Galvão M M, Sotto M N, Kihara S M, Rivitti E A, Sabbaga E
Kidney Transplant Unit, University of São Paulo School of Medicine, Brazil.
J Am Acad Dermatol. 1998 Jan;38(1):38-44. doi: 10.1016/s0190-9622(98)70536-5.
Patients who have received renal allografts experience early aging of the skin, opportunistic infections, and an increased incidence of skin cancer.
We compared the density of lymphocyte subsets and Langerhans cells in normal-appearing skin of renal allograft recipients without skin cancer at 5 to 6 years (group 1) and 14 years after transplant (group 2) with a matched normal control group.
Biopsy specimens of sun-protected and exposed areas from 18 white, kidney allograft recipients (10 in group 1 and 8 in group 2) with normal renal function and from 10 healthy volunteers were semiquantitatively analyzed for dermal lymphocyte subsets and Langerhans cells.
There was a statistically significant decrease in all dermal cell elements in the sun-protected skin of both groups of patients who had received grafts. The sun-exposed skin of group 2 also showed a significant decrease of dermal CD4+ and CD8+ lymphocytes, and group 1 had a significant decrease in dermal CD8+ lymphocytes. The dermal CD1a+ cell population in the sun-exposed skin from both grafted groups did not differ from the control group.
Kidney transplant recipients showed dermal depletion of cells related to immune surveillance against tumors even before skin cancer occurred, and this depletion seemed to become more marked with the duration of immunosuppression.
接受肾移植的患者会出现皮肤过早老化、机会性感染以及皮肤癌发病率增加的情况。
我们将移植后5至6年（第1组）和14年（第2组）且无皮肤癌的肾移植受者外观正常皮肤中的淋巴细胞亚群和朗格汉斯细胞密度与匹配的正常对照组进行了比较。
对18名肾功能正常的白色人种肾移植受者（第1组10名，第2组8名）以及10名健康志愿者的防晒和暴露部位皮肤活检标本进行真皮淋巴细胞亚群和朗格汉斯细胞的半定量分析。
两组接受移植患者的防晒皮肤中所有真皮细胞成分均有统计学意义的减少。第2组暴露于阳光下的皮肤中真皮CD4 +和CD8 +淋巴细胞也显著减少，第1组真皮CD8 +淋巴细胞显著减少。两组移植受者暴露于阳光下皮肤中的真皮CD1a +细胞群体与对照组无差异。
肾移植受者在皮肤癌发生之前，其与肿瘤免疫监视相关的真皮细胞就已减少，并且这种减少似乎随着免疫抑制时间的延长而更加明显。
