Comparative analysis of immune cells participating in acute and chronic rejection of kidney allografts.

将介导慢性排斥反应(CR)的T细胞与介导急性排斥反应(AR)的T细胞相比较，研究其在移植肾慢性排斥反应中的作用。使用活检标本(23个CR和8个AR)进行两条线的分析。首先，通过检测移植物中CD4和CD8mRNA的表达来评估移植物中CD8和CD8+T细胞的浸润程度。CR组和AR组在CD4~+和CD8~+T细胞的浸润程度上无显著差异，强调了免疫学对CR进展的重要性。其次，通过检测Th1型细胞因子干扰素-γ和Th2型细胞因子IL-4的基因表达，研究浸润性T细胞的Th1型/Th2型极化。干扰素-γ在大多数CR标本中均有表达，CR组与AR组之间差异无统计学意义。而IL-4仅在2例CR和1例AR标本中表达，从病理特征看，后者的AR伴发CR。这些结果表明，大多数CR和AR是由Th1机制介导的，尽管有些CR同时表现出Th1和Th2的特征。

T cells mediating chronic rejection (CR) of human kidney allografts were characterized by comparing them with those mediating acute rejection (AR). Two lines of analysis were performed using biopsy specimens (23 CR and 8 AR). First, the extent of infiltration of CD4^+ and CD8^+T cells into allografts was assessed from mRNA expression of CD4 and CD8. The group of CR specimens was not significantly different from the group of AR specimens in terms of the extent of CD4^+ and CD8^+T-cell infiltration, underlining the importance of the immunological contribution to the progress of CR. Second, Th1/Th2 polarization in infiltrating T cells was investigated by measuring mRNA expression of interferon gamma (IFN-γ, a Th1 cytokine) and interleukin 4 (IL-4, a Th2 cytokine). IFN-γ expression was detected in most CR specimens, and was not significantly different between the group of CR specimens and the group of AR specimens. On the other hand, IL-4 expression was detected in only two CR specimens and one AR specimen ; from its pathological features, the AR in this last case was concomitant with CR. These results suggest that most cases of CR and of AR are mediated by Th1 mechanisms, although some cases of CR show features of both Th1 and Th2.