Nadasdy T, Smith J, Laszik Z, Waner J L, Johnson L D, Silva F G
Department of Pathology, University of Oklahoma, Oklahoma City.
Mod Pathol. 1994 Apr;7(3):289-94.
Cytomegalovirus (CMV) was recently identified, using in situ hybridization, in the coronary arteries of patients with cardiac transplant rejection, suggesting a role of CMV in the development of obliterative transplant arteriopathy in cardiac allografts. We sought to verify this observation by examining arteries in kidney transplants with intimal thickening due to chronic rejection. Eleven renal biopsies and 13 nephrectomies from 24 patients, all showing obliterative transplant arteriopathy, were collected for this study. Of these patients, six were seropositive for CMV before transplantation, three were identified as seropositive following renal transplantation, nine had no evidence of CMV infection, and clinical data were not available for an additional six patients. Paraffin-embedded renal sections were examined for the presence of CMV by immunohistochemistry in situ hybridization and polymerase chain reaction. By these methods, only one case (1/24) was demonstrated to have CMV infected cells in the renal interstitium, tubules, and glomeruli, but none (0/24) showed CMV to be located in any of the renal arteries or arterioles. Thus, our results suggest that obliterative transplant arteriopathy can occur in the absence of demonstrable CMV and is probably unrelated to direct CMV infection of the graft.
最近，通过原位杂交技术在心脏移植排斥反应患者的冠状动脉中发现了巨细胞病毒（CMV），这表明CMV在心脏同种异体移植中闭塞性移植性动脉病的发生中起作用。我们试图通过检查因慢性排斥反应而内膜增厚的肾移植动脉来验证这一观察结果。本研究收集了24例患者的11份肾活检标本和13份肾切除术标本，所有标本均显示闭塞性移植性动脉病。在这些患者中，6例在移植前CMV血清学呈阳性，3例在肾移植后被鉴定为血清学阳性，9例没有CMV感染的证据，另外6例患者没有临床数据。通过免疫组织化学原位杂交和聚合酶链反应检测石蜡包埋的肾切片中是否存在CMV。通过这些方法，仅1例（1/24）在肾间质、肾小管和肾小球中检测到CMV感染细胞，但没有（0/24）显示CMV存在于任何肾动脉或小动脉中。因此，我们的结果表明，在没有可证实的CMV的情况下也可发生闭塞性移植性动脉病，并且可能与移植物的直接CMV感染无关。
