Scoazec J Y, Durand F, Degott C, Delautier D, Bernuau J, Belghiti J, Benhamou J P, Feldmann G
Laboratoire de Biologie Cellulaire, Faculté de Médecine Xavier Bichat, Paris, France.
Gastroenterology. 1994 Oct;107(4):1094-102. doi: 10.1016/0016-5085(94)90234-8.
BACKGROUND/AIMS: Allogeneic recognition of donor cells by host T lymphocytes requires the expression of cytokine-dependent molecules, such as class II major histocompatibility antigens, intracellular adhesion molecule 1 (ICAM-1), and lymphocyte function-associated antigen 3 (LFA-3). In the liver, activation of Kupffer cells after ischemic injury during the transplantation procedure may result in an early induction of cytokine-dependent molecules.
The pattern of induction of ICAM-1, HLA-DR, HLA-DQ, and LFA-3 was investigated in 30 postreperfusion surgical biopsy specimens of liver allografts by an immunohistochemical technique.
Two patterns of induction were observed: focal or diffuse. On hepatocytes, ICAM-1 was induced in 22 cases (11 focal, 11 diffuse), HLA-DR in 18 cases (13 focal, 5 diffuse), HLA-DQ in 13 cases (3 focal, 10 diffuse), and LFA-3 in 1 case (focal). On bile duct cells, HLA-DR was expressed in 19 cases, associated with HLA-DQ in 7 cases. No induction of ICAM-1 and LFA-3 was detected. Compared with the other patients, the group of patients with diffuse postoperative hepatocellular induction of ICAM-1 was characterized by higher preharvesting serum transaminase levels in the donor (P < or = 0.001), suggestive of preoperative ischemic injury, and increased incidence of acute graft rejection (P = 0.04).
Preoperative warm ischemia may modify the immunogenicity of liver allografts.
背景/目的：宿主T淋巴细胞对供体细胞的同种异体识别需要细胞因子依赖性分子的表达，如II类主要组织相容性抗原、细胞间黏附分子1（ICAM-1）和淋巴细胞功能相关抗原3（LFA-3）。在肝脏中，移植过程中缺血性损伤后库普弗细胞的激活可能导致细胞因子依赖性分子的早期诱导。
采用免疫组织化学技术，对30例肝移植术后再灌注手术活检标本中ICAM-1、HLA-DR、HLA-DQ和LFA-3的诱导模式进行了研究。
观察到两种诱导模式：局灶性或弥漫性。在肝细胞上，22例诱导了ICAM-1（11例局灶性，11例弥漫性），18例诱导了HLA-DR（13例局灶性，5例弥漫性），13例诱导了HLA-DQ（3例局灶性，10例弥漫性），1例诱导了LFA-3（局灶性）。在胆管细胞上，19例表达了HLA-DR，7例与HLA-DQ相关。未检测到ICAM-1和LFA-3的诱导。与其他患者相比，术后肝细胞弥漫性诱导ICAM-1的患者组的特点是供体术前血清转氨酶水平较高（P≤0.001），提示术前存在缺血性损伤，且急性移植物排斥反应的发生率增加（P = 0.04）。
术前热缺血可能改变肝移植的免疫原性。
