THE FINE-STRUCTURE OF HUMAN RECTAL EPITHELIUM IN ACUTE GRAFT VERSUS HOST-DISEASE
THE FINE-STRUCTURE OF HUMAN RECTAL EPITHELIUM IN ACUTE GRAFT VERSUS HOST-DISEASE
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DOI：
10.1097/00000478-198206000-00002
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发表时间：
1982-01-01
影响因子：
5.6
通讯作者：
THOMAS, ED
中科院分区：
文献类型：
--
作者：
GALLUCCI, BB;EPSTEIN, R;THOMAS, ED
对7例同种异体骨髓移植患者行胃肠道移植后直肠黏膜的精细结构进行了观察。与4例未患宿主病的受者进行比较。在GVHD中，淋巴细胞形成主要的细胞浸润。淋巴细胞通过点接触在肠细胞的细胞质膜上形成凹痕，向肠细胞核膜延伸出宽的假足，并包围桥粒。靶细胞的细胞膜从未被破坏。这些淋巴细胞与上皮细胞的接触代表了同种免疫t淋巴细胞溶解的识别阶段。肠细胞的损伤导致凝固性坏死和细胞凋亡（膜结合细胞碎片、sba、凋亡小体的形成）。在轻度GVHD中，上皮损伤和淋巴细胞浸润主要发生在隐窝基部，在重度GVHD中扩展到表面上皮。放化疗引起的损伤，在移植后早期出现，是弥漫性和严重的，但是短暂的。在GVHD中，肠细胞损伤、坏死和细胞间水肿持续时间超过放化疗引起的损伤消退时间。无GVHD的患者，在放化疗损伤消退后，直肠上皮几乎没有损伤，没有淋巴细胞数量增加的证据，也没有GVHD患者所描述的密切淋巴细胞-上皮细胞接触的证据。
The fine structure of the biopsied rectal mucosa of 7 allogeneic bone marrow transplant recipients who had gastrointestinal graft-vs. host disease (GVHD)was compared with that of 4 recipients without GVHD. In GVHD, lymphocytes formed the predominant cellular infiltrate. Lymphocytes indented the cytoplasmic membranes of enterocytes by point contact, extended broad pseudopods to the nuclear membranes of the enterocytes, and surrounded desmosomes. The membranes of target cells were never breached. These lymphocyte-to-epithelial-cell contacts represent the recognition phase of alloimmune T-lymphocyte cytolysis. Damage to the enterocytes resulted in both coagulative necrosis and apoptosis (the development of membrane-bound cell fragments.sbd.apoptotic bodies). Epithelial injury and lymphocytic infiltration predominated in the bases of the crypts in mild GVHD and extended to the surface epithelium in severe GVHD. Chemoradiotherapy-induced injury, present early post-transplant, was diffuse and severe but transient. In GVHD, damage to the enterocytes, necrosis and intercellular edema extended beyond the time of resolution of chemoradiotherapy-induced injuries. Patients without GVHD, studied after resolution of chemoradiation injury, had rectal epithelium with little or no injury and no evidence of either increased numbers of lymphocytes or of the intimate lymphocyte-to-epithelial-cell contacts described in those with GVHD.