Compromised immune status of patients with post-liver transplant biliary complications.
Compromised immune status of patients with post-liver transplant biliary complications.
复制标题
肝移植后胆道并发症患者免疫状态受损
DOI：
10.1097/cm9.0000000000001088
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发表时间：
2020-11-05
影响因子：
6.1
通讯作者：
Lyu Y
中科院分区：
文献类型：
--
作者：
Lei H;Tian M;Zhang XG;Meng LS;Zhu WH;Liu XM;Wang MZ;Wang T;Chang PK;Chen H;Wang B;Wu RQ;Lyu Y
免疫抑制（IS）是肝移植（LTx）患者不可或缺的，以控制不必要的同种免疫反应，这主要是由T细胞介导的。然而，T细胞的抗原非依赖性稳态对于维持长期T细胞介导的免疫至关重要，过度IS可能增加机会性感染和恶性肿瘤的风险。因此，LTx患者的IS治疗应根据个体患者的免疫状态进行调整。[1]胆道并发症（BC），包括胆管狭窄和胆管炎，是LTx后最常见的并发症。然而，这些患者的免疫学特征，特别是T细胞介导的免疫功能尚不清楚，人类T细胞是异质性的，根据CD45RA和CD62L的表达，具有不同的亚群和功能。这些细胞包括幼稚细胞（Tn，CD45RA + CD62L+）、干细胞记忆T细胞（Tscm，CD45RA + CD62L + CD95+）、中枢记忆细胞（Tcm，CD45RA + CD62L+）、效应记忆细胞（Tem，CD45RA-CD62L-）和终末分化效应子亚群（CD45RA + CD62L-）。记忆比幼稚T细胞更有效地控制病原体。TSCM是记忆T细胞的一个专门子集，直接从幼稚前体分化而来。TSCM在抗原引发后重建记忆T细胞的全部多样性，并通过自我更新维持其自身的池大小。[2]然而，人Tscm向Tcm或Tem的分化以及它们在LTx患者中的功能尚不清楚。
Immunosuppression (IS) is indispensable for liver transplant (LTx) patients to control the unwanted alloimmune responses, which are mainly mediated by T cells. However, antigen-independent homeostasis of T cells is vital for sustaining long-lived T cell-mediated immunity, and excessive IS may increase the risk of opportunistic infections and malignancies. Therefore, IS therapy for LTx patients should be tailored to the immune status of the individual patient.[1] Biliary complications (BC), including biliary strictures with cholangitis, are the most common complications after LTx. However, the immunological characteristics especially T cell-mediated immunity of these patients are unknown yet.Human T cells are heterogeneous with different subsets and functions according to the expression of CD45RA and CD62L. The cells include naïve cells (Tn, CD45RA+ CD62L+), stem cell memory T cells (Tscm, CD45RA+CD 62L+CD95+), central-memory cells (Tcm, CD45RACD62L+), effector-memory cells (Tem, CD45RA-CD62L-), and terminally differentiated effector subsets (CD45RA+ CD62L-). Pathogens are controlled more efficiently by memory than by naïve T cells. Tscm are a specialized subset of memory T cells that differentiate directly from naïve precursors. Tscm reconstitute the full diversity of memory T cells upon antigen priming and maintain their own pool size through self-renewal.[2] However, the differentiation of human Tscm to Tcm or Tem, and their function in LTx patients are unclear.