Monocyte infiltration and kidney allograft dysfunction during acute rejection
Monocyte infiltration and kidney allograft dysfunction during acute rejection
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DOI：
10.1111/j.1600-6143.2007.02109.x
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发表时间：
2008-03-01
影响因子：
8.8
通讯作者：
Kirk, A. D.
中科院分区：
文献类型：
--
作者：
Girlanda, R.;Kleiner, D. E.;Kirk, A. D.
多种细胞类型浸润急性排斥肾移植物。通常，单核细胞和T细胞占主导地位。虽然已知T细胞是急性排斥反应所必需的，但单核细胞影响这一过程的程度仍不完全确定。具体而言，尚未确定单核细胞在多大程度上影响排斥反应的临床表型，或者它们的影响与T细胞的影响相比如何。因此，我们研究了T细胞和单核细胞的相对影响，通过相关的免疫组织化学染色测量的肾功能的急性变化的幅度在活检时，在78例连续的组织学急性排斥反应患者的存在。我们发现，功能障碍与使用班夫标准评分的总体细胞浸润程度密切相关。然而，当考虑细胞类型时，单核细胞浸润与肾功能不全定量相关，而T细胞浸润则不相关。类似地，肾小管应激，如HLA-DR表达所示，随着单核细胞而不是T细胞浸润而增加。这些数据表明，急性同种异体移植物功能障碍与单核细胞浸润密切相关，而孤立的T细胞浸润对急性功能影响较小。这种关系可能是有用的分配急性临床相关性活检结果。
Multiple cell types infiltrate acutely rejecting renal allografts. Typically, monocytes and T cells predominate. Although T cells are known to be required for acute rejection, the degree to which monocytes influence this process remains incompletely defined. Specifically, it has not been established to what degree monocytes impact the clinical phenotype of rejection or how their influence compares to that of T cells. We therefore investigated the relative impact of T cells and monocytes by correlating their presence as measured by immunohistochemical staining with the magnitude of the acute change in renal function at the time of biopsy in 78 consecutive patients with histological acute rejection. We found that functional impairment was strongly associated with the degree of overall cellular infiltration as scored using Banff criteria. However, when cell types were considered, monocyte infiltration was quantitatively associated with renal dysfunction while T-cell infiltration was not. Similarly, renal tubular stress, as indicated by HLA-DR expression, increased with monocyte but not T-cell infiltration. These data suggest that acute allograft dysfunction is most closely related to monocyte infiltration and that isolated T-cell infiltration has less acute functional impact. This relationship may be useful in assigning acute clinical relevance to biopsy findings.