慢性移植肾病中高内皮微静脉新生与树突状细胞的关系

The relationship between neogenesis of high endothelial venlues and dendritic cells in chronic renal allograft nephropathy

目的探讨慢性移植肾病肾组织内树突状细胞(dendritic cell,DC)与高内皮微静脉(high endothelial venlues,HEVs)新生的相关性。方法收集20例经病理确诊为慢性移植肾病并行移植肾切除的肾组织标本,免疫组织化学检测HEVs及DC、CD5^+/CD19^+B淋巴细胞等各自标志物的免疫反应性;根据PAS、HE染色,用肾移植Banff1997标准进行病理评分。统计分析3类细胞和各病理变化指标在HEVs(+)组和HEVs(-)组间的差异。结果 20例样本中有3例呈HEVs标志物MECA-79免疫反应阳性,即HEVs(+),占15%;17例MECA-79免疫反应阴性,即HEVs(-),占85%。HEVs(+)组CD5+B淋巴细胞、CD19^+B淋巴细胞数量比HEVs(-)组相应阳性细胞多,但差异无显著性;标志物CD208阳性的DC数在HEVs(+)组较HEVs(-)组明显增多。移植肾Banff 1997病理评分显示,HEVs(+)组所有病变指标评分虽均高于HEVs(-)组,但亦无统计学意义。结论慢性移植肾病肾组织存在HEVs的新生,可能参与肾脏炎症微环境的形成;DC可能与HEVs的生成有关。

Objective To study the relationship between DCs（dendritic cells） and HEVs neogenesis in chronic renal allograft nephropathy（CAN）.Methods Twenty samples of resected renal tissue with chronic allograft nephropathy confirmed by pathological diagnosis were collected.Immunohistochemical methods were used to detect HEVs and immunoreactivity of DC、CD5^＋/CD19^＋ B lymphocyte cells.By PAS and HE staining,The Banff 1997 standard for evaluation of renal allograft rejection was used to score the pathological lesions of the twenty examples.The differences of the lesions between HEVs（＋） and HEVs（-） were analyzed with statistical methods.Results Of a total of 20 samples,three were MECA-79（＋）,accounting for 15%,and 17 were MECA-79（-）,accounting for85%,representing the HEVs（＋） group and HEVs（-） group respectively.The number of CD5 ＋ B lymphocyte cells and CD19 ＋ B lymphocyte cells was larger in HEVs（＋） than in HEVs（-）,but the difference was not significant.The number of CD208 ＋ DC was significandy larger in HEVs（＋） group than in HEVs（-） group.The Banff 1997 classification showed that while all pathological scores were higher in HEVs（＋） than in HEVs（-）,there were no significant differences between the two groups.Conclusions HEVs neogenesis occurred in the renal tissue of CAN.HEVs may participate in the formation of renal inflammatory microenvironment.As a kind of inflammatory cell,DC may relate to the neogenesis and formation of HEVs.