Monocytes and peritubular capillary C4d deposition in acute renal allograft rejection
Monocytes and peritubular capillary C4d deposition in acute renal allograft rejection
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DOI：
10.1046/j.1523-1755.2003.00921.x
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发表时间：
2003-05-01
影响因子：
19.6
通讯作者：
Tinckam, K
中科院分区：
文献类型：
--
作者：
Magil, AB;Tinckam, K
背景。同种异体肾移植物中补体分裂因子C4d的小管周围毛细血管沉积已被证明与循环抗供体抗体密切相关，并且是相对较差的移植物存活的标志。单核细胞/巨噬细胞（MO）浸润肾移植物已被证明会对移植物的存活产生不利影响。本研究的目的是评估这两种现象是否相关。来自15例患者的23例活检显示C4d的PTC弥漫性强染色（C4d+组）和急性小管损伤伴或不伴明显细胞排斥反应，而28例活检（急性排斥反应）PTC C4d阴性作为对照组（C4d-组）。C4d+组肾小球和间质MO浸润明显高于C4d-组[3.4 +/- 2.0 vs. 0.2 +/- 0.3 MO/肾小球，P < 0.0001；12.9 +/- 9.2 vs. 6.5 +/- 5.0 MO/high power field (hpf), P = 0.0030]。C4d+组肾小球和PTC的中性粒细胞（PMN）浸润也显著高于C4d- 1组（0.8 +/- 0.6 vs. 0.3 +/- 0.3 PMN/肾小球，P = 0.0003; 0.9 +/- 0.8 vs. 0.4 +/- 0.3 PTC PMN/hpf, P = 0.0035）。结果表明PTC C4d沉积与MO浸润密切相关，特别是肾小球，并证实了先前关于PTC C4d染色与PMN浸润相关的观察结果。
Background. Peritubular capillary (PTC) deposition of complement split factor C4d in renal allografts has been shown to be closely associated with circulating antidonor antibodies and a marker for relatively poor graft survival. Monocyte/macrophage (MO) infiltration of renal allografts has been shown to adversely affect graft survival. The purpose of this study was to assess whether the two phenomena are related.Methods. Twenty-three biopsies (from 15 patients) demonstrated diffuse strong staining of PTC for C4d (C4d+ group) and acute tubular injury with or without significant cellular rejection, while 28 biopsies (with acute rejection) but negative for PTC C4d served as controls (C4d- group).Results. The C4d+ group demonstrated significantly greater glomerular and interstitial MO infiltration than did the C4d- group [3.4 +/- 2.0 vs. 0.2 +/- 0.3 MO/glomerulus, P < 0.0001; 12.9 +/- 9.2 vs. 6.5 +/- 5.0 MO/high power field (hpf), P = 0.0030]. Neutrophilic (PMN) infiltration of glomeruli and PTC was also significantly greater in the C4d+ group than in the C4d- one (0.8 +/- 0.6 vs. 0.3 +/- 0.3 PMN/glomerulus, P = 0.0003; 0.9 +/- 0.8 vs. 0.4 +/- 0.3 PTC PMN/hpf, P = 0.0035).Conclusion. The results indicate a close association between PTC C4d deposition and MO infiltration, particularly glomerular, and confirm previous observations regarding the correlation of PTC C4d staining and PMN infiltration.