Ramessur Chandran Sharmila, Tesch Greg H, Han Yingjie, Woodman Naomi, Mulley William R, Kanellis John, Blease Kate, Ma Frank Y, Nikolic-Paterson David J
Department of Nephrology, Monash Medical Centre, Clayton, Vic., Australia; Centre for Inflammatory Diseases, Monash Medical Centre, Monash University, Clayton, Vic., Australia.
Int J Exp Pathol. 2015 Feb;96(1):54-62. doi: 10.1111/iep.12110. Epub 2014 Dec 22.
Kidney allografts induce strong T-cell and antibody responses which mediate acute rejection. Spleen tyrosine kinase (Syk) is expressed by most leucocytes, except mature T cells, and is involved in intracellular signalling following activation of the Fcγ-receptor, B-cell receptor and some integrins. A role for Syk signalling has been established in antibody-dependent native kidney disease, but little is known of Syk in acute renal allograft rejection. Sprague-Dawley rats underwent bilateral nephrectomy and received an orthotopic Wistar renal allograft. Recipient rats were treated with a Syk inhibitor (CC0482417, 30 mg/kg/bid), or vehicle, from 1 h before surgery until being killed 5 days later. Vehicle-treated recipients developed severe allograft failure with marked histologic damage in association with dense leucocyte infiltration (T cells, macrophages, neutrophils and NK cells) and deposition of IgM, IgG and C3. Immunostaining identified Syk expression by many infiltrating leucocytes. CC0482417 treatment significantly improved allograft function and reduced histologic damage, although allograft injury was still clearly evident. CC0482417 failed to prevent T-cell infiltration and activation within the allograft. However, CC0482417 significantly attenuated acute tubular necrosis, infiltration of macrophages and neutrophils and thrombosis of peritubular capillaries. In conclusion, this study identifies a role for Syk in acute renal allograft rejection. Syk inhibition may be a useful addition to T-cell-based immunotherapy in renal transplantation.
肾移植会引发强烈的T细胞和抗体反应,介导急性排斥反应。脾酪氨酸激酶(Syk)在除成熟T细胞外的大多数白细胞中表达,参与Fcγ受体、B细胞受体和一些整合素激活后的细胞内信号传导。Syk信号传导在抗体依赖性原发性肾病中已被证实有作用,但在急性肾移植排斥反应中对Syk的了解甚少。将Sprague-Dawley大鼠进行双侧肾切除术,并接受原位Wistar肾移植。从手术前1小时开始,给受体大鼠用Syk抑制剂(CC0482417,30mg/kg,每日两次)或赋形剂治疗,直至5天后处死。接受赋形剂治疗的受体出现严重的移植失败,伴有明显的组织学损伤,同时有密集的白细胞浸润(T细胞、巨噬细胞、中性粒细胞和自然杀伤细胞)以及IgM、IgG和C3的沉积。免疫染色显示许多浸润的白细胞表达Syk。CC0482417治疗显著改善了移植肾功能并减少了组织学损伤,尽管移植肾损伤仍明显可见。CC0482417未能阻止移植肾内T细胞的浸润和激活。然而,CC0482417显著减轻了急性肾小管坏死、巨噬细胞和中性粒细胞的浸润以及肾小管周围毛细血管的血栓形成。总之,本研究确定了Syk在急性肾移植排斥反应中的作用。抑制Syk可能是肾移植中基于T细胞的免疫治疗的有益补充。