Forbes G M, Erber W N, Herrmann R P, Davies J M, Collins B J
Department of Gastroenterology, Royal Perth Hospital, Western Australia.
J Clin Pathol. 1995 Apr;48(4):308-13. doi: 10.1136/jcp.48.4.308.
To determine whether there are characteristic immunohistological changes in the colonic mucosa in acute graft versus host disease (GvHD).
Consecutive allogeneic (n = 11) and autologous (n = 11) bone marrow transplant recipients underwent endoscopic biopsy of sigmoid mucosa before transplant and on day 30 post-transplant. Immunohistochemical staining and quantitation of intraepithelial and lamina propria mononuclear cells were undertaken using a panel of monoclonal antibodies and a Streptavidin-biotin alkaline phosphatase staining technique.
In the allogeneic group (nine of whom had clinical acute GvHD) there was a fivefold increase in lamina propria CD16+ mononuclear cells (3.1 +/- 4.3 to 17.0 +/- 12.2 per 100 lamina propria nucleated cells), compared with autologous transplant recipients in whom this rise was twofold (5.5 +/- 4.6 to 10.6 +/- 7.1 per 100 lamina propria nucleated cells). The CD16+ mononuclear cells had morphological appearances of tissue macrophages, but in neither the allogeneic nor autologous groups was there an increase in total macrophage numbers (CD14+). In patients with acute GvHD the lamina propria CD4+:CD8+ lymphocyte ratio fell (1.97 +/- 1.12 to 1.07 +/- 1.01), primarily because of a fall in the number of lamina propria CD4+ lymphocytes. In both allogeneic and autologous groups there was a fall in intraepithelial lymphocyte numbers, but there was no change in CD19+ (B cell), CD25+ (interleukin-2 receptor positive) or CD56+ (natural killer) cell numbers.
Following bone marrow transplantation, there appears to be upregulation of lamina propria tissue macrophage CD16 (an Fc receptor for IgG), a change which is more noticeable after allogeneic transplantation and which may be related to the development of acute GvHD. In patients with acute GvHD there was a fall in the lamina propria CD4+:CD8+ lymphocyte ratio. If these changes are functionally important, they may have significant implications for understanding the pathogenesis of GvHD.
确定急性移植物抗宿主病（GvHD）时结肠黏膜是否存在特征性免疫组织学改变。
连续纳入11例同种异体和11例自体骨髓移植受者，在移植前及移植后第30天对乙状结肠黏膜进行内镜活检。使用一组单克隆抗体和链霉亲和素-生物素碱性磷酸酶染色技术，对上皮内和固有层单核细胞进行免疫组织化学染色及定量分析。
在同种异体组（其中9例有临床急性GvHD）中，固有层CD16 +单核细胞增加了5倍（每100个固有层有核细胞中从3.1±4.3增至17.0±12.2），而自体移植受者中该升高为2倍（每100个固有层有核细胞中从5.5±4.6增至10.6±7.1）。CD16 +单核细胞具有组织巨噬细胞的形态学特征，但在同种异体组和自体组中，总巨噬细胞数量（CD14 +）均未增加。急性GvHD患者的固有层CD4 +:CD8 +淋巴细胞比值下降（从1.97±1.12降至1.07±1.01），主要是由于固有层CD4 +淋巴细胞数量减少。在同种异体组和自体组中，上皮内淋巴细胞数量均下降，但CD19 +（B细胞）、CD25 +（白细胞介素-2受体阳性）或CD56 +（自然杀伤）细胞数量无变化。
骨髓移植后，固有层组织巨噬细胞CD16（IgG的Fc受体）似乎上调，这种变化在同种异体移植后更明显，可能与急性GvHD的发生有关。急性GvHD患者的固有层CD4 +:CD8 +淋巴细胞比值下降。如果这些变化具有功能重要性，则可能对理解GvHD的发病机制具有重要意义。
