| | | 辛伐他汀对肾移植后高脂血症患者RANTES及其受体CCR5 mRNA表达的影响
| | 小论文下载 作者：史艳玲, 邹和群, 王玉新, 徐琴君, 唐孝达
【关键词】 ,肾移植
Effect of simvastatin on expression of RANTES and its receptor CCR5 mRNA in renal transplant recipients with hyperlipidemia
【Abstract】 AIM: To study whether hyperlipidemia after renal transplantation is related to the expression of RANTES (regulated on activation normal Tcell expressed and secreted) and its receptor CCR5 (chemokine receptor 5) mRNA in peripheral monocyte cells (PMCs) and to explore its therapy. METHODS: Renal recipients were divided into normal lipidemia group (n=30) and hyperlipidemia group (n=30) according to the serum lipid level 6-8 months after transplantation. The patients in the hyperlipidemia group were treated with simvastatin for 1.5 months (1.5month treatment group) or 3 months (3month treatment group). The control group consisted of 30 healthy subjects. Serum total cholesterol (TC), triglyceride (TG), lowdensity lipoprotein (LDL), highdensity lipoprotein (HDL) were measured and RTPCR was used to detect the expression of RANTES and CCR5 mRNA in PMCs. RESULTS: The renal function of all the patients was normal. TC, TG, LDL and expression of RANTES and CCR5 mRNA in the normal lipidemia group were lower than those in the hyperlipidemia group, but higher than those in control group (P<0.05), and those in 3month treatment group were significantly lower than those in 1.5month treatment group (P<0.05). CONCLUSION: The expression of RANTES and CCR5 mRNA is involved in the earlystage chronic injury of kidney allografts. Hyperlipidemia can strengthen the increased expression of RANTES and CCR5 mRNA. Simvastatin can reduce the expression of RANTES and CCR5 mRNA in the kidney transplant recipients with hyperlipidemia.
【Keywords】 kidney transplantation；hyperlipidemia；RANTES；RTPCR；simvastatin
【摘要】 目的小论文下载: 探讨肾移植术后高脂血症患者外周血RANTES (regulated on activation normal Tcell expressed and secreted)及其受体CCR5(chemokine receptor 5) mRNA表达及治疗. 方法: 根据患者肾移植术后6~8 mo的小论文下载血脂水平分血脂正常组（n=30）和血脂增高组（n=30），血脂增高组又根据辛伐他汀治疗时间分1.5 mo治疗组（n=30）和3 mo治疗组（n=30），并设正常对照组（n=30），利用RTPCR检测各组患者外周血RANTES和CCR5 mRNA表达水平. 结果: 各组肾功能正常，胆固醇酯，三酰甘油，低密度脂蛋白水平均按对照组，血脂正常组，血脂增高组顺序递增(P<0.05)，3 mo治疗组较1.5 mo治疗组有显著降低(P<0.05)；RANTES及其受体CCR5 mRNA表达水平按对照组，血脂正常组，血脂增高组顺序递增，1.5 mo治疗组和3 mo治疗组均较血脂增高组有显著降低（P<0.05)，而3 mo治疗组又明显低于1.5 mo治疗组(P<0.05). 结论： RANTES及其受体CCR5 mRNA表达可能在移植肾慢性损伤早期起作用；高脂血症能加重已增高表达，辛伐他汀治疗可降低表达.
【关键词】 肾移植；高脂血症；RANTES；逆转录聚合酶链反应；辛伐他汀
0引言
肾移植后约半数以上患者发生脂代谢紊乱，主要表现为胆固醇（cholesterol, CH），三酰甘油(triglyceride, TG)，低密度脂蛋白（LDL）和极低密度脂蛋白（VLDL）升高，高密度脂蛋白（HDL）降低［1］. 高脂血症不但是移植后心血管疾病发生的危险因子，也是移植肾慢性排斥发生的重要原因［2］. 趋化因子（chemokine）受体CCR5（chemokine receptor 5）是RANTES（regulated on activation normal Tcell expressed and secreted）的主要受体. 我们应用RTPCR方法检测肾移植术后高脂血症患者外周血中RANTES及其受体CCR5 mRNA水平，并观察辛伐他汀降脂治疗对其影响如下.
1材料和方法
1.1材料
肾移植患者60例，原发病为慢性肾小球肾炎，移植前血清总胆固醇（total cholesterol,TC），TG水平正常；术后6~8 mo：① 血脂正常组：TC<5.85 mmol/L或(和)TG<1.70 mmol/L，30（男16，女14）例，年龄（40±10）岁；②血脂增高组：TC>5.85 mmol/L或(和)TG>1.70 mmol/L，30（男17，女13）例，年龄（41±9）岁；血脂增高组予辛伐他汀治疗1.5 mo和3 mo时收集标本，即为1.5 mo治疗组和3 mo治疗组. 对照组为健康体检者30(男15，女15)例，年龄（40±9）岁. 抽取空腹静脉血，分成2份，一份检测血脂水平，一份分离外周单个核细胞(peripheral mononuclear cell, PMNC) 抽提总RNA. 抽血前1 mo内无感染性疾病史. 淋巴细胞分离液Ficol购自上海生物制品所；Trizol，氯仿，异丙醇，MMLV逆转录酶、RNA酶抑制剂，0.1 mol/L DTT，随机引物，dNTP，购自Gibco公司；Taq DNA聚合酶，2.5 mmol/L MgCl2，琼脂糖，购自Promega公司.
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