Hoffmann U, Banas B, Krüger B, Banas M, Bergler T, Böger C, Kammerl M, Obed A, Rümmele P, Segerer S, Riegger G A J, Krämer B K
Klinik und Poliklinik für Innere Medizin II, University of Regensburg, Regensburg, Germany.
Clin Transplant. 2006 Nov-Dec;20(6):712-8. doi: 10.1111/j.1399-0012.2006.00540.x.
The exact mechanism of acute and chronic allograft rejection still remains unclear. The chemokine SDF-1 as mediator of allograft rejection has been under intensive investigation in liver, cardiac and bone marrow transplantation, whereas in renal transplantation, there are no reports about SDF-1 to date. This study was performed to evaluate if SDF-1 might also play an important role in human renal graft biopsies. One hundred and ninety formalin-fixed, paraffin-embedded renal allograft biopsies were included in the analysis from patients with normal renal graft morphology (according to Banff 97 classification grade 1, n = 84), with acute interstitial rejection (Banff grade 4 type I, n = 10), with acute vascular rejection (Banff grade 4 type II, n = 21), with chronic allograft nephropathy (CAN, Banff grade 5, n = 23), and without rejection but with various other lesions (Banff grade 6, n = 42). SDF-1 was localized by immunohistochemistry. In biopsies with CAN, SDF-1 expression was significantly elevated in interstitial infiltrates and infiltrating neointimal cells of arteries compared with biopsies with normal renal graft morphology. This is the first study describing a role of SDF-1 in human renal allograft rejection. We were able to demonstrate in a large number of biopsies an upregulation of SDF-1 in patients with CAN. Whether SDF-1 has pro-inflammatory or protective properties in this setting has to be evaluated in further trials.
急性和慢性同种异体移植排斥反应的确切机制仍不清楚。趋化因子SDF-1作为同种异体移植排斥反应的介质，在肝移植、心脏移植和骨髓移植中一直受到深入研究，而在肾移植中，迄今为止尚无关于SDF-1的报道。本研究旨在评估SDF-1在人类肾移植活检中是否也发挥重要作用。分析纳入了190例经福尔马林固定、石蜡包埋的肾移植活检标本，这些患者的肾移植形态正常（根据Banff 97分类为1级，n = 84）、有急性间质排斥反应（Banff 4级I型，n = 10）、有急性血管排斥反应（Banff 4级II型，n = 21）、有慢性同种异体肾病（CAN，Banff 5级，n = 23），以及无排斥反应但有其他各种病变（Banff 6级，n = 42）。通过免疫组织化学对SDF-1进行定位。与肾移植形态正常的活检标本相比，在患有CAN的活检标本中，SDF-1在间质浸润和动脉浸润性新生内膜细胞中的表达显著升高。这是第一项描述SDF-1在人类肾移植排斥反应中作用的研究。我们能够在大量活检标本中证明CAN患者中SDF-1上调。在这种情况下，SDF-1具有促炎还是保护特性必须在进一步试验中进行评估。
