Lajoie G, Nadasdy T, Laszik Z, Blick K E, Silva F G
Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City 73104, USA.
Mod Pathol. 1996 Dec;9(12):1118-25.
Mast cells (MCs), few in the normal kidney, are found in increased number in the renal parenchyma in diseases associated with persistent chronic inflammation. MCs are not easily identified in routinely processed archival tissue sections with histochemical stains. A more reliable method of detection was provided with the introduction of MC tryptase-specific monoclonal antibodies. To determine the possible role of MCs in renal allograft rejection, we studied 28 biopsy specimens from renal allografts that had been in place for various lengths of time (from 3 days to 40 months) in patients whose primary diagnosis was acute interstitial rejection; the specimens were associated with varying degrees of interstitial fibrosis, edema, and hemorrhage. The specimens were graded on a semiquantitative scale (from 0 to 3+) for the severity of rejection, the degree of interstitial fibrosis, interstitial edema, and interstitial hemorrhage. Eosinophils, plasma cells, and MCs were quantitatively evaluated in these biopsy specimens. MCs were detected by use of a commercially available anti-MC tryptase monoclonal antibody, which proved to be an excellent tool to detect MCs in routinely processed paraffin sections. A positive correlation was found between the number of MCs and the time since transplantation (R = 0.841, P < 0.005) and between the number of MCs and the severity of interstitial fibrosis (R = 0.489, P < 0.005), as well as with interstitial edema (R = 0.517, P < 0.005). MCs were increased in number in patients with moderate (n = 18; mean, 18.00 MCs per 10 high power fields [HPFs]) and severe (n = 5; mean, 12.20 MCs per 10 HPFs) acute rejection compared with patients with mild (n = 5; mean, 2.44 MCs per 10 HPFs) acute rejection and normal kidneys (n = 6; mean, 1.75 MCs per 10 HPFs). These results suggested that MCs might play a role in the process of acute rejection of renal allografts and in the development of interstitial fibrosis.
肥大细胞（MCs）在正常肾脏中数量很少，而在与持续性慢性炎症相关的疾病中，其在肾实质中的数量会增加。在常规处理的存档组织切片中，用组织化学染色法不易识别MCs。随着MC类胰蛋白酶特异性单克隆抗体的引入，提供了一种更可靠的检测方法。为了确定MCs在肾移植排斥反应中的可能作用，我们研究了28例肾移植活检标本，这些标本来自原发性诊断为急性间质性排斥反应的患者，肾移植时间长短不一（3天至40个月）；标本伴有不同程度的间质纤维化、水肿和出血。根据排斥反应的严重程度、间质纤维化程度、间质水肿程度和间质出血程度，对标本进行半定量评分（从0到3+）。对这些活检标本中的嗜酸性粒细胞、浆细胞和MCs进行定量评估。使用市售的抗MC类胰蛋白酶单克隆抗体检测MCs，结果证明该抗体是检测常规处理石蜡切片中MCs的优良工具。发现MCs数量与移植后的时间之间呈正相关（R = 0.841，P < 0.005），与间质纤维化的严重程度之间呈正相关（R = 0.489，P < 0.005），与间质水肿之间也呈正相关（R = 0.517，P < 0.005）。与轻度急性排斥反应患者（n = 5；平均每10个高倍视野[HPFs]中有2.44个MCs）和正常肾脏患者（n = 6；平均每10个HPFs中有1.75个MCs）相比，中度急性排斥反应患者（n = 18；平均每10个HPFs中有18.00个MCs）和重度急性排斥反应患者（n = 5；平均每10个HPFs中有12.20个MCs）的MCs数量增加。这些结果表明，MCs可能在肾移植急性排斥反应过程和间质纤维化的发展中起作用。
