慢性移植肾肾病管周毛细血管内皮细胞嵌合现象分析  

Endothelial chimerism of peritubular capillaries in nephrectomized chronic renal allograft nephropathy

作　　者：柏宏伟[1] 钱叶勇[1] 石炳毅[1] 钟定荣[2] 曾瑄[2] 武莎菲[2] 周文强[1] 常京元[1] 李宁[3] 

机构地区：[1]解放军总医院第309临床部全军器官移植中心,北京100091 [2]中国医学科学院中国协和医科大学北京协和医院病理科,北京100730 [3]解放军总医院第309临床部病理科,北京100091

出　　处：《军医进修学院学报》2007年第2期84-86,共3页Academic Journal of Pla Postgraduate Medical School

基　　金：首都医学发展科研基金(2005-3093)

摘　　要：目的:观察慢性移植肾肾病(CAN)中血管内皮细胞被受者内皮细胞替代(内皮嵌合)的现象,分析内皮嵌合对CAN进展的影响。方法:无功能移植肾切除组织,符合慢性移植肾肾病(CAN)造成移植肾失功、男性供者女性受者标本29例,选择Y染色体长臂Yq12区域(异染色质区)DNA片段作为探针,同时选择X染色体着丝粒区(α卫星DNA)探针作为对照,通过在石蜡切片标本上进行间期细胞双色荧光原位杂交(FISH),观察肾小管周毛细血管(PTC)内皮细胞的嵌合程度。结果:CAN中PTC内皮细胞嵌合现象较普遍存在,内皮细胞的分布呈灶状,供者内皮细胞和受体内皮细胞可相邻存在。PTC密度与间质纤维化程度有关,CD31阳性的PTC每单位面积密度14.52±4.85个,微血管内皮细胞嵌合出现比例为0.16±0.04,两者无明显相关性(r=0.13,P>0.05)。结论:肾脏移植物中血管内皮细胞可以被受者来源的内皮细胞所替代,CAN中PTC密度减少,内皮细胞的嵌合的发生与CAN的进展无直接关系。Objective：We aimed to find out the presence of endothelial chimerism and its relationship with progress of chronic renal allograft nephropathy （ CAN ）. Methods： We studied samples from 29 dysfunctional nephrectomized renal transplants of female recipients who received the kidneys from male donors for the presence of endothelial cells of recipient origin. Formalin-fixed, paraffln-embedded tissue sections of renal samples＂ were examined by fluorescence in situ hybridization for the presence of endothelial cells containing two X-chromosomes using biotinylated Y-chromosome probe and digoxigenin labeled X-chromosome probe. Endothelial staining was performed on the sequential section with anti-CD31 monoclonal antibody in immunohistochemistry technique. Results：The FISH methods did identify endothelial cells of recipient origin. The density of CD31 positive peritubular capillaries were decreased with the progressing of chronic allograft nephropathy. The density of PTC was 14.52±4.85/5285.5m^2, and the percentage of endothelial chimerism was 0.16 ±0.04. There was no correlation between the density of CD31 positive peritubular capillaries and the ratio of microvessels in which endothelial cells were replaced by recipients （r =0.13, P 〉 0.05 ）. Conclusion ：The deterioration of chronic allograft nephropathy has no relation with endothelial cell chimerism.

关 键 词：原位杂交 荧光 肾移植 内皮细胞 移植嵌合体 慢性移植肾肾病 

分 类 号：R617[医药卫生—外科学]