Circulation:CD16依赖性自然杀伤细胞活化的遗传学和功能性分析可以识别心脏同种异体移植物脉管病的高风险患者

2017-11-03 xiangting MedSci原创

这项研究揭示了CD16依赖性NK细胞活化通路在促进移植动脉硬化中的重要作用。

心脏移植是治疗终末期心衰的有效疗法。由于心脏同种异体移植物脉管病(CAV)是心脏移植(HT)后期死亡的主要原因,因此需要识别导致CAV出现反映炎症或细胞毒性免疫机制的标志物。对危险患者进行无创和早期分层仍然是适应个体化治疗的挑战。最近,CD16(Fc-γ受体3A,FCGR3A)受体被鉴定为HT活组织中抗体介导的自然杀伤(NK)细胞活化的主要决定因素;然而,关于CD16在促进异体移植物脉管病中的作用仍知之甚少。这项研究旨在探讨反映CD16依赖性循环NK细胞活化的标志物是否可以识别HT后发生CAV的高风险患者。

采集103例接受常规冠脉造影来诊断是否为CAV的患者(HT后的中位数为5年)。在CAV阳性(n = 52)和无CAV的患者(n = 51)中比较FCGR3A/CD16Fc受体(FcR)谱的基因组和表型分析。使用非侵入性NK细胞体液活化试验(NK-CHAT)评估心脏移植受者(HTRs)中外周NK细胞的CD16表达和利妥昔单抗依赖性细胞毒性活性水平。

FCGR3A-VV基因型与HTRs的CD16表达水平增强和抗体依赖性NK细胞的细胞毒性功能有关。CAV+组比CAV-组FCGR3A-VV的基因型频率更高(比值比(OR):3.9,p= 0.0317)。使用多因素logistic回归模型,FCGR3A-VV基因型被确定为冠脉造影时与CAV存在相关的独立标记物。FCGR3A-VV基因型也被确定为基线CAV风险的独立预测指标(OR:4.7,p = 0.023)。

本研究揭示了CD16依赖性NK细胞活化通路在促进移植动脉硬化进展复杂阵列中的重要作用。它突出了非侵入性评估FCGR3A/CD16在CAV风险早期分层中的临床潜力。认识到CD16是控制免疫监视的主要检查点可以促进个体化的NK细胞靶向治疗的设计,以限制在高度敏感患者中的血管损伤。

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    2018-07-14 yeye5224612
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time=2017-11-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=258590, encodeId=abfd2585903b, content=谢谢分享.学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=50, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sat Nov 04 11:54:03 CST 2017, time=2017-11-04, status=1, ipAttribution=)]
    2018-04-30 xuyong535
  4. 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  5. 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  6. 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  7. 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    2017-11-04 清风拂面

    谢谢分享.学习了

    0

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