Iványi B, Hansen H E, Olsen S
Institute of Pathology, Albert Szent-Györgyi Medical University, Szeged, Hungary.
Transplantation. 1993 Sep;56(3):581-5. doi: 10.1097/00007890-199309000-00017.
The term tubulitis denotes infiltration of the renal tubular epithelium by mononuclear cells. Tubulitis is one of the most reliable signs of acute renal allograft rejection. However, its segmental localization and quantitative characteristics are not precisely known. To investigate this question, formalin-fixed kidney biopsy specimens from 15 patients with transplanted allografts undergoing acute rejection were studied stereologically by identifying cortical tubules with segment-specific markers. The periodic acid-Schiff reaction, peanut lectin, and antibodies against Tamm-Horsfall protein and epidermal cytokeratins, all applied to the same section, were used to identify the profiles of proximal tubules (PTs), distal convoluted tubules (DCTs), distal straight tubules (DSTs), and the cortical collecting system (CCS, connecting tubules and cortical collecting ducts), respectively. Two parameters, the relative intrasegmental length and the average intensity of tubular damage, were determined to describe the degree of tubulitis quantitatively. Tubulitis was most prominent in the DCTs, followed by the CCS. The average intensity of tubulitis was lowest in the DSTs. The results indicate that the PTs are not the main site of tubulitis, despite the fact that they are regarded primary targets of the rejection response.
肾小管炎一词指单核细胞浸润肾小管上皮。肾小管炎是急性肾移植排斥反应最可靠的征象之一。然而，其节段定位和定量特征尚不完全清楚。为研究这一问题，我们对15例接受急性排斥反应的移植肾福尔马林固定活检标本进行了体视学研究，采用节段特异性标志物识别皮质肾小管。将高碘酸-希夫反应、花生凝集素以及抗Tamm-Horsfall蛋白和表皮细胞角蛋白的抗体应用于同一切片，分别用于识别近端小管（PT）、远端曲管（DCT）、远端直管（DST）和皮质集合系统（CCS，连接小管和皮质集合管）的轮廓。确定了两个参数，即相对节段内长度和肾小管损伤平均强度，以定量描述肾小管炎的程度。肾小管炎在DCT中最为突出，其次是CCS。DST中肾小管炎的平均强度最低。结果表明，尽管PT被认为是排斥反应的主要靶点，但它们并非肾小管炎的主要部位。
