同种异体移植肾组织中PCNA蛋白检测诊断的意义

为了提高肾移植急性排斥反应的诊断和治疗效果，选择增殖细胞核抗原（ＰＣＮＡ）作为标记蛋白，观察１７例５９例次移植肾发生急性细胞性排斥（ＡＣＲ）和无ＡＣＲ时，其肾小管浸润细胞中该蛋白的变化，以及与间质浸润细胞的关系。结果表明，无ＡＣＲ的肾组织中，ＰＣＮＡ蛋白仅轻度增加；当移植肾出现ＡＣＲ时，ＰＣＮＡ的增加十分显著，并与间质浸润的ＣＤ８密切相关。结果认为：ＰＣＮＡ对于ＡＣＲ的诊断及鉴别诊断具有一定的临床应用价值。

Predictive value of various immunological markers expressed in renal tissue during acute renal allograft rejection

A retrospective longitudinal study to compare the clinical significance of various immunological markers in renal materials obtained from human renal allografts was carried out.Three to 6 consecutive allgraft biopsy were obtained from 17 serial human transplant recipients over an eight month period.A total of 59 core needle biopsies were examined. The expression of proliferation cell nucleus antigen (PCNA) in the interstitial infiltrates, as well as the presence of CD 4/CD 8 T cell infiltrates were assessed by immunocytochemical staining of frozen sections.When ACR occurred, all the immune activation markers above mentioned increased significantly in the renal specimens as compared with those specimens without ACR, PCNA increased by about 14.7 fold. After MTX pulse therapy the expressions of PCNA in biopsies were evidently down regulated by about 47%.The results of this study suggested that the expression of PCNA in renal allograft might be a useful and helpful adjunct in the diagnosis of ongoing acute cellular rejection, and reduction in these expression might be indictive of successful antirejection therapy.