Circulating CD4(+)CD28null T Cells May Increase the Risk of an Atherosclerotic Vascular Event Shortly after Kidney Transplantation.
Circulating CD4(+)CD28null T Cells May Increase the Risk of an Atherosclerotic Vascular Event Shortly after Kidney Transplantation.
复制标题
循环中的 CD4(+)CD28null T 细胞可能会增加肾移植后不久发生动脉粥样硬化性血管事件的风险。
DOI：
10.1155/2013/841430
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发表时间：
2013
影响因子：
2.5
通讯作者：
Litjens NH
中科院分区：
文献类型：
--
作者：
Betjes MG;Weimar W;Litjens NH
无共刺激分子CD 28的促炎性CD 4 + T细胞（CD 4 + CD 28 null T细胞）在终末期肾病（ESRD）患者中扩增，并与动脉粥样硬化血管事件（AVE）相关。在一项前瞻性研究中，在295名接受肾移植前的ESRD患者中建立了循环CD 4 + CD 28 null T细胞的数量。在移植后的第一年内，20例患者发生了AVE。单因素分析显示，除了心血管疾病史外，（CVDpos，HR 8.1，P < 0.001），年龄（HR 1.04，P = 0.02），血脂异常CD 4 + CD 28 null T细胞百分比（HR 1.04/ %增加，95% CI 1.00-1.09，P = 0.01）与移植后AVE的发生显著相关。在多变量分析中，只有CVDpos仍然是一个显著的风险因素，CVDpos和CD 4 + CD 28 null T细胞%之间存在显著的正相互作用（HR 1.05，95% CI 1.03-1.11，P < 0.001）。在CVDpos组中，CD 4 + CD 28无效T细胞百分比最低三分位数的AVE发生率为13%，而最高三分位数的AVE发生率为25%。总之，循环中CD 4 + CD 28 null T细胞的存在与肾移植后不久心血管事件的风险增加有关。
Proinflammatory CD4+ T cells without the costimulatory molecule CD28 (CD4+CD28null T cells) are expanded in patients with end-stage renal disease (ESRD) and associated with atherosclerotic vascular events (AVE). In a prospective study, the number of circulating CD4+CD28null T cells was established in 295 ESRD patients prior to receiving a kidney allograft. Within the first year after transplantation, an AVE occurred in 20 patients. Univariate analysis showed that besides a history of cardiovascular disease (CVDpos, HR 8.1, P < 0.001), age (HR 1.04, P = 0.02), dyslipidaemia (HR 8.8, P = 0.004), and the % of CD4+CD28null T cells (HR 1.04 per % increase, 95% CI 1.00–1.09, P = 0.01) were significantly associated with the occurrence of a posttransplantation AVE. In a multivariate analysis, only CVDpos remained a significant risk factor with a significant and positive interaction between the terms CVDpos and the % of CD4+CD28null T cells (HR 1.05, 95% CI 1.03–1.11, P < 0.001). Within the CVDpos group, the incidence of an AVE was 13% in the lowest tertile compared to 25% in the highest tertile of % of CD4+CD28null T cells. In conclusion, the presence of circulating CD4+CD28null T cells is associated with an increased risk for a cardiovascular event shortly after kidney transplantation.