Hubscher S G, Adams D H, Elias E
Department of Pathology, Medical School, University of Birmingham, U.K.
J Pathol. 1990 Oct;162(2):165-71. doi: 10.1002/path.1711620210.
The expression of major histocompatibility complex (MHC) class II antigens was studied in human liver grafts by immunohistochemical staining with monoclonal antibodies to HLA-DR, HLA-DP, and HLA-DQ antigens. Staining was carried out on frozen sections from 13 normal livers, used as controls, and 85 post-transplant specimens in six histological categories: acute rejection (n = 25); chronic rejection (n = 21); massive haemorrhagic necrosis (n = 2); resolving acute rejection (n = 10); non-rejection complications--pure cholestasis, ischaemia, biliary obstruction (n = 23); and stable graft function greater than 1 year post-transplantation (n = 4). Staining was graded semi-quantitatively on a scale of 0-3+ in bile ducts, hepatocytes, and vascular endothelium. Expression of class II antigens was increased in bile ducts, hepatocytes, and vascular endothelium in all of the post-transplant groups compared with controls. The degree of expression of HLA-DR and HLA-DP in bile ducts and vascular endothelium was significantly greater in cases of rejection than in the non-rejection groups. These observations suggest that increased class II antigen expression may be important in the pathogenesis of immune-mediated bile duct and endothelial damage in liver allografts. Immunohistochemical staining for class II antigens in post-transplant biopsies may also be useful as an adjunct to conventional histological diagnosis.
采用针对HLA - DR、HLA - DP和HLA - DQ抗原的单克隆抗体进行免疫组织化学染色，研究人类肝脏移植中主要组织相容性复合体（MHC）Ⅱ类抗原的表达。对13例正常肝脏的冰冻切片进行染色作为对照，另外对85例移植后的标本进行染色，这些标本分为六个组织学类别：急性排斥反应（n = 25）；慢性排斥反应（n = 21）；大量出血性坏死（n = 2）；急性排斥反应缓解期（n = 10）；非排斥并发症——单纯胆汁淤积、缺血、胆管梗阻（n = 23）；移植后1年以上移植肝功能稳定（n = 4）。在胆管、肝细胞和血管内皮中，对染色进行0 - 3 +的半定量分级。与对照组相比，所有移植后组的胆管、肝细胞和血管内皮中Ⅱ类抗原的表达均增加。排斥反应病例中胆管和血管内皮中HLA - DR和HLA - DP的表达程度明显高于非排斥组。这些观察结果表明，Ⅱ类抗原表达增加可能在同种异体肝移植免疫介导的胆管和内皮损伤发病机制中起重要作用。移植后活检中Ⅱ类抗原的免疫组织化学染色也可能作为传统组织学诊断的辅助手段。
