Department of Pathology, PTB, 2 rue Angélique Ducoudray 21070 Dijon, France.
Transpl Immunol. 2010 Feb;22(3-4):110-4. doi: 10.1016/j.trim.2009.11.001. Epub 2009 Nov 10.
In order to look for a relationship between humoral mechanisms of rejection and chronic allograft dysfunction, plasma cells, C4d deposits and donor-specific antibodies (DSA) were simultaneously sought on serial biopsies of kidney allograft recipients.
Ten recipients with chronic dysfunction (G1) and 8 recipients with long-term normal graft function (G2) were included. Biopsies and serums were sampled at early graft dysfunction (T1), between 8months and 2years (T2) and after the third year following transplantation (T3).
In G1, plasma cells represented 12.3% (T1), 8.2% (T2) and 14.1% (T3) of mononuclear cells. The mean percentage of plasma cells was 11.6% in G1 versus 0.4% in G2 (p<0.05). A progressive rise in C4d deposits was seen in G1, from 25% at T1 to 80% at T3. Donor-specific antibodies were identified in at least one serum sample of 60% of the patients in G1 and 12.5% of the patients in G2 (p=0.012), whereas donor-specific antibodies were eluted from at least one biopsy of 50% of the patients in G1 and 12.5% of the patients in G2 (p=0.03). In G1, C4d deposits were significantly associated with plasma cells (p=0.0012) and anti-HLA Abs in serum samples and/or eluates (p=0.026).
This study shows that plasma cells, DSA and C4d are associated in renal transplants developing chronic rejection.
为了寻找排斥反应的体液机制与慢性移植物功能障碍之间的关系，对肾移植受者的连续活检标本同时寻找浆细胞、C4d 沉积和供体特异性抗体（DSA）。
纳入 10 例慢性功能障碍（G1 组）和 8 例长期正常移植功能（G2 组）的受者。在早期移植物功能障碍（T1）、8 个月至 2 年（T2）和移植后第 3 年（T3）时采集活检标本和血清。
在 G1 组中，浆细胞分别占单核细胞的 12.3%（T1）、8.2%（T2）和 14.1%（T3）。G1 组的平均浆细胞百分比为 11.6%，而 G2 组为 0.4%（p<0.05）。G1 组的 C4d 沉积呈进行性升高，从 T1 时的 25%增加到 T3 时的 80%。在 G1 组的至少 60%的患者和 G2 组的 12.5%的患者的至少一个血清样本中鉴定出 DSA，而在 G1 组的至少 50%的患者和 G2 组的 12.5%的患者的至少一个活检标本中洗脱了 DSA（p=0.012）。在 G1 组中，C4d 沉积与浆细胞（p=0.0012）和血清样本和/或洗脱液中的抗 HLA Abs 显著相关（p=0.026）。
本研究表明，在发生慢性排斥反应的肾移植中，浆细胞、DSA 和 C4d 相关。
