Lautenschlager I, Höckerstedt K, Taskinen E, Korsbäck C, Mäkisalo H, Häyry P
Fourth Department of Surgery, University of Helsinki, Finland.
Transplantation. 1988 Jul;46(1):41-6. doi: 10.1097/00007890-198807000-00006.
We have used allogeneic pig liver transplants to investigate the structure of inflammation in acute liver allograft rejection. An inflammatory episode of acute cellular rejection was observed in 9/10 allografts in nonimmunosuppressed recipients, when monitored with simultaneous fine-needle aspiration biopsies (FNAB) and core needle biopsies (NB). The intensity of inflammation in FNAB was quantitated using the corrected increment method and correlated with NB findings. In FNAB, all inflammatory episodes were detected on the 4th day after transplantation with lymphoid blast and lymphocyte infiltration, later accompanied by monocytes and macrophages. Maximal intensity of inflammation was recorded in FNAB on day 14. In NB, histology demonstrated distinct inflammation in the portal area on day 4. The predominantly lymphocytic infiltration, also containing varying numbers of plasma cells, eosinophils, neutrophils and macrophages, reached its maximum 7-14 days after transplantation. With the indirect immunoperoxidase technique, lymphoid cell subpopulation analysis of FNAB demonstrated an increase of both T4 and T8 cells during rejection. The T4/T8 ratio was first low, and increased at the beginning of the episode, on day 4, but decreased again on days 7 and 14. The number of B cells in the graft was also elevated during rejection. The cellular changes in the corresponding blood specimens followed approximately the same lines, although the changes were less prominent. NB immunohistology, using immunoperoxidase and frozen sections, correlated well with FNAB results, and demonstrated a T4 predominance in the portal area on day 4 but a T8 predominance on days 7 and 14. In addition to lymphoid cells, macrophages/granulocytes were also frequent in the portal area and scattered in the parenchyma on days 7 and 14. An additional inflammatory cell component in liver allograft rejection, detectable only in the NB, was eosinophils in the portal area, recorded in maximum on day 14. Taken together, the inflammatory changes in the FNAB and NB were similar, and time-related changes of cellular infiltrate in FNAB and NB correlated closely.
我们已使用同种异体猪肝移植来研究急性肝移植排斥反应中的炎症结构。在未接受免疫抑制的受体的10个同种异体移植中，有9个通过同时进行细针穿刺活检（FNAB）和粗针穿刺活检（NB）监测时，观察到急性细胞排斥反应的炎症发作。FNAB中的炎症强度采用校正增量法进行定量，并与NB结果相关联。在FNAB中，所有炎症发作均在移植后第4天检测到，伴有淋巴母细胞和淋巴细胞浸润，随后伴有单核细胞和巨噬细胞。FNAB中炎症强度在第14天达到最大值。在NB中，组织学显示移植后第4天门静脉区域有明显炎症。主要为淋巴细胞浸润，也含有不同数量的浆细胞、嗜酸性粒细胞、中性粒细胞和巨噬细胞，在移植后7 - 14天达到最大值。采用间接免疫过氧化物酶技术，对FNAB进行淋巴细胞亚群分析显示，排斥反应期间T4和T8细胞均增加。T4/T8比值最初较低，在发作开始时即第4天升高，但在第7天和第14天再次下降。移植中B细胞数量在排斥反应期间也升高。相应血液标本中的细胞变化大致遵循相同趋势，尽管变化不太明显。使用免疫过氧化物酶和冰冻切片的NB免疫组织学与FNAB结果相关性良好，并显示移植后第4天门静脉区域以T4为主，但在第7天和第14天以T8为主。除淋巴细胞外，巨噬细胞/粒细胞在第7天和第14天也常见于门静脉区域并散在于实质中。肝移植排斥反应中另一种仅在NB中可检测到的炎症细胞成分是门静脉区域的嗜酸性粒细胞，在第14天达到最大值。总体而言，FNAB和NB中的炎症变化相似，FNAB和NB中细胞浸润的时间相关变化密切相关。
