Ramos E L, Barri Y M, Croker B P, Clapp W L, Peterson J C, Wilcox C S
Department of Medicine, University of Florida, Gainesville 32610-0224.
Transplantation. 1995 Feb 27;59(4):490-4.
Thromboxane synthase (TS) catalyzes the formation of thromboxane (TxA2) in monocytes/macrophages, platelets, and various tissues. TxA2 is likely to play a role in graft dysfunction due to its vasoconstrictive and platelet aggregatory properties. We studied the expression of TS in 7 normal native kidneys, 29 consecutive renal allograft biopsies (performed for rising serum creatinine, n = 23, and delayed graft function, n = 6), and one transplant nephrectomy specimen with severe acute rejection. TS expression was determined by immunocytochemistry using a monoclonal antibody against human TS, Kon-7. Histologic grading of the transplant biopsy specimens was based on the Banff classification. The degree of TS staining was graded in the glomeruli, interstitium, tubules and vessels from 0 to 3+. Of 29 biopsies, 13 had chronic nephropathy (CN), 6 had acute rejection (AR) with chronic nephropathy (AR/CN), 4 had acute rejection (AR), and 6 had acute tubular necrosis (ATN). TS staining of native kidneys showed sporadic interstitial cells. The biopsy and transplant nephrectomy specimens showed significant staining, predominantly in the glomeruli and interstitium. Positively staining cells appeared to be of macrophage/monocyte lineage by morphology. The mean glomerular staining grade was significantly increased in specimens with AR (2.3 +/- 0.9) and the mean interstitial staining was increased in specimens with AR/CN (2.2 +/- 0.9). Follow-up renal function 6 months post-biopsy showed that patients with higher TS staining grades had a faster decline in graft function. In conclusion, TS expression is increased in patients with acute rejection with or without chronic nephropathy and is associated with more rapid deterioration in function.
血栓素合酶（TS）催化单核细胞/巨噬细胞、血小板及多种组织中血栓素（TxA2）的形成。由于其具有血管收缩和血小板聚集特性，TxA2可能在移植肾功能障碍中发挥作用。我们研究了TS在7个正常自体肾、29例连续肾移植活检标本（因血清肌酐升高进行活检的23例，因移植肾功能延迟进行活检的6例）以及1例伴有严重急性排斥反应的移植肾切除标本中的表达情况。使用抗人TS的单克隆抗体Kon-7通过免疫细胞化学法测定TS表达。移植活检标本的组织学分级基于班夫分类法。TS染色程度在肾小球、间质、肾小管和血管中从0至3+进行分级。29例活检标本中，13例有慢性肾病（CN），6例有急性排斥反应合并慢性肾病（AR/CN），4例有急性排斥反应（AR），6例有急性肾小管坏死（ATN）。自体肾的TS染色显示散在的间质细胞。活检和移植肾切除标本显示有明显染色，主要在肾小球和间质。从形态学上看，阳性染色细胞似乎是巨噬细胞/单核细胞谱系。AR标本的平均肾小球染色分级显著升高（2.3±0.9），AR/CN标本的平均间质染色升高（2.2±0.9）。活检后6个月的随访肾功能显示，TS染色分级较高的患者移植肾功能下降更快。总之，急性排斥反应患者无论有无慢性肾病，其TS表达均增加，且与功能更快恶化相关。
