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目的 :研究肾移植术后患者尿沉渣中的细胞抗原 ,特别是在排斥反应时的变化。 方法 :以肾移植患者 5 6例为研究对象 ,自尿中提取mRNA ,经逆转录获得cDNA ,利用RT PCR法对HLA DR抗原基因进行检测。 结果 :急性排斥反应 (AR ,n =18)组 :HLA DR基因 16例表达 ,2例无表达。慢性排斥反应 (CR ,n =12 )组 :HLA DR基因 2例表达 ,10例无表达。环孢霉素中毒 (CRA ,n =6 )组 :HLA DR基因 6例均无表达 ,正常移植肾组 (Normal,n=2 0 ) :HLA DR基因 1例表达 ,19例无表达。 结论 :从肾移植患者尿沉渣中提取mRNA是可能的 ,HLA DR抗原基因mRNA在AR组病例的尿沉渣中高频率地表达 ,并且其表达与供体和受体HLA DR抗原错配无相关性 ,提示尿中HLA DR抗原基因的表达有可能成为诊断肾移植AR的一种新的指标
OBJECTIVE: To study the cellular antigens in urinary sediment after renal transplantation, especially in rejection. Methods: Fifty-six renal transplant recipients were enrolled in this study. MRNA was extracted from urine and cDNA was obtained by RT-PCR. The HLA-DR antigen gene was detected by RT-PCR. Results: Acute rejection (AR, n = 18) group: 16 cases of HLA DR gene expression, 2 cases no expression. Chronic rejection (CR, n = 12) group: HLA DR gene expression in 2 cases, 10 cases without expression. Cyclosporine poisoning (CRA, n = 6): HLA DR was not expressed in all 6 cases, and in normal kidney transplantation group (Normal, n = 20): HLA DR was expressed in 1 case and no expression in 19 cases. CONCLUSION: It is possible to extract mRNA from urinary sediment in renal transplant recipients. HLA DR antigen mRNA is highly expressed in urinary sediment of patients with AR and its expression is not correlated with HLA DR antigen mismatch between donor and recipient. Prompt urinary HLA DR antigen gene expression may be a diagnostic indicator of renal transplant AR a new indicator