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Differential diagnosis between acute rejection and infection after lung transplantation : a basic, experimental and immunohistochemical study in rats.

肺移植后急性排斥和感染的鉴别诊断：大鼠的基础、实验和免疫组织化学研究。

基本信息

批准号：
02404055
负责人：
YAGYU Kuniyoshi
金额：
$ 1.98万
依托单位：
University of Tokyo
依托单位国家：
日本
项目类别：
Grant-in-Aid for General Scientific Research (A)
财政年份：
1990
资助国家：
日本
起止时间：
1990 至 1991
项目状态：
已结题

来源：
https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-02404055/
关键词：
Lung transplantation acute rejection rat mononuclear cell mycoplasma pneumonia bronchoalveolar lavage 肺感染

项目摘要

Infiltration pattern of mononuclear cell subpopulations in lung tissue and changes of cellular components in bronchoalveolar lavage (BAL) fluid were analyzed immunohistochemically in acute lung allograft rejection (BN/LEW) and mycoplasma pulmonis pneumonia in inbred rats. RESULTS : (1) All allotransplants developed acute rejection on day 2, and it advanced until day 6, demmonstrating severe perivascular and peribronchiolar infiltration of mononuclear cells. (2) In lung allograft rejection, marked infiltration of activated macrophages, moderate infiltration of helper and suppressor T lymphocytes, and slight or moderate infiltration of B lymphocytes were observed around bronchioles and vessels, as a thick layr of cells like concentric circles, forming a dense cuff. (3) In the mycoplasma pulmonis infection group, all rats developed acute or chronic bronchopneumonia. (4) In acute and chronic mycoplasma infection, focal inflammatory reactions were observed with various degrees of infiltration of mononuclear cell subpopulations around bronchioles and vessels, ranging from very mild to severe infiltration, even in the same section or even around the same bronchiole. (5) In BAL fluid, the number of total cells, macrophages, and neutrophils increased significantly both in the rejection group and infection group. CONCLUSIONS : The difference in the infiltration pattern between the focal, unequal and dappled infiltration in lung infection and the homogeneous and even cuff infiltration in acute rejection may be useful in differential diagnosis between acute rejection and infection after lung transplantation.

采用免疫组织化学方法分析近交系大鼠急性肺移植排斥反应（BN/LEW）和肺支原体肺炎肺组织中单核细胞亚群的浸润模式以及支气管肺泡灌洗（BAL）液中细胞成分的变化。结果：（1）所有同种异体移植物在第2天均出现急性排斥反应，并持续到第6天，表明血管周围和细支气管周围有严重的单核细胞浸润。 (2)同种异体肺排斥反应中，细支气管和血管周围可见活化巨噬细胞明显浸润，辅助性和抑制性T淋巴细胞中度浸润，B淋巴细胞轻度或中度浸润，呈同心圆状细胞厚层，形成致密的袖口。 (3)肺支原体感染组所有大鼠均出现急性或慢性支气管肺炎。 (4)急、慢性支原体感染时，细支气管和血管周围均可见局灶性炎症反应，有不同程度的单核细胞亚群浸润，从极轻微到重度浸润，甚至在同一断面甚至同一细支气管周围均有不同程度的浸润。 (5)BAL液中，排斥组和感染组的细胞总数、巨噬细胞和中性粒细胞数量均显着增加。结论：肺部感染中局灶性、不均匀、斑驳状浸润与急性排斥反应中均匀、均匀的浸润模式之间的差异可能有助于肺移植后急性排斥反应和感染的鉴别诊断。