The study of corelationship between the level of immunosuppression and the cytokine levels in kidney transplant recipients.

本研究检测了CsA与类固醇在体内对肾移植受体单核细胞产生细胞因子的能力及其信使RNA（mRNA）水平上基因表达的影响。与正常人相比，csa -泼尼松龙（Pred）处理的受体外周血单核细胞（PBMC）对IL-2的抑制作用为40-50%，对γ - ifn产生的抑制作用为66%。硫唑嘌呤（azathiopine， AZ）预处理的受体对IL-2和γ - inf生成的抑制作用明显低于CsA治疗的患者。CsA-Pred处理的受体巨噬细胞（mphi）也显示出60.0%的抑制（5.1% + 0.7%）U/ml, n=20, p<0.01)，与正常人（13.0 +2.9U/ml, n=21）比较。这些结果通过IL-2、γ - ifn和il - 1 （β）的CDNA探针实验得到证实。通过杂交判断，在正常个体中，pra刺激的PBL中存在高水平的IL-2和γ - ifn mRNA， lps刺激的mphi中存在高水平的IL-1(β) mRNA，而在CsA处理的受体中则没有。此外，还研究了急性排斥反应的发生与受体PBL上IL-2或转铁蛋白（TF）受体的表达之间的关系。急性排斥反应发生时，淋巴细胞表达IL-2或转铁蛋白受体的比例升高，提示IL-2或TF受体的测定是判断肾移植受者急性排斥反应的良好指标。

The present study examined the effects of CsA administered with steroid in vivo on the capacity of kidney transplant recipient mononuclear cells to generate cytokines and their gene expression at the level messenger RNA(mRNA). Peipherel blood mononuclear cells(PBMC) from CsA-Prednisolon(Pred) treated recipients displayed 40-50% inhibition of IL-2 and 66% inhibition of gamma-IFN production compared with normal individuals. Azathioprine(AZ)-pred treated recipients displayed significantly less inhibition of IL-2 and gamma-INF generation than CsA treated patients. Macrophages(mphi) from CsA-Pred treated recipients also displayed 60.0% inhibition (5.l+O.7 U/ml, n=20, p<0.01) of IL-1 production compared with normal individuals (13.O+2.9U/ml, n=21). These result were confirmed by the experiments using CDNA probe for IL-2, gamma-IFN and IL-l(beta). High levels of IL-2 and gamma-IFN mRNA in PRA-stimulated PBL or IL-1(beta) mRNA in LPS-stimulated mphi were present in normal individuals, but not in CsA treated recipients as judged by hybridization. Moreover, the relationship between the onset of acute rejection crises and the expression of IL-2 or transferrin(TF) receptor on PBL from recipients was investigated.The percentage of lymphocytes expressed IL-2 or transperrin receptor was increased at the onset of acute rejection crises, indicating that the measurement of IL-2 or TF receptor is good indicater for acute rejection crises in kidney transplant recipients.