Oliveira J G, Xavier P, Neto S, Mendes A A, Guerra L E
Renal Department, Hospital S. João, Porto, Portugal.
Transplantation. 1997 Jun 27;63(12):1751-6. doi: 10.1097/00007890-199706270-00008.
Monocytes-macrophages are found within kidney allografts during the first days after surgery, where they perform "housekeeping" tasks, participate in postreperfusion injury, and act as antigen-presenting cells, as well as become involved in the effector phase of acute rejection. They also seem to play a prominent role in chronic rejection. We quantified their presence in fine-needle aspiration biopsies and studied the growth factors that, we hypothesized, would mark the different implications of the presence of monocytes-macrophages.
Fine-needle aspiration biopsies were obtained from 56 adult renal transplants and analyzed for CD14+ using the alkaline phosphatase-anti-alkaline phosphatase procedure. Thirty-three patients were studied on the production of interleukin (IL)-1 receptor antagonist (IL-1ra), IL-6, IL-8, macrophage colony-stimulating factor, monocyte chemotactic protein 1, and macrophage inflammatory protein 1alpha by aspiration biopsies cultures using enzyme-linked immunosorbent assay techniques.
CD14+ cells were present at significantly higher numbers in steroid-resistant acute rejections but also during the first days after surgery, especially if acute tubular necrosis was present. We found a significantly higher production of IL-1ra by rejection-free patients compared with acutely rejecting patients, and this difference was already established on day 7 after surgery (10+/-10.5 days before rejection).
Monocytes-macrophages are present at higher numbers in aspiration biopsies of kidney transplant patients suffering either acute tubular necrosis or steroid-resistant rejections, but they are present during the first days after transplant in stable patients, too. The production of IL-1ra is significantly up-regulated in stable patients, which suggests that monocytes-macrophages may constitute an early key factor in the down-regulation of the anti-allograft immune response.
单核细胞 - 巨噬细胞在肾移植术后最初几天出现在移植肾内，它们执行“清理”任务，参与再灌注损伤，作为抗原呈递细胞，并参与急性排斥反应的效应阶段。它们似乎在慢性排斥反应中也起重要作用。我们对细针穿刺活检中它们的存在进行了定量，并研究了我们推测会标志单核细胞 - 巨噬细胞存在的不同影响的生长因子。
从56例成人肾移植受者获取细针穿刺活检标本，采用碱性磷酸酶 - 抗碱性磷酸酶法分析CD14 + 细胞。使用酶联免疫吸附测定技术，对33例患者的穿刺活检培养物中白细胞介素（IL）-1受体拮抗剂（IL-1ra）、IL-6、IL-8、巨噬细胞集落刺激因子、单核细胞趋化蛋白1和巨噬细胞炎性蛋白1α的产生情况进行研究。
CD14 + 细胞在激素抵抗性急性排斥反应中数量显著更高，但在术后最初几天也较高，尤其是存在急性肾小管坏死时。我们发现与急性排斥患者相比，无排斥反应患者产生的IL-1ra显著更高，这种差异在术后第7天就已存在（排斥反应前10±10.5天）。
在患有急性肾小管坏死或激素抵抗性排斥反应的肾移植患者的穿刺活检中，单核细胞 - 巨噬细胞数量较多，但在移植后最初几天稳定患者中也存在。稳定患者中IL-1ra的产生显著上调，这表明单核细胞 - 巨噬细胞可能是下调抗移植免疫反应的早期关键因素。
