Ishida Toshiro, Hyodo Yoji, Ishimura Takeshi, Takeda Masashi, Hara Isao, Fujisawa Masato
Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Clin Transplant. 2005 Dec;19(6):817-24. doi: 10.1111/j.1399-0012.2005.00427.x.
In human kidney transplantation the main cause of declining long-term graft function is chronic allograft nephropathy (CAN). Recent studies have implicated human mast cells (MC) in chronic inflammation and fibrosis, MC can be subtyped according to protease content: MC(T) containing tryptase only and MC(TC) containing both tryptase and chymase. We investigated immunohistochemically whether numbers and subtypes of MC in biopsy specimens 100 d after transplantation could predict subsequent fibrosis and graft dysfunction. The total number of MC/high-power field at 100 d after transplantation correlated significantly with change in creatinine clearance (DeltaCcr), defined as (Ccr at 100 d) - (Ccr at 3 yr) (R = 0.597, p = 0.0021); fibrosis index (FI) at 100 d (R = 0.583, p = 0.0066); and DeltaFI, defined as (FI at 3 yr) - (FI at 100 d) (R = 0.406, p < 0.05). The ratio of MC(TC) to total MC at 100 d also correlated with DeltaCcr (R = 0.491, p = 0.0148), FI at 100 d (R = 0.527, p = 0.0081), and DeltaFI (R = 0.417, p < 0.05). Thus, increases in number of total MC and the ratio of MC(TC) to total MC in early biopsy specimens were related to decline of long-term graft function and fibrosis.
在人类肾移植中，长期移植肾功能下降的主要原因是慢性移植肾肾病（CAN）。最近的研究表明，人类肥大细胞（MC）参与慢性炎症和纤维化过程，MC可根据蛋白酶含量进行亚型分类：仅含类胰蛋白酶的MC（T）和同时含类胰蛋白酶和糜蛋白酶的MC（TC）。我们通过免疫组织化学方法研究了移植后100天活检标本中MC的数量和亚型是否能够预测随后的纤维化和移植肾功能障碍。移植后100天每高倍视野MC总数与肌酐清除率变化（DeltaCcr）显著相关，DeltaCcr定义为（100天时的Ccr） - （3年时的Ccr）（R = 0.597，p = 0.0021）；100天时的纤维化指数（FI）（R = 0.583，p = 0.0066）；以及DeltaFI，定义为（3年时的FI） - （100天时的FI）（R = 0.406，p < 0.05）。100天时MC（TC）与总MC的比例也与DeltaCcr（R = 0.491，p = 0.0148）、100天时的FI（R = 0.527，p = 0.0081）和DeltaFI（R = 0.417，p < 0.05）相关。因此，早期活检标本中总MC数量的增加以及MC（TC）与总MC的比例与长期移植肾功能下降和纤维化有关。
