Versluis D J, ten Kate F J, Wenting G J, Weimar W
Department of Internal Medicine, University Hospital Rotterdam-Dijkzigt, The Netherlands.
Transpl Int. 1988 Dec;1(4):205-8. doi: 10.1111/j.1432-2277.1988.tb01817.x.
Focal small mononuclear cell infiltrates were found in renal allograft biopsies of 13/14 transplant recipients with a stable function after long-term cyclosporin A (CsA) therapy. Phenotypical analysis of the infiltrating cells using monoclonal antibodies showed a slight preponderance of T cells (56% +/- 8%), with only small percentages of B cells (5% +/- 2%), NK cells (2% +/- 1%), and monocytes (2% +/- 1%). Within the T-cell population the median calculated CD4/CD8 ratio was 1:3. Thirty-five percent of the infiltrating mononuclear cells remained unidentified with the monoclonal antibody panel used (silent cells). Three months after immunosuppressive therapy had been changed from CsA to azathioprine (AZA), the size of the infiltrates was significantly increased and there was a marked invasion of mononuclear cells between tubular epithelium despite a significant improvement in creatinine clearance (P less than 0.01). the phenotypical composition of these infiltrates was dominated by T cells (84% +/- 3%), with a median CD4/CD8 ratio of 2:7 due to an increase in CD4+ cells and a decrease in CD8+ after conversion (P less than 0.05). The percentages of B cells, NK cells, and monocytes showed no significant changes after conversion. During AZA therapy nearly all infiltrating mononuclear cells were stained with the monoclonals used, leaving no silent cells postconversion.
在接受长期环孢素A（CsA）治疗且功能稳定的14例移植受者中，13例的肾移植活检发现局灶性小单核细胞浸润。使用单克隆抗体对浸润细胞进行表型分析显示，T细胞略占优势（56%±8%），B细胞、NK细胞和单核细胞的比例较小，分别为5%±2%、2%±1%和2%±1%。在T细胞群体中，计算得出的CD4/CD8比值中位数为1:3。使用该单克隆抗体组合时，35%的浸润单核细胞无法识别（沉默细胞）。免疫抑制治疗从CsA改为硫唑嘌呤（AZA）三个月后，浸润灶大小显著增加，尽管肌酐清除率显著改善（P<0.01），但肾小管上皮之间仍有明显的单核细胞浸润。这些浸润灶的表型组成以T细胞为主（84%±3%），转换后CD4+细胞增加，CD8+细胞减少，CD4/CD8比值中位数为2:7（P<0.05）。转换后B细胞、NK细胞和单核细胞的比例无显著变化。在AZA治疗期间，几乎所有浸润的单核细胞都被所用的单克隆抗体染色，转换后没有沉默细胞。
