Th17细胞及白细胞介素-17在肝移植急性排斥反应中的意义

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。

Significance of Th17 and IL-17 to acute rejection following liver transplantation

Objective To explore the significance of Th17 and IL-17 in acute rejection following liver transplantation. Methods 28 cases of liver transplant patients were collected in the 2nd affiliated hospital of Dafian Medical University between January 2011 and December 2012. According to the pathological result of transplanted hepatic tissue biopsy, the patients were divided into acute rejection group （6 cases） and stable-graft group （22 cases）, with 15 healthy people as control. Both groups were performed liver biopsy for pathological diagnosis on the 3rd and 7th post-operative day （POD） ; Th17 in peripheral blood and the level of IL-17 in serum were detected. Results （1） Pathological examination showed an increased severity of graft rejection along with the post-transplantation time. Pathological changes at POD7 was more serious compared to POD3; （2） Th17 and IL-17 were significantly higher in acute rejection group compared to the stable-graft group and healthy group （ P 〈 0.05 ） , and their levels at POD7 were significantly higher compared to POD3 （ P 〈 0.05 ）. Conclusion Thl7 and IL-17 may play an important role in the development of acute rejection following liver transplantation. Th17 and IL-17 may serve as potential specific indicators for predicting allograft rejection.