抑炎因子IL-35与移植肾功能延迟恢复关系的研究

胡林昆; 陈城; 王卫珍; 赵晓俊; 李峰; 张学锋; 潘浩; 浦金贤; 侯建全

doi:10.3969/j.issn.1674-7445.2018.04.006

抑炎因子IL-35与移植肾功能延迟恢复关系的研究

doi: 10.3969/j.issn.1674-7445.2018.04.006

215006 江苏苏州，苏州大学附属第一医院泌尿外科（胡林昆、王卫珍、赵晓俊、李峰、张学锋、潘浩、浦金贤、侯建全）；常州市第一人民医院泌尿外科（陈城）

基金项目:

国家自然科学基金青年基金 81500572

江苏省临床医学科技专项——重点病种的规范化诊疗研究 BL2013013

详细信息

作者简介:
胡林昆，男，1983年生，博士研究生，主治医师，研究方向为肾移植临床及基础，Email：hulinkunsz@163.com

通讯作者:
侯建全，男，1960年生，博士研究生，主任医师，研究方向为泌尿系疾病基础及临床，Email：xf192@163.com

中图分类号: R617, R692.5
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出版历程
- 收稿日期: 2018-03-23
- 网络出版日期: 2021-01-19
- 刊出日期: 2018-07-15

Study on the relationship between anti-inflammatory cytokine IL-35 and delayed renal graft function

Department of Urology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China

More Information

Corresponding author: Hou Jianquan,Email：xf192@163.com

摘要

摘要: 目的探讨白细胞介素（IL）-35与移植肾功能恢复情况之间的关系。方法回顾性分析45例心脏死亡器官捐献（DCD）供肾肾移植受体的临床资料。根据肾移植术后是否发生移植物功能延迟恢复（DGF），所有受体分为早期肾功能恢复良好（IGF）组（32例）和DGF组（13例）。比较肾移植术后1、2、3、7、14、28 d及术后3个月、6个月、1年各时间点两组受体的血清肌酐（Scr）和估算肾小球滤过率（eGFR）水平；比较肾移植术后1、2、3、7、14、28 d各时间点两组受体血清和尿液IL-35含量。结果 DGF组受体术后肾功能恢复迟缓，术后7 d时Scr水平高于IGF组，eGFR水平低于IGF组，差异均有统计学意义（均为P < 0.05）。术后1年，两组受体Scr水平的差异无统计学意义，但eGFR仍存在较大差异，与IGF组相比，DGF组受体术后1年时eGFR仍降低（P < 0.05）。术后1、2、3、7、14 d，DGF组血清中IL-35含量均低于IGF组，两组比较差异均有统计学意义（均为P < 0.05）；术后28 d，与IGF组相比，DGF组血清IL-35含量反而升高，两组比较差异有统计学意义（P < 0.05）。术后1、2、3、7 d，DGF组尿液中IL-35含量均低于IGF组，两组比较差异均有统计学意义（均为P < 0.05）；术后14、28 d，两组受体尿液IL-35含量进行比较，差异均无统计学意义（均为P > 0.05）。结论肾移植术后受体血清和尿液中IL-35含量低与DGF发生存在一定的联系，提示术后早期受体全身和移植肾局部抑炎应答过弱，过度的炎症应答得不到有效控制，可能是DGF发生的重要原因。
- 肾移植 /
- 抑炎细胞因子 /
- 白细胞介素-35（IL-35） /
- 移植物功能延迟恢复（DGF） /
- 炎症应答 /
- 缺血-再灌注损伤（IRI） /
- 血清肌酐（Scr） /
- 估算肾小球滤过率（eGFR）
Abstract: Objective To investigate the relationship between the interleukin (IL)-35 and the recovery of renal graft function. Methods Clinical data of 45 recipients receiving renal transplantation from donation after cardiac death (DCD) were retrospectively analyzed. According to the presence of delayed graft function (DGF) after renal transplantation, all recipients were divided into the immediate graft function (IGF) group (n=32) and DGF group (n=13). The serum creatinine (Scr) level and estimated glomerular filtration rate (eGFR) in the recipients were statistically compared between two groups at 1, 2, 3, 7, 14, 28 d and 3, 6 and 12 months after renal transplantation. The IL-35 levels in the serum and urine samples of the recipients were statistically compared between two groups at 1, 2, 3, 7, 14, 28 d following renal transplantation. Results In the DGF group, the renal function was restored slowly. Compared with the IGF group, the Scr level was significantly higher, whereas the eGFR was considerably lower in the DGF group at postoperative 7 d (both P < 0.05). At 1 year after surgery, there was no significant difference in the Scr level between two groups. Compared with the IGF group, the eGFR in the DGF group was significantly lower at postoperative 1 year (P < 0.05). At 1, 2, 3, 7, 14 d after operation, the serum levels of IL-35 in the DGF group were evidently lower than those in the IGF group (all P < 0.05). Compared with the IGF group, the serum level of IL-35 in the DGF group was significantly increased at postoperative 28 d (P < 0.05). At postoperative 1, 2, 3, 7 d, the IL-35 levels in the urine samples in the DGF group were significantly lower than those in the IGF group (all P < 0.05). At postoperative 14 and 28 d, the IL-35 levels in the urine samples did not significantly differ between two groups (both P > 0.05). Conclusions The low levels of IL-35 in the serum and urine of recipients after renal transplantation are associated with the incidence of DGF to certain extent, prompting that excessively weak systemic and local anti-inflammatory responses early after renal transplantation and uncontrolled excessive inflammatory response are probably the pivotal causes of DGF.
- Renal transplantation /
- Anti-inflammatory cytokine /
- Interleukin-35 (IL-35) /
- Delayed graft function (DGF) /
- Inflammatory response /
- Ischemia-reperfusion injury (IRI) /
- Serum creatinine (Scr) /
- Estimated glomerular filtration rate (eGFR)

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图 1 两组受体肾移植术后1年内Scr及eGFR的动态变化

Figure 1. Dynamic changes of Scr and eGFR of recipients in two groups within 1 year after renal transplantation

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图 2 肾移植术后早期两组受体血清和尿液IL-35含量的变化

Figure 2. Changes of serum and urine IL-35 levels of recipients in two groups at early stage after renal transplantation

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