Andersen C B, Ladefoged S D, Lauritsen H K, Hansen P R, Larsen S
Department of Pathology, University Hospital, Herlev, Denmark.
Nephrol Dial Transplant. 1990;5(12):1045-50. doi: 10.1093/ndt/5.12.1045.
One hundred kidney allograft biopsies from 85 patients and tissue specimens from 31 failed allografts were analysed by immunohistochemistry (IMH) with a monoclonal antibody against a cytomegalovirus (CMV) antigen and by in situ hybridisation (ISH) with a biotinylated CMV DNA probe. Six clinically and serologically CMV-infected patients with AIDS served as positive controls. Biopsies from six seronegative donor kidneys and autopsy specimens from five clinically and serologically negative patients served as negative controls. Adequate serology in 56 patients showed 50% to be actively CMV infected. No statistically significant difference was found between the frequency of acute rejection in the seropositive and the seronegative patients. Four seropositive transplanted patients contained CMV DNA or CMV antigen in the biopsies and in the grafts. Both methods gave a negative result in 15 patients with glomerulopathy. Expression of MHC class I and II antigens in 17 of the biopsies demonstrated no relation to positive serology or local demonstration of CMV. In conclusion, (1) CMV was not renotropic, (2) there was no correlation between (a) CMV and acute rejection, (b) CMV and glomerulopathy, or (c) CMV and MHC class I and II antigen expression. The study suggests that CMV does not play a major role in rejection.
采用抗巨细胞病毒（CMV）抗原的单克隆抗体，通过免疫组织化学（IMH）方法，以及采用生物素化的CMV DNA探针，通过原位杂交（ISH）方法，对85例患者的100份肾移植活检标本和31份移植失败的组织标本进行了分析。6例临床和血清学诊断为CMV感染的艾滋病患者作为阳性对照。6份来自血清学阴性供体肾脏的活检标本以及5例临床和血清学均为阴性患者的尸检标本作为阴性对照。56例患者的血清学检查结果显示，50%的患者存在CMV活动性感染。血清阳性和血清阴性患者的急性排斥反应发生率之间未发现统计学上的显著差异。4例血清阳性的移植患者的活检标本和移植物中含有CMV DNA或CMV抗原。两种方法在15例肾小球病患者中均得出阴性结果。17份活检标本中MHC I类和II类抗原的表达与血清学阳性或CMV的局部检测结果无关。总之，（1）CMV对肾脏无亲嗜性，（2）（a）CMV与急性排斥反应、（b）CMV与肾小球病、或（c）CMV与MHC I类和II类抗原表达之间均无相关性。该研究表明，CMV在排斥反应中不发挥主要作用。
