Kidney Disease Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China; Key Laboratory of Kidney Disease Prevention and Control Technology, Zhejiang Province, China; The Third Grade Laboratory under the National State, Administration of Traditional Chinese Medicine, Hangzhou 310003, China.
J Immunol Res. 2016;2016:7473239. doi: 10.1155/2016/7473239. Epub 2016 Dec 12.
. It is controversial whether lymphocyte infiltration exhibited in biopsy specimens is associated with transplant outcomes. This study focused on the effect of CD20-positive B cell infiltration in biopsy specimens from allografts with acute cellular rejection (ACR) in a Chinese population. . Altogether, 216 patients transplanted from Sep. 2001 to Dec. 2014 with biopsy-proved ACR (Banff I or Banff II) were included in the analysis. Biopsies were immunostained for CD20 and C4d. Baseline information, serum creatinine and GFR before and after treatment, steroid resistance, response to treatment, graft loss, and survival were analyzed. . Eighty-three patients were classified into CD20-negative group, and 133 patients were classified into CD20-positive group. Significantly more CD20-negative patients (49/83, 59.0%) received steroid plus antibody therapy compared with the CD20-positive group (52/133, 39.1%) ( = 0.004). The response to treatment for ACR did not differ between these two groups. The CD20-positive group had less graft loss (18.8% versus 32.5%, = 0.022) and a better graft survival rate. Further exploration of the infiltration degree suggested that it tended to be positively related to graft survival, but this did not reach statistical significance. . CD20-positive B cell infiltration in renal allograft biopsies with ACR is associated with less steroid resistance and better graft survival. The presence of CD20-positive B cells is protective for renal allografts.
. 活检标本中显示的淋巴细胞浸润是否与移植结局相关仍存在争议。本研究主要关注中国人群同种异体移植急性细胞排斥反应（ACR）活检标本中 CD20 阳性 B 细胞浸润的影响。. 共纳入 216 例 2001 年 9 月至 2014 年 12 月因 ACR（Banff I 或 Banff II）行移植后接受活检证实的患者。免疫组化染色检测 CD20 和 C4d。分析基线资料、治疗前后血肌酐和 GFR、激素抵抗、治疗反应、移植物丢失和存活率。. 83 例患者归入 CD20 阴性组，133 例归入 CD20 阳性组。与 CD20 阳性组（52/133，39.1%）相比，CD20 阴性组（49/83，59.0%）更多患者接受激素加抗体治疗（ = 0.004）。两组间 ACR 的治疗反应无差异。CD20 阳性组移植物丢失更少（18.8%比 32.5%， = 0.022），移植物存活率更高。进一步探讨浸润程度提示其与移植物存活率呈正相关，但无统计学意义。. 在 ACR 肾移植活检中 CD20 阳性 B 细胞浸润与较少的激素抵抗和更好的移植物存活率相关。CD20 阳性 B 细胞的存在对肾移植具有保护作用。
