th-17 polarization. In summary, infusion of ADSC one day post-transplantation dramatically increases skin allograft survival by inhibiting the Th-17 pathogenic immune response and enhancing the protective Treg immune response. Finally, these data suggest that ADSC therapy will open new opportunities for promoting drug-free allograft survival in clinical transplantation.