IL-17在移植肾不同排斥反应过程中的表达和分布

Expression and distribution of IL-17 in different rejection processes of kidney transplantation

目的:探讨肾移植患者在发生不同排斥反应过程时,IL-17在血液中的表达情况及其在移植肾组织不同位置的表达特征及意义。方法:收集在我院定期随诊经病理证实的不同类型排斥反应患者的外周血液及组织病理标本,检测其IL-17基因和蛋白的表达情况,免疫组化染色观察移植肾组织中IL-17的表达位置。结果:肾移植患者在发生急性排斥反应时,IL-17在基因表达水平和血液中蛋白质含量显著升高(P<0.05)。免疫组织化学染色结果显示,IL-17在急性T细胞排斥反应组肾小管和肾间质中的表达与未见异常组比较有差异(P=0.02,P=0.004),并且在小管中主要高表达于急性T细胞排斥反应,IL-17在肾小管上皮高表达与小管炎存在呈正相关(r=0.455,P=0.034)。急性抗体介导排斥反应中IL-17表达与C4d沉积呈正相关(r=0.71,P=0.001)。浸润于肾小球的炎细胞偶见IL-17表达,而血管上皮细胞未见IL-17表达。结论:移植肾急性排斥反应时IL-17表达升高,在各组移植肾穿刺活检组织中亦有不同程度表达,主要定位于肾小管上皮细胞及间质中浸润的炎细胞,并与小管炎严重程度及C4d沉积呈正相关,其表达水平可作为早期监测移植肾功能状态、组织损伤以及预后判断的重要指标。

Objective:To investigate the expression of IL-17 in the blood of renal transplant patients,and the expression characteristics and significance of IL-17 in different positions of renal transplant tissues during different rejection processes.Methods:Peripheral blood and histological specimens of patients with different types of rejection confirmed by pathology in our hospital were collected,and the expression of IL-17 gene and protein were detected in blood.Immunohistochemical staining was used to observe the expression position of IL-17 in the transplanted kidney tissues.Results:The expression of IL-17 gene and protein in the blood of renal transplant were significantly increased when acute rejection occurs(P<0.05).Immunohistochemical staining showed that the expression of IL-17 in the renal tubules and interstitium of the acute T-cell rejection group was different from that of the non-abnormal group(P=0.02,P=0.004),and the expression in the tubules was significantly higher in the acute T-cell rejection.The expression degree of IL-17 in renal tubular epithelia of acute T-cell rejection was positively correlated with the severity of tubulitis(r=0.455,P=0.034).IL-17 expression in acute antibody-mediated rejection was positively correlated with C4d deposition(r=0.71,P=0.001).IL-17 expression was found occasionally in inflammatory cells infiltrating the glomeruli,but not in vascular epithelial cells.Conclusion:The expression of IL-17 in the blood of the acute renal transplant rejection is elevated and is also expressed in each type of renal transplanted biopsy tissues to some extent,which was mainly positioning in renal tubular epithelial cells and interstitial infiltrating inflammatory cells.The expression of IL-17 in the renal transplanted biopsy tissue during the rejection is positively correlated with the severity of tubulitis and C4d deposition.The expression level of IL-17 can be used as early indicator for monitoring graft function status,and an important index of tissue injury and prognosis judgement.