内皮微粒在肾移植急性排斥反应中的诊断作用

背景:血管内皮细胞的变化与移植排斥反应的关系极为密切,内皮微粒脱落于激活或凋亡的内皮细胞,能直接而特异地反映血管内皮细胞的变化,检测血浆中内皮微粒对肾移植排斥反应的诊断监测具有一定的理论和实际意义。目的:探讨肾移植急性排斥反应时循环内皮微粒的数量和表型的变化及与急性排斥反应之间的关系。方法:建立同基因和同种异基因大鼠腹腔原位肾移植模型;移植后5d苏木精-伊红染色观察肾组织的病理学改变,并进行Banff评分;采用免疫组化法检测肾组织中细胞间黏附分子1表达;采用流式细胞术检测血浆中CD144+内皮微粒数量及细胞间黏附分子1+/CD144+内皮微粒的数量;分析内皮微粒的数量和表型与肾组织病理变化的关系。结果与结论:与同基因移植组比较,异基因移植组Bnaff评分明显增加(P<0.01),肾组织中细胞间黏附分子1表达明显增强(P<0.01);与同基因移植组比较,异基因移植组CD144+内皮微粒的数量和携带细胞间黏附分子1的内皮微粒的水平明显增加(P<0.01)。内皮微粒的数量与移植肾急性排斥反应的程度呈正相关(P<0.01),携带细胞间黏附分子1内皮微粒的水平与移植肾脏中细胞间黏附分子1的表达呈正相关(P<0.01)。提示肾移植后对内皮微粒数量和表型进行检测对诊断急性排斥反应的发生有一定意义。

Endothelial microparticles for diagnosis of acute rejection following renal transplantation

BACKGROUND:Variation of endothelial cells is closely associated with graft rejective reaction. After transplantation, endothelial microparticles (EMPs) are shed from the plasma membrane of endothelial cells, and can reflect the change of endothelial cells directly. Accordingly, it is significant to detect plasma EMPs for monitoring acute rejection after renal transplantation. OBJECTIVE:To study the changes of EMPs in rats of acute rejection after renal transplantation and their relations with acute rejection. METHODS:The syngeneic and allogeneic rat models of orthotopic renal transplantation were established. Pathological changes of the kidneys were observed at 5 days after transplantation by haematoxylin-eosin staining, and were graded according to the Bnaff criteria. The expression of intercellular adhesion molecule-1 in rat kidneys was quantitatively detected by immunohistochemistry. The level of CD144+ EMPs and intercellular adhesion molecule (ICAM)-1+/CD144+ EMPs were measured by flow cytometry. The relation between quantity and phenotype of EMPs and pathological changes of kidneys was analyzed. RESULTS AND CONCLUSION:Compared with syngeneic group, the Bnaffs grades (P < 0.01), the expression of ICAM-1 of kidney (P < 0.01) in allogeneic group was significantly increased. Compared with syngeneic group, the level of CD144+ EMPs and ICAM-1+/CD144+EMPs (P < 0.01) in allogeneic group were significantly increased. The level of CD144+ EMPs was positively related with the Bnaffs grades (P < 0.01), and the level of ICAM-1+/ CD144+EMPs was positively related with the expression of ICAM-1 of kidney (P < 0.01). The level of EMPs detection may be helpful to the diagnosis of acute rejection after transplantation.