摘要
目的：探讨标记蛋白质在肾移植急性细胞性排异（ＡＣＲ）时的作用及其临床诊断意义。方法：选择一组具有重要生物学功能的蛋白质，如ＰＣＮＡ、Ｂｃｌ－２、ＩＬ－２Ｒ（ＣＤ２５）、ＩＣＡＭ－１、ＨＬＡ－ＤＲ等作为标记蛋白，着重观察移植肾发生ＡＣＲ时，肾小管和间质浸润细胞中上述标记蛋白的变化，及其与间质浸润ＣＤ４或ＣＤ８细胞的关系，并与未发生排异反应者作对照。结果：无ＡＣＲ的肾组织中，ＰＣＮＡ和ＤＲ蛋白仅轻度增加，Ｂｃｌ－２、ＩＬ－２Ｒ和ＩＣＡＭ－１的增加不明显。当移植肾出现ＡＣＲ时，上述标记蛋白均明显增加，尤以ＰＣＮＡ和ＩＬ－２Ｒ增加最为显著，且与间质浸润的ＣＤ８细胞密切相关。结论：鉴于ＩＬ－２Ｒ具有的独特免疫学作用，以及变化的选择性和特异性。
BJECTIVEThepaternofintragraftimmunologicaleventsassociatedwithacutecelularrejection(ACR)hasbenpreviouslydefined.METHODOLOGYInthisstudyweconductedaretrospectivesequentialstudytoobservetheclinicalsignificanceofvariousimmunologicalmarkersinrenalmaterialsobtainedfromhumanrenalalografts.Threto6consecutivealograftbiopsieswereperformedincasesof17transplantpatientsoveraneight-monthperiod.Atotalof59corenedlebiopsieswerecolectedandexamined.Theexpresionofprolif-erationcelnucleusantigen(PCNA),interlukin-2receptor(IL-2R),intercelularadhesionmolecule-1(ICAM-1),andHLA-DRinthetubulesandinterstitialinfiltrates,aswelasthepresenceofCD4/CD8Tcelinfiltrateswereasesedbyimmunocytochemicalstainingoffrozensections.RESULTS WhenACRoccured,altheimmuneactivationmarkersmentioneaboveincreasedinamountintherenalspecimenssignificantlyascomparedwiththosespecimenswithoutACR.ThedegreeofincreamentforIL-2R(16.3fold)andPCNA(14.7fold)weremostconspicuous,folowedbyHLA-DR(4.7fold)andICAM-1(2.1fold).AfterMTX-pulseantirejectiontreatmenttheexpresionsofIL-2RandPCNAinbiopsieswereevidentlydown-regulatedforabout60%and47%respectively.HLA-DRwasthemostprevalentantigennotedduringexaminationofACRspecimens(96.7%ofsamples),buttheexpressionofthisproteinmaylastforalongtimeafterefectiveMTX-pulsetherapy.CONCLUSIONSTheresultsofthisstudysuggestedthattheincreasedexpresionofIL-2RandPCNAinrenalalograftmaybeausefulandhelpfuladjunctinthediagnosisofongoingacutecelularrejection,andthereductionoftheirexpressioninpost-treatmentspecimenmaypredictasuccesfulantirejectiontherapy.
出处
《肾脏病与透析肾移植杂志》
CAS
CSCD
1996年第6期15-19,共5页
Chinese Journal of Nephrology,Dialysis & Transplantation
关键词
肾移植
急性
细胞性
排异反应
免疫病理
renaltransplantationacutecelularrejectionimmunologicalmarker
