Martin L, Funes de la Vega M, Bocrie O, Harzallah A, Justrabo E, Rifle G, Mousson C
Department of Pathology, Faculty of Medicine, Centre Hospitalier Universitaire, 7 boulevard Jeanne d'Arc, 21079 Dijon Cedex, France.
Transplant Proc. 2007 Oct;39(8):2586-8. doi: 10.1016/j.transproceed.2007.08.037.
This retrospective study was conducted to examine whether the presence of Foxp3+ cells in biopsies of kidney transplants displaying early acute rejection (AR) predicted the outcome of the episode. Seventeen biopsies showing AR included in this study were obtained at 42 +/- 30 days after transplantation. Lesions were graded according to the Banff classification. Foxp3 staining was performed on paraffin-embedded sections with a monoclonal antibody after antigen retrieval. We evaluated relationships between the number and the location of Foxp3+ cells, the type of rejection, and the serum creatinine value at 1 year. Foxp3+ cells were detected in 11 of 17 biopsies with AR (9.5 +/- 13.3 cells/mm(2)). These elements were mixed with other interstitial inflammatory cells. Intraepithelial tubular Foxp3+ cells were seen in 9 biopsies (1.5 +/- 2.5 cells/mm(2)). Foxp3+ cells were associated with borderline lesions (25.5 +/- 22.4/mm(2)); type 1 AR (7.18 +/- 9/mm(2)) and type 2 AR (1.99 +/- 3.46/mm(2)). The average number of cells per field was not different in C4d(+) and C4d(-) AR (6 +/- 8.35 vs 8.5 +/- 14.7/mm(2)). Graft loss within the first year was higher among the group of recipients without Foxp3+ cells (3/6) than those with Foxp3+ cells (0/11). All AR with intraepithelial tubular Foxp3 cells had favorable outcomes. Foxp3 has been proposed as a relevant marker of CD4(+)CD25(+) regulatory T cells. This study showed that Foxp3+ cells can be detected in kidney transplant biopsies with AR. The absence of Foxp3+ cells, especially in epithelial tubular cells, might indicate a poor prognosis following an AR episode.
本回顾性研究旨在探讨在显示早期急性排斥反应（AR）的肾移植活检组织中，Foxp3+细胞的存在是否能预测该排斥反应的结局。本研究纳入的17例显示AR的活检组织是在移植后42±30天获取的。病变根据Banff分类法进行分级。抗原修复后，用单克隆抗体对石蜡包埋切片进行Foxp3染色。我们评估了Foxp3+细胞的数量和位置、排斥反应类型与1年时血清肌酐值之间的关系。17例AR活检组织中有11例检测到Foxp3+细胞（9.5±13.3个细胞/mm²）。这些细胞与其他间质炎性细胞混合存在。9例活检组织中可见上皮内肾小管Foxp3+细胞（1.5±2.5个细胞/mm²）。Foxp3+细胞与临界病变（25.5±22.4/mm²）、1型AR（7.18±9/mm²）和2型AR（1.99±3.46/mm²）相关。C4d(+)和C4d(-) AR中每视野细胞的平均数量无差异（6±8.35 vs 8.5±14.7/mm²）。在无Foxp3+细胞的受者组中，第一年移植物丢失率高于有Foxp3+细胞的受者组（3/6 vs 0/11）。所有伴有上皮内肾小管Foxp3细胞的AR均有良好结局。Foxp3已被认为是CD4(+)CD25(+)调节性T细胞的相关标志物。本研究表明，在发生AR的肾移植活检组织中可检测到Foxp3+细胞。Foxp3+细胞的缺失，尤其是在上皮肾小管细胞中，可能预示着AR发作后的预后不良。
