IL-12P70及IFN-γ在预测肾移植术后急性排斥反应中的应用

【Objective】To study the values of serum IL-12P70, IFN-γ, and IL-4 concentration in prediction of early immune state of the renal allograft recipients. 【Methods】The subjects were 52 patients (28 men and 24 women, mean age 42.3 years, S=13.9) who underwent renal allograft transplantation from a cadaveric donor between January 2008 and December 2009 at Department of Renal Transplantation of The Third Affiliated Hospital of Sun Yat-sen University. They were divided into 3 groups: Normal, acute rejection, and infection group. Serum samples were collected before transplantation and at 1, 5 days post-transplantation. IL-12P70, IFN-γand IL-4 serum level were determined by an Double-antibody-boated ELISA method using Invitrogen system kits. By contrast the cytokines levels among the three group patients, the value of the cytokines profiles in indicating immune state was studied prospectively. A P value of 0.05 or less using the SPSS software (version 15.0) was considered significant. The difference of the serum concentrations of these cytokines among the three groups was tested using One-Way ANOVA, and LSD-t test and SNK-q test were used to test the difference between groups. Receiver operating characteristic (ROC) curve was used to evaluate the diagnosis value of the variables. 【Results】There were no significant differences in the mean pre-transplantation and at 1 day post-transplantation serum IL-12P70, IFN-γconcentration and IFN-γ/IL-4 among the threegroups. There were no significant differences in the mean serum IL-4 concentration pre-transplantation and 1 and at 5 days post-transplantation among the three groups. The mean levels of IL-12P70, IFN-γand IFN-γ/IL-4 at 5 days post-transplantation were significantly higher among acute rejection group compared with the other two groups. Additionally, mean serum IL-12P70, IFN-γ concentration at 5 days post-transplantation were significantly higher than pre-transplantation and 1 day post-transplantation (9.012 ±0.736 vs 6.613±0.598; 40.402±13.414 vs 31.539±13.323, P＜0.05). ROC curve showed that the value of IL-12P70, IFN-γ, IL-4, IFN-γ/IL-4 at 5 days post-transplantation were 0.975, 0.808, 0.492, and 0.708, respectively. The predict index of IL-12P70 and IFN-γ was 7.4 pg/Ml (sensitivity 100%, specificity 85.0%), 31.48 pg/mL(sensitivity 83.3%, specificity 85.0%) respectively. 【Conclusion】Concentration of serum IL-12P70 or IFN-γis favorable index in prediction of early immune state of the renal allograft recipients. We suggest that the monitoring of IL-12P70 and IFN-γof renal allograft recipients be used to evaluate the subsequent 0-5 day immune state.