Wramner L, Olausson M, Söderström T, Lindholm L, Rydberg L, Brynger H
Transplantation. 1987 Sep;44(3):390-5. doi: 10.1097/00007890-198709000-00013.
Twenty patients with well-functioning kidney grafts from one-haplotype-mismatched related donors, were studied 1-10 years after transplantation (A). Another group of six patients were studied at various times after transplantation (B). The presence of donor-specific transplantation tolerance, using mixed lymphocyte culture (MLC) and cell-mediated lympholysis (CML) tests was investigated, as well as the possible existence of cells with suppressive activity. All recipients were transfused prior to transplantation and treated with conventional immunosuppression. The patients in group A showed MLC reactivity against donor and third-party cells, indicating a allogeneic response capacity. The CML activity against the donor was low, however, and remained low also following removal of adherent cells. The CML activity toward third-party cells was within the normal range of unmatched individuals. In group B, two of six recipients and high postoperative CML activity against the donor. Both recipients showed clinical signs of rejection. In the remaining four recipients, the antidonor CML reactivity one week after transplantation was lower than the preoperative level. The decrease was even more pronounced at 12 months, although the reactivity against third-party cells was unaltered. The CML reactivity from unrelated fourth-party individuals toward donors was suppressed when cells from recipients with long-term functioning kidneys were added to the cell cultures. The results suggest the presence of a donor-specific cellular suppressor mechanism underlying the donor-specific CML unresponsiveness in recipients with long-term-functioning kidney allografts.
对20名接受来自单倍型不匹配相关供体的功能良好的肾移植患者进行了研究，研究时间为移植后1至10年（A组）。另一组6名患者在移植后的不同时间进行了研究（B组）。使用混合淋巴细胞培养（MLC）和细胞介导的淋巴细胞溶解（CML）试验研究了供体特异性移植耐受的存在情况，以及具有抑制活性的细胞的可能存在情况。所有受者在移植前均接受输血，并接受常规免疫抑制治疗。A组患者对供体细胞和第三方细胞表现出MLC反应性，表明具有同种异体反应能力。然而，对供体的CML活性较低，去除贴壁细胞后仍保持较低水平。对第三方细胞的CML活性在不匹配个体的正常范围内。在B组中，6名受者中有2名术后对供体的CML活性较高。两名受者均出现排斥反应的临床症状。在其余4名受者中，移植后1周的抗供体CML反应性低于术前水平。在12个月时下降更为明显，尽管对第三方细胞的反应性未改变。当将具有长期功能肾脏的受者的细胞添加到细胞培养物中时，无关第三方个体对供体的CML反应性受到抑制。结果表明，在具有长期功能肾移植的受者中，供体特异性CML无反应性的基础上存在供体特异性细胞抑制机制。
