移植肾慢性排异反应动脉炎浸润的免疫细胞类型  

Infiltrating immunocyte types in arteritis of patients with renal allograft chronic rejection

作　　者：王雪瑶[1] 于金宇[2] 张丽红[3] 李婷婷[1] 周晶晶[1] 闫琪[1] 吴珊[3] 孙连坤[4] 

机构地区：[1]吉林大学临床医学院,长春130021 [2]吉林大学第一医院泌尿中心,长春130021 [3]吉林大学基础医学院病理学系,长春130021 [4]吉林大学病理生理学系,长春130021

出　　处：《临床与实验病理学杂志》2015年第12期1330-1333,1338,共5页Chinese Journal of Clinical and Experimental Pathology

基　　金：吉林大学大学生创新项目(2014A79341);吉林省科技厅基金(201015196)

摘　　要：目的观察移植肾慢性排异反应动脉炎浸润的免疫细胞类型,为移植肾慢性排异的研究提供参考。方法筛选10例因慢性功能丧失而切除的移植肾为观察对象,选用5种免疫细胞标记抗体,免疫细胞包括巨噬细胞、T淋巴细胞、B淋巴细胞和中性粒细胞,应用免疫组化SP法检测切除移植肾组织慢性排异反应动脉炎中浸润的免疫细胞类型。结果形态学上所筛选的10例切除终末移植肾均符合有慢性活动性抗体介导排异反应,其慢性排异反应动脉炎中浸润的免疫细胞以CD68阳性的巨噬细胞浸润比率最高(42.88±6.91)%,随后是CD3阳性的T淋巴细胞(27.18±9.74)%,二者差异无统计学意义;在浸润的T淋巴细胞中有41.35%是CD8阳性的细胞毒性T淋巴细胞。CD20阳性B淋巴细胞的浸润在慢性排异反应动脉炎中所占比例很少,低于5%。此外,慢性排异反应动脉炎中CD15阳性的中性粒细胞浸润比率平均也低于5%。结论在移植肾慢性排异反应动脉炎中,以巨噬细胞和T淋巴细胞浸润为主,浸润的T淋巴细胞中近一半为细胞毒性T淋巴细胞;B淋巴细胞和中性粒细胞的浸润比率较低。Purpose To detect the infiltrating immunocyte types in arteritis of renal allograft undergoing chronic rejection to provide some references for mechanism study on renal allograft chronic rejection. Methods By immunohistochemical SP staining with five immunocyte antibodies,including macrophage,T lymphocyte,B lymphocyte and neutrophils,the proportions of infiltration immunocytes were classified in 10 cases of arteritis in patients with resected renal allograft undergoing chronic functional failure. Results These ten allografts had features of chronic active antibody-mediated rejection based on their morphological appearances. In arteritis,CD68 positive macrophages occupied the highest proportion（ 42. 88 ± 6. 91） %,followed by CD3 positive T lymphocyte（ 27. 18 ± 9. 74） %. But there was no statistical difference between the proportion of macrophages and T lymphocytes. 41. 35% of T lymphocyte belonged to CD8 positive cytotoxic T cells. CD20 positive B lymphocytes accounted for a very low proportion of cells in arteritis,less than 5%. Meanwhile,CD15 positive neutrophils also occupied the low proportion,less than 5%. Conclusion Macrophage and T lymphocyte account for the highest percentage of immunocytes in artertitis of renal allograft associated with chronic rejection. Nearly half of T cells are cytotoxic T cell. B lymphocytes and neutrophils account for very low percentage.

关 键 词：移植肾 慢性排异反应 动脉炎 免疫细胞 

分 类 号：R692[医药卫生—泌尿科学]