关键词:

Abstract:

Objective To assess the impacts of sirolimus（SRL）and tacrolimus（TAC）on immune conditionin renal transplant recipients，in order to find the optimal immunosuppressive regimens. Methods According to the different immunosuppressive regimens，18 living donor renal transplant recipients with stable renal functionwere divided into two groups ：SRL group（n ＝ 8）on SRL + mycophenolate mofetil（MMF）+ prednisone（Pred）and TAC group（n ＝ 10）on TAC + MMF + Pred. All the patients received the immunosuppressive regimens for atleast one year. The living donors were chosen as the blank control. All the subjects of the 3 groups were examined for the proportion of Regulatory T（Treg）cells（CD4+CD25+Foxp3+）and Regulatory B（Breg）cells（CD19+CD5+CD1d+） in their peripheral blood mononuclear cells（PBMCs）by flow cytometry. After stimulation by the corresponding donor's PBMCs，the recipient's PBMCs were measured through the production of interferon-γ（IFN-γ）and interleukin-10（IL-10）of the recipient's PBMCs of SRL group and TAC group were measured by enzyme-linkedimmunospot assay（ELISPOT）. Results The proportion of CD4+ CD25+ Foxp3+ Treg in the SRL group，TACgroup and blank control group were（6.68±0.42）％，（3.59±0.47）％ and（6.59±0.36）％，respectively. The ratio of the SRL group and blank control group were significantly higher than that of the TAC group（both P ＜ 0.05），and there was no statistically significant difference between the SRL group and blank control group（P ＞ 0.05）. Theproportion of CD19+CD5+CD1d+ B cells in the SRL group，TAC group and blank control group were（16.43±3.56）%，（13.09±1.64）％ and（16.58±1.31）％，respectively. There were no statistically significant differences among thethree groups（all P ＞ 0.05）. The frequency of the cellsproducing IFN-γ in the SRL group and TAC group detectedby ELISPOT were（117.00±21.54）/ 500 000 and（126.00±24.08）/ 500 000，without significant difference （P ＞ 0.05）. The frequency of the cellsproducing IL-10 in the SRL group and TAC group were（347.00±55.29）/ 500 000 and（249.00±58.97）/ 500 000，without significant difference（P ＞ 0.05）. Conclusion The regimenbased on SRL shows no effect on the percentage of Treg of PBMC in long-term renal transplant recipients，however， the regimen based on TAC reduces the percentages. Meanwhile，both the regimens have no impact on the proportionof Breg in the peripheral CD19+ B cells and on the donor-specific immune reaction.