慢性排斥移植肾浸润细胞亚群及TNFα和IL-2R原位表达

Infiltrating lymphocyte subtypes,TNFα and IL 2R expression in chronic renal allograft rejection

目的探讨移植肾慢性排斥的细胞免疫学机制。方法对１８例肾移植术后慢性排斥病人移植肾进行活检，采用免疫组化技术检测移植肾内浸润炎性细胞亚群及ＴＮＦα和ＩＬ２Ｒ原位表达。结果慢性排斥移植肾间质中呈明显的单核细胞／巨噬细胞和淋巴细胞灶样浸润伴纤维化和小管萎缩，浸润细胞组成分别为ＣＤ＋３细胞（４６８±１９．０）％，ＣＤ＋４细胞（２４１±１７３）％，ＣＤ＋８细胞（２７３±６９）％，ＣＤ＋１４细胞（３３４±１９６）％，ＣＤ＋１９细胞仅（３２±１９）％，以Ｔ淋巴细胞和巨噬细胞为主。移植肾中ＴＮＦα和ＩＬ２Ｒ表达较正常肾脏明显增强，且主要分布于移植肾间质浸润炎性细胞。结论慢性排斥移植肾内浸润淋巴细胞和巨噬细胞处于活化状态，可能通过产生和释放各种细胞因子发挥其生物学作用，从而介导细胞免疫损伤，认为细胞免疫可能在慢性排斥发病中起作用。

Objective To study the cell mediated immune response involved in chronic renal allograft rejection. Methods An immunocytochemical study using ABC technique was carried out to detect lymphocyte subset populations,the TNFα expression and IL 2R in 18 renal allografts with chronic rejection. Results The interstitial infiltration was predominantly monocytes/macrophages and T lymphocytes.The quatitative study showed CD + 3,CD + 4,CD + 8,CD + 14 and CD + 19 cell was (46.8±19.0)%,(24.1± 17.3) %,(27.3±6.9)%,(33.4±19.6)% and (3.2±1.9)% respectively.A marked increase of TNFα and IL 2R in the interstitial infiltrating cells was also noted in the majority of the biopsies. Conclusions It was suggested that the infiltrating lymphocytes and macrophages in the renal allografts were activated and these might play an important role in mediating allograft injury by producing and releasing of cytokines and their receptors.