IL-2R 在急性细胞性排异反应的同种异体尸体移植肾组织中的检测及意义

为探讨白介素－２受体（ＩＬ－２Ｒ，即ＣＤ２５）在同种异体肾移植急性细胞性排异（ＡＣＲ）临床诊断的作用，着重观察移植肾发生（ＡＣＲ）和无ＡＣＲ时，其间质浸润细胞中ＩＬ－２Ｒ阳性细胞数的变化，及其与间质浸润的淋巴细胞的关系。作者选择同期行异体肾移植，且无并发症患者１７例，采用ＰＡＰ四层免疫酶标法，检测移植肾组织中间质浸润细胞中ＩＬ－２Ｒ阳性细胞数的变化。结果显示：无ＡＣＲ的肾组织中，ＩＬ－２Ｒ阳性细胞仅轻度增加，当移植肾出现ＡＣＲ时，ＩＬ－２Ｒ阳性细胞数的增加十分显著，并与间质浸润的ＣＤ８密切相关。作者认为ＩＬ－２Ｒ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 IL 2R in renal tissue during acute renal allograft rejection

The pattern of intragraft immunological events associated with acute cellular rejection(ACR) has been previously defined. We conducted a retrospective longitudinal study to compare the clinical significance of various immunological markers in renal materials obtained from human renal allografts.Three to 6 consecutive allograft biopsies were obtained from 17 serial human transplant recipients over an 8 month period. A total of 59 core needle biopsies were examined. The expression of interlukin 2 receptor (IL 2R) in 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, IL 2R expression increased about 16.3 fold in the renal specimens significantly as compared with those specimens without ACR. After MTX pulse therapy the expression of IL 2R in biopsies were evidently down regulated about 60%.The results suggested that the expression of IL 2R in renal allograft may be a useful and helpful adjunct in the diagnosis of ongoing acute cellular rejection, and decrease in these expression may be indicative of successful antirejection therapy.