OBJECTTVE To investigate the relationship between allograft rejection and expression of lymphocyte costimulatorymolecules on peripheral blood cells in renal transplant recipients. METHODOLOGY This study included 42 renal transplantrecipiens who were divide into rejection group(18 cases)and non-rejection control group (24 cases with normal renal function).Expressions of CD28 and CTLA4, CD40 and its counter receptor CD40L molecules on CD4 + and CD8 + T lymphocytes were exam-ined by flow cytometry. RESULTS In the rejection group, the expressions of CD28, CTLA4, CD40 and CD40L molecules wereincreased. The increased CD28+ cells were mainly of CD4+ T lymphocyte subset. In contrast,the increased expression of CTLA4molecule was detected mainly on CD8+ T lymphocytes. The differences of expressions of CD28 molecule on CD8+ T cells,and ofCTLA4 molecule on CD4 + T cells between the two groups were not of significance. There was no significant difference in the ex-pressions of CD40 and CD40L molecules on CD4 + or CD8 + T lymphocytes between the two groups. CONCLUSION Renaltransplant rejection is associated with the increased expression of costimulatory molecules. Non T cells that highly express CD40and/or CD40L molecules may play important roles in renal transplant rejection. Examining the expression of costimulatorymolecules on peripheral blood cells is helpful to the diagnosis of rejection in clinic.%目的：探讨肾移植受者外周血T细胞CD28和CD40共刺激通路相关分子的表达及其与排斥反应的关系。 方法：采用流式细胞仪检测了42例肾移植受者外周血CD28、CTLA4、CD40及CD40L分子在CD4+T细胞和CD8+T细胞表面的表达。病例分为两组，排斥反应组18例，肾功能正常组(对照组)24例。结果：排斥反应组患者外周血CD28、CTLA4、CD40和CD40L分子的表达均增强，其中CD28+T细胞的增多主要表现在CD4+T细胞亚群，CTLA4分子的表达增强主要为CD8+T细胞。CD40及CD40L在CD4+或CD8+T细胞上的表达，排斥组与非排斥组间无显著差异。结论：肾移植排斥反应的发生与CD28和CD40共刺激通路的活化有密切关系，非T细胞表面CD40及CD40L分子表达的增强在排斥反应中可能也起着重要作用。检测外周血共刺激分子的表达，有助于临床排斥反应的诊断。
展开▼
