The Role Of CD4~+CD25~+ Regulatory T Cell,CD40~+ Cell And CD40L~+ T Cells In Immune Regulation After Liver Transplantation

Objective:To detecte the level of CD4+CD25+ regulator T cells, CD40+ cells and CD40L+ T cells in peripheral blood by flow cytometry and analysis the relationship between their level and the immune complications such as acute rejection.Methods:(1) Fifty-two recipients after allogeneic liver transplantation were studied during May 2003 to November 2009 in our hospital, and their clinical data and liver and renal function test were recorded, and the level of CD4+CD25+ regulator T cells, CD40+ cells and CD40L+ T cells levels in their peripheral blood was tested by flow cytometry. (2) The patients were divided into three groups according to the clinical symptoms and laboratory tests (normal group, acute rejection group and drug-reaction group) (3) Analyse the relationship between the three groups.Results:(1) CD4+CD25+ regulator T cells:acute rejection group (7.05±2.41) was significantly higher than the normal group (3.84±1.87) and drug-reactive group (2.43±0.96) (t=3.218,P=0.000,t=4.627, P=0.000), the normal group was higher than drug-reaction group (t=1.408, P=0.041). (2) CD40+ cells:acute rejection group (31.44±2.24) was significantly higher than the normal group (23.78±0.99) and drug-reactive group (17.35±0.94) (t=7.663, P=0.000; t=14.084; P=0.000) the normal group was significantly higher than drug-reaction group (t=6.420, P=0.003). (3) CD40L+ T cells: acute rejection group (1.44±0.74) was significantly higher than the normal group (0.24±0.22) and drug-reactive group (0.19±0.13) (t=1.198, P=0.000; t=1.251, P=0.000). There was no significant difference between the normal group and the drug-reaction group(t=0.053, P=0.715). (4) The immunosuppressant FK-506 trough concentrations in peripheral blood:drug reaction group (14.79±3.85 ng/mL) was significantly higher than the normal group (5.70±2.76 ng/mL) and acute rejection group (4.32±2.06 ng/mL) (t= 9.087, P=0.000; t=10.476, P=0.000). There was no significant difference between the normal group and acute rejection group (t=1.388, P=0.156).Conclusions:CD4+CD25+ regulator T cells, CD40+ cells and CD40L+ T cells can reflect the patients'immune status. CD4+CD25+ regulator T cells, CD40+ cells and CD40L+ T cells were increased during acute rejection, and CD4+CD25+ regulator T cells and CD40+ cells were decreased during drug reaction. CD4+ CD25+ regulator T cells, CD40+ cells and CD40L+ T cells in peripheral blood can be used to evaluate patients'immune status after liver transplantation, and to identify complications associated with liver transplantation.