Hippen Benjamin E, DeMattos Angelo, Cook William J, Kew Clifton E, Gaston Robert S
Division of Nephrology, Department of Medicine, University of Alabama, Birmingham, Alabama, USA.
Am J Transplant. 2005 Sep;5(9):2248-52. doi: 10.1111/j.1600-6143.2005.01009.x.
We undertook a study to ascertain the relationship between the presence of CD20-positive B-lymphocytes in renal allografts undergoing acute cellular rejection and graft survival. We identified 27 patients transplanted between January 1, 1998 and December 31, 2001, with biopsy-proven Banff 1-A or Banff 1-B rejection in the first year after transplantation, and stained the specimens for CD20 and C4d. At least 4 years of follow-up data were available for each patient studied. Six patients had CD20-positive B-cell clusters in the interstitium, and 21 patients were negative for CD20 infiltrates. The CD20-positive group was significantly more likely to have steroid-resistant rejection and reduced graft survival compared to CD20-negative controls. This study supports prospective identification of CD20-positive B-cell clusters in biopsy-proven rejection and offers a therapeutic rationale for a trial of monoclonal anti-CD20 antibody in such patients.
我们开展了一项研究，以确定接受急性细胞排斥反应的肾移植受者中CD20阳性B淋巴细胞的存在与移植肾存活之间的关系。我们确定了1998年1月1日至2001年12月31日期间接受移植的27例患者，这些患者在移植后第一年经活检证实为班夫1-A级或班夫1-B级排斥反应，并对标本进行CD20和C4d染色。对所研究的每位患者均有至少4年的随访数据。6例患者间质中有CD20阳性B细胞簇，21例患者CD20浸润阴性。与CD20阴性对照组相比，CD20阳性组发生激素抵抗性排斥反应的可能性显著更高，移植肾存活率降低。本研究支持在经活检证实的排斥反应中对CD20阳性B细胞簇进行前瞻性识别，并为在此类患者中试用抗CD20单克隆抗体提供了治疗依据。
