Scoazec J Y, Borghi-Scoazec G, Durand F, Bernuau J, Pham B N, Belghiti J, Feldmann G, Degott C
Laboratoire de Biologie Cellulaire and INSERM Unite 327, Faculte de Medecine Xavier Bichat, Paris, France.
Gastroenterology. 1997 Mar;112(3):908-18. doi: 10.1053/gast.1997.v112.pm9041253.
BACKGROUND & AIMS: Little is known about the occurrence and possible consequences of local complement activation in human liver transplantation. The aim of this study was to search for signs of complement activation in human liver allografts and evaluate their relationship to cell injury and leukocyte sequestration.
In 33 postreperfusion biopsy specimens, 9 preoperative specimens, and 10 intraoperative specimens, the cytolytic membrane attack complex of complement was localized, expression of complement inhibitors was evaluated, and intragraft accumulation of leukocytes and platelets was quantitated.
In control samples and preoperative biopsy specimens, the membrane attack complex was detected only in extracellular deposits, associated with its soluble inhibitors clusterin and vitronectin. Comparable observations were performed in 14 postoperative specimens. In the remaining 19 postoperative specimens, membrane attack complex decorated a variable proportion of hepatocytes. The extent of membrane attack complex deposition correlated with the increase in postoperative aspartate aminotransferase levels in serum (P = 0.002) and the decrease in postoperative factor V levels in serum (P = 0.002). It also correlated with the number of leukocytes and platelets accumulating within the graft (P < or = 0.001).
Local complement activation is frequent during human liver transplantation and probably contributes to cell injury and leukocyte sequestration in the allograft.
关于人类肝移植中局部补体激活的发生情况及其可能的后果，目前了解甚少。本研究的目的是寻找人类肝脏同种异体移植物中补体激活的迹象，并评估其与细胞损伤和白细胞滞留的关系。
在33份再灌注后活检标本、9份术前标本和10份术中标本中，对补体的溶细胞性膜攻击复合物进行定位，评估补体抑制剂的表达，并对移植物内白细胞和血小板的积聚进行定量分析。
在对照样本和术前活检标本中，仅在细胞外沉积物中检测到膜攻击复合物，其与可溶性抑制剂簇集素和玻连蛋白相关。在14份术后标本中也有类似的观察结果。在其余19份术后标本中，膜攻击复合物标记了不同比例的肝细胞。膜攻击复合物沉积的程度与术后血清中天冬氨酸转氨酶水平的升高（P = 0.002）以及术后血清中凝血因子V水平的降低（P = 0.002）相关。它还与移植物内积聚的白细胞和血小板数量相关（P≤0.001）。
在人类肝移植过程中，局部补体激活很常见，可能导致同种异体移植物中的细胞损伤和白细胞滞留。
