Ruiz P, Fuller J, Sanfilippo F
Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710.
Transplantation. 1990 Jan;49(1):175-83. doi: 10.1097/00007890-199001000-00039.
The effects of pre- and posttransplant immunization on graft survival, infiltrate intensity, and host in situ/systemic cellular immune responsiveness were examined for class I MHC-disparate rat renal allograft recipients. Naive, unsensitized PVG (RT1c) recipients of class I MHC disparate PVG.R1 (RT1.Aa on PVG background) orthotopic kidney transplants displayed long-term (greater than 50 days) survival (LTS) in a majority (41/52) of cases. Pretransplant immunization of recipients with a PVG.R1 skin graft most often resulted in rejection (mean survival greater than 21.3 days) with 8/15 rats surviving less than or equal to 2 weeks and only 3/15 with LTS. Pretransplant immunization with a skin graft from a fully MHC-disparate PVG.1A (RT1a on PVG background) donor resulted in acute rejection (mean = 6.1 days) with 0/8 rats surviving greater than or equal to 2 weeks. Donor-specific class I and II disparate (PVG.1A), and third-party (LEW) skin transplants applied on LTS (greater than 50 days) PVG.R1 kidney graft recipients showed typical 1st- and accelerated 2nd-set skin graft rejection, but had no effect on kidney graft survival. In contrast, 6/7 LTS PVG.R1 kidney graft recipients accepted PVG.R1 skin grafts indefinitely following their transient partial rejection. Histologic analysis of kidney allografts revealed the highest degree of mononuclear cell infiltrates in animals specifically sensitized by PVG.1A skin grafts prior to transplant. Donor class I-specific cytotoxic T lymphocyte precursor (pCTL) frequencies, as determined by limiting dilution assays, were increased and equivalent at 1 week posttransplant in kidney allograft cell eluates from nonrejecting naive recipients (1/127-1/2209) and rejecting presensitized animals (1/470-1/7848). LTS animals had decreased intragraft pCTL at greater than 50 days (1/2969-1/61875), as did LTS at greater than 50 days that received PVG.R1, PVG.1A, or LEW skin grafts posttransplant. In all groups, splenocyte pCTL frequencies were significantly lower than the corresponding values within the allograft. By comparison, no significant differences in intragraft or splenic proliferative T lymphocyte (pPTL) precursor frequencies were observed between any groups. These results indicate that unsensitized recipients of class I-disparate renal cells grafts are capable of maintaining graft survival in the early posttransplant period, despite the presence of significant in situ antidonor class I MHC-specific cellular immune responsiveness. These findings also indicate that long-surviving PVG recipients of class I-disparate renal allografts develop specific functional tolerance to donor class I alloantigens, that may be associated with a diminished frequency of anti-class I cytotoxic (but not proliferative) T cell precursors.
对于I类主要组织相容性复合体(MHC)不相合的大鼠肾移植受者,研究了移植前和移植后免疫对移植物存活、浸润强度以及宿主原位/全身细胞免疫反应性的影响。I类MHC不相合的PVG.R1(PVG背景上的RT1.Aa)原位肾移植的未致敏、天真的PVG(RT1c)受者在大多数(41/52)病例中表现出长期(超过50天)存活(LTS)。移植前用PVG.R1皮肤移植物对受者进行免疫,最常导致排斥反应(平均存活超过21.3天),15只大鼠中有8只存活时间小于或等于2周,只有3只具有长期存活。移植前用完全MHC不相合的PVG.1A(PVG背景上的RT1a)供体的皮肤移植物进行免疫,导致急性排斥反应(平均=6.1天),8只大鼠中无1只存活超过或等于2周。将供体特异性I类和II类不相合(PVG.1A)以及第三方(LEW)皮肤移植物应用于长期存活(超过50天)的PVG.R1肾移植受者,显示出典型的初次和加速二次皮肤移植物排斥反应,但对肾移植存活没有影响。相比之下,7只长期存活的PVG.R1肾移植受者中有6只在短暂部分排斥后无限期接受了PVG.R1皮肤移植物。肾移植的组织学分析显示,移植前经PVG.1A皮肤移植物特异性致敏的动物中单核细胞浸润程度最高。通过有限稀释分析确定,在非排斥的未致敏受者(1/127 - 1/2209)和排斥的致敏动物(1/470 - 1/7848)的肾移植细胞洗脱物中,移植后1周供体I类特异性细胞毒性T淋巴细胞前体(pCTL)频率增加且相当。长期存活动物在超过50天时移植内pCTL减少(1/2969 - 1/61875),移植后接受PVG.R1、PVG.1A或LEW皮肤移植物且存活超过50天的长期存活动物也是如此。在所有组中,脾细胞pCTL频率显著低于移植内相应值。相比之下,任何组之间在移植内或脾增殖性T淋巴细胞(pPTL)前体频率上均未观察到显著差异。这些结果表明,I类不相合肾细胞移植物的未致敏受者在移植后早期能够维持移植物存活,尽管存在显著的原位抗供体I类MHC特异性细胞免疫反应性。这些发现还表明,I类不相合肾移植的长期存活PVG受者对供体I类同种异体抗原产生了特异性功能耐受,这可能与抗I类细胞毒性(但非增殖性)T细胞前体频率降低有关。