探讨骨髓间充质干细胞（MSCs）对肾移植受者T淋巴细胞分化和miRNA-155表达的影响。

选取2013年1月至2017年12月于福州总医院接受MSCs诱导+同种异体肾移植术的受者20例（MSCs组），对照组为同期配对的异体肾移植受者20例。两组患者术后免疫抑制方案均为霉酚酸酯+他克莫司+强的松。两组患者分别于移植术前、术后第15天抽取静脉血，流式细胞仪检测外周血CD4⁺ CD25⁺ FoxP3⁺ Treg细胞/?CD4⁺细胞亚群比值；ELISA检测白细胞介素2（IL-2）、肿瘤坏死因子α（TNF-α）和白细胞介素10（IL-10）浓度；免疫磁珠分选外周血T淋巴细胞后，Rea1-time PCR法检测外周血T淋巴细胞中miRNA-?155的表达。两组间均数比较采用独立t检验，治疗前后均数比较采用配对t检验。

移植前两组肾移植受者外周血CD4⁺ CD25⁺ FoxP3⁺ Treg细胞/?CD4⁺细胞比值、IL-2、IL-?10、TNF-α、T淋巴细胞miRNA-155表达水平差异均无统计学意义（P均> 0.05）；术后第15天，与对照组相比，MSCs组外周血CD4⁺ CD25⁺ FoxP3⁺ Treg细胞/?CD4⁺细胞亚群比值（30.44﹪?± 4.23﹪? vs 26.06﹪?±4.77﹪，t = 2.365，P = 0.042）、IL-10水平（20.35?ng/?L?±?5.10?ng/?L? vs 16.63?ng/?L±6.26?ng/?L，t = 2.062，P?=?0.046）上升，而IL-2（27.47ng/?L±4.30 ng/?L vs 31.40?ng/?L±5.33 ng/L，t = 2.252，P = 0.015）、TNF-α（41.52?ng/?L±8.32?ng/L vs 46.67?ng/?L±6.71?ng/L，t = 2.157，P = 0.037）和T淋巴细胞miRNA-155表达水平（1.61±0.31 vs 1.89±0.15，t = 3.688，P?= 0.001）则降低。

MSCs能够升高肾移植受者外周血CD4⁺ CD25⁺ FoxP3⁺ Treg细胞/?CD4⁺细胞比值和IL-10水平，降低IL-2、TNF-α和T淋巴细胞miRNA-155表达水平，与MSCs的免疫耐受诱导有关。

To explore the effect of bone mesenchymal stem cells (MSCs) on cell differentiation and miRNA-155 expression of T lymphocytes in patients receiving kidney transplantation.

From January 2013 to December 2017, twenty patients receiving kidney and MSC transplantation were enrolled. Another 20 matched patients served as control. The immunosuppression protocol was mycophenolate mofetil + tacrolimus + prednisone in both groups. Before transplantation and 15 days after transplantation, the ratio of CD4⁺ CD25⁺ FoxP3⁺ Treg cells to CD4⁺ cells in the peripheral blood was evaluated with a flow cytometer, serum IL-2, IL-10 and TNF-α levels were essayed by ELISA, and the expression of miRNA-155 in T lymphocytes was determined by Rea1-time PCR. Independent t test or paired t test was used for the comparison between the two groups or mean values before and after the treatment, respectively.

Before transplantation, no difference was observed between the two groups in terms of the ratio of CD4⁺ CD25⁺ FoxP3⁺ Treg cells to CD4⁺ cells, IL-2, IL-10 and TNF-α levels as well as the expression of miRNA-155 in T lymphocytes in the peripheral blood (P > 0.05 for all) . Fifteen days after transplantation the ratio of CD4⁺ CD25⁺ FoxP3⁺ Treg cells to CD4⁺ cells (30.44﹪± 4.23﹪ vs 26.06﹪±4.77﹪, t = 2.365, P = 0.042) and IL-10 levels (20.35 ng/L ± 5.10 ng/L vs 16.63 ng/ L±6.26 ng/L, t = 2.062, P = 0.046) were significantly increased, while IL-2 (27.47 ng/ L± 4.30 ng/L vs 31.40 ng/ L±5.33 ng/L, t = 2.252, P = 0.015) , TNF-α (41.52?ng/?L±8.32 ng/ L vs 46.67 ng/L±6.71 ng/ L, t = 2.157, P = 0.037) and miRNA-155 expression levels in T lymphocytes (1.61±0.31 vs 1.89±0.15, t = 3.688, P = 0.001) were significantly decreased in the MSC group compared with the control group.

The ratio of CD4⁺ CD25⁺ FoxP3⁺ Treg cells to CD4⁺ cells in the peripheral blood and serum IL-10 levels can be up-regulated by MSCs, while serum IL-2, TNF-α levels and the expression of miRNA-155 in T lymphocytes can be down-regulated by MSCs, which may be related to the induction of immune tolerance of MSCs.