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目的探讨肿瘤坏死因子-α(TNF-α)细胞间粘附分子-1(ICAM-1)和血管细胞粘附分子(VCAM-1)在慢性排斥移植肾组织中的表达及其意义。方法采用免疫组化技术对30例慢性排斥移植肾活检组织中TNF-α、ICAM-1和VCAM-1表达进行检测。12例正常肾脏组织作为对照。结果在发生慢性排斥的移植肾组织中,大多数病例有活动性间质及血管周围淋巴细胞浸润和小管局部炎症,肾小球、肾小管及间质浸润细胞TNF-α、ICAM-1和VCAM-1表达程度和分布普遍增强,但主要见于间质浸润细胞、肾小管损伤部位上皮细胞、炎症区域管周毛细血管和微小动脉内皮细胞,与正常对照有明显差异。结论细胞免疫可能在慢性排斥发病中起作用,细胞因子和粘附分子则是一过程中的重要介质。
Objective To investigate the expression of tumor necrosis factor-α (ICAM-1) and vascular cell adhesion molecule (VCAM-1) in chronic rejection of renal allograft and its significance. Methods Immunohistochemistry was used to detect the expression of TNF-α, ICAM-1 and VCAM-1 in 30 cases of chronic rejection renal allograft. 12 cases of normal kidney tissue as a control. Results In the chronic rejection renal transplant recipients, most of the cases had active stroma and perivascular lymphocyte infiltration and local inflammation of the tubules, TNF-α, ICAM-1 and VCAM in glomerular, tubular and interstitial infiltrating cells -1 expression level and distribution generally enhanced, but mainly found in interstitial infiltrating cells, epithelial cells of the tubular injury site, perivascular capillaries and arteriolar endothelial cells in the inflammatory area, there are significant differences with the normal control. Conclusions Cellular immunity may play a role in the pathogenesis of chronic rejection. Cytokines and adhesion molecules are important mediators in the process.