Werner M, Keitel R, Schürer K D, Otto U, Klötzer B, Kothe W, Sauer H, Ambrosius H
Z Exp Chir Transplant Kunstliche Organe. 1986;19(5):279-92.
After allogenic renal transplantation in pigs kinetics of the immunological reactivity have been investigated in order to diagnose rejection crisis. In a first series of 26 transplants without any immunosuppression we secured the diagnosis of rejection in 95% of cases of acute or chronic rejection by a combination of antigen-specific rosette test, inhibition of this parameter by autologous serum, complement dependent cytotoxicity and antibody dependent cell-mediated cytotoxicity. The antigen-specific rosette test reacts very early, 2-3 days before a bad clinical feeling in the course of acute rejection or 5-14 days by chronic rejection. Under the therapy with prednisolone and azathioprine we could not reach any prolongation of survival by arbitrary donor-recipient-selection. Under immunosuppression antibodies have never been observed by acute rejection in CDC and ADCC. In every case of acute rejection an increasing rosette formation of specific antigen binding cells appeared 2-3 days before an increasing of serum creatinine. In the case of other complications like infection or thrombosis this test is not reacting. However, by thrombosis of arteria or vena renalis there can be an increased specific rosette formation either independent of this process by beginning of immune reaction or by causal connection of both processes (necrotizing thrombotic rejection). So we have given the evidence, that the antigen-specific rosette test on a high level meets all requirements of a specific diagnosis of rejection under immunosuppression in pig.
为了诊断排斥反应危机,对猪同种异体肾移植后的免疫反应动力学进行了研究。在第一组26例未进行任何免疫抑制的移植中,通过抗原特异性玫瑰花结试验、自体血清对该参数的抑制、补体依赖性细胞毒性和抗体依赖性细胞介导的细胞毒性相结合,我们在95%的急性或慢性排斥病例中确诊了排斥反应。抗原特异性玫瑰花结试验反应非常早,在急性排斥过程中出现临床不适前2 - 3天,或慢性排斥时在5 - 14天。在泼尼松龙和硫唑嘌呤治疗下,通过任意选择供体 - 受体,我们未能延长存活时间。在免疫抑制下,在补体依赖性细胞毒性(CDC)和抗体依赖性细胞介导的细胞毒性(ADCC)中,急性排斥从未观察到抗体。在每例急性排斥中,血清肌酐升高前2 - 3天,特异性抗原结合细胞的玫瑰花结形成增加。在感染或血栓形成等其他并发症情况下,该试验无反应。然而,肾动脉或静脉血栓形成时,可能会出现特异性玫瑰花结形成增加,这要么是免疫反应开始时与该过程无关,要么是两个过程存在因果联系(坏死性血栓性排斥)。因此,我们已经证明,高水平的抗原特异性玫瑰花结试验满足猪免疫抑制下排斥反应特异性诊断的所有要求。