肾移植急性排斥反应中肾小管上皮细胞凋亡的观察  

Epithelial cells apoptosis in acute rejection of renal allograft

作　　者：史其新[1] 谢蜀生[2] 郭应禄[1] 

机构地区：[1]北京大学第一医院泌尿外科,北京大学泌尿外科研究所,100034 [2]北京大学医学部免疫系

出　　处：《中华泌尿外科杂志》2000年第7期393-395,共3页Chinese Journal of Urology

基　　金：国家自然科学基金项目资助! ( 3 983 0 3 4 0 )

摘　　要：目的　探讨肾移植急性排斥期肾小管上皮细胞凋亡与移植排斥的关系。　方法　选用近交系DA大鼠 ,LEW大鼠进行原位左肾移植。实验组 :异基因移植组 (DA→LEW ) ,对照组 :同基因移植组 (LEW→LEW)。于手术后第 2、4、6天分别取移植肾进行病理学检查及电镜扫描 ,采用TdT介导的脱氧核苷酸原位末端标记法 (TUNEL)检测移植肾脏中的凋亡细胞及血清肌酐水平。　结果　病理学检查结果显示实验组大鼠在术后第 2、4、6天分别发生轻、中、重度排斥 ,对照组无明显排斥现象。TUNEL法结果显示实验组于手术后第 2、4、6天细胞凋亡数明显高于对照组 (P <0 .0 1) ,手术后第 4天差异最大 ,术后第 6天因严重排斥而使肾小管上皮细胞坏死脱落。肾小管上皮细胞凋亡程度与血清肌酐水平、病理学检查结果一致。　结论　肾小管上皮细胞凋亡在大鼠异基因肾脏移植急性排斥反应中发挥重要作用。Objective To elucidate the relation of apoptosis of tubular epithelial cells and renal allograft rejection in rats. Methods Orthotopic left kidney transplantation was performed with inbred rat DA (RT1 a) and inbred rat LEW (RT1 1). All recipients were divided into two groups,the experimental allogenic transplant group (DA→LEW) and the control group: (LEW→LEW).The grafts were harvested on day 2、4、6 after operation.All graft samples were subjected to histological examination and electron microscopy examination.Apoptosis cells of grafts were monitored by terminal deoxynucleotidyl transferase mediated dUTP nick end labeling (TUNEL) and the level of blood serum carnine was examined. Results Histologically,mild、moderate and severe acute rejection occurred on day 2、4、6 after operation in experimental group. But none of control group had the histological evidence of acute rejection. The TUNEL showed that the number of apoptosis cells in experimental group was significantly higher than that in the control group on day 2、4、6 (P<0.01),the variance being the most obvious on day 4 after operation, and necrosis or sloughing of the tubular epithelial cells occurred on day 6.Apoptotic degrees of tubular epithelial cells were in correspondence with level of blood serum carnine and the degree of histologic damage. Conclusions Apoptosis of tubular epithelial cells might play an important role in acute rejection of renal allograft.

关 键 词：肾移植 急性排斥反应 肾小管上皮细胞凋亡 

分 类 号：R699[医药卫生—泌尿科学]