| |
[摘要]：Background. Sialoadhesin (CD169) facilitates T-cell priming when overexpressed on inflammatory monocytes. Monocyte-derived macrophages prime acute cellular rejection after intestine transplantation (ITx). The purpose of this study was to evaluate whether CD169-expressing activated monocytes associate with or predict ITx rejection. Methods. After informed consent (ClinicalTrials. gov NCT No. 01163578), activated CD169+ CD14+ monocytes were measured by flow cytometry in five normal healthy adult volunteers (group A), and 56 children with ITx sampled cross-sectionally (group B, 26), longitudinally (group C, 18), or during infection/inflammation without rejection (group D: acute enteritis, 9; Helicobacter pylori, 1; Streptococcal pharyngitis 1; and posttransplant lymphoma, 1). Activated monocytes were tested for correlations with donor-specific alloreactivity in simultaneous mixed lymphocyte co-cultures. Results. Median age was 3 years (range 0.5-21 yr), and distribution of ITx-alone: combined liver-ITx was 25:31. Higher frequencies (%) of activated monocytes were seen during rejection in group B and infection/inflammation without rejection in group D (58 +/- 28 and 73 +/- 26), compared with nonrejectors or normal controls (10.6 +/- 7.9 or 10.7 +/- 6.5, P = 0.001). In longitudinal monitoring, rejectors also showed higher activated monocyte frequencies (%) before ITx (64 +/- 26 vs. 13.4 +/- 8.6, P = 0.0007) and during acute cellular rejection (55 +/- 28 vs. 22.4 +/- 15, P = 0.006) when compared with nonrejectors. Activated monocytes correlated significantly with allospecific CD154+ T-cytotoxic memory cells (Spearman r = 0.688, P = 7.1E - 05) and CD154+ B cells (r = 0.518, P = 0.005) in ITx recipients without inflammation/infection but not in group D. Conclusions. Monocytes overexpress sialoadhesin nonspecifically during ITx rejection and systemic or enteritic inflammatory states. When combined with allospecific T and B cells, this information may differentiate between rejection and other enteritides. |
|
