移植肾急性抗体介导排斥反应中半乳糖凝集素7的表达
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摘要
背景:半乳糖凝集素家族蛋白在移植免疫调节中的作用已被提出,目前尚未有半乳糖凝集素7检测对于肾移植后围手术期移植肾功能不全的辅助诊断,对肾移植受者而言,监测半乳糖凝集素7可能及早发现移植后肾功能异常,为临床治疗争取时间。目的:检测半乳糖凝集素7在移植肾急性抗体介导性排斥反应中的表达。方法:选取同种异体肾移植后行移植肾穿刺活检诊断为急性抗体介导性排斥反应的患者27例,同时选取同期移植后肾病理穿刺经诊断为正常的患者10例做对照。应用免疫组织化学染色法检测半乳糖凝集素7在组织中的表达情况、应用Western Blot法检测各组血清半乳糖凝集素7蛋白表达水平差异。结果与结论:免疫组织化学正常组光镜下半乳糖凝集素7表达于近曲小管上皮细胞表面微绒毛,肾小球、远曲小管、集合管和静脉未见其表达;急性抗体介导的体液性排斥反应组光镜下肾小动脉内膜水肿,管壁纤维素样坏死,肾小球肾小管淋巴细胞和单核细胞浸润,半乳糖凝集素7仅见于近曲小管上皮细胞表面微绒毛,同时动脉平滑肌也有表达,阳性度较高。急性抗体介导的体液性排斥反应组半乳糖凝集素7阳性细胞计数显著高于正常对照组(P<0.01)。Western Blot检测结果,急性抗体介导的体液性排斥反应组血清半乳糖凝集素7的表达高于正常对照组(P<0.05)。结果说明,移植肾穿刺病理活检安全可靠,对患者及移植肾无不良影响,半乳糖凝集素7检测对于肾移植后围手术期移植肾功能不全的辅助诊断具有重要的指导意义。
BACKGROUND: The role of galactose lectin family proteins in transplantation immunity has been proposed, but there is currently no galectin-7 detection for auxiliary diagnosis of renal dysfunction in the perioperative period after renal transplantation. For renal transplant recipients, monitoring of galectin-7 may contribute to early diagnosis of renal dysfunction after renal transplantation, and buy time for clinical treatment. OBJECTIVE: To detect the expression of galactose-7 in acute antibody mediated rejection after renal transplantation. METHODS: Twenty-seven patients who were diagnosed as having acute antibody mediated rejection after renal transplantation by renal biopsy were enrolled, and another 10 patients without acute antibody mediated rejection after renal transplantation were selected as controls. Immunohistochemical staining and western blot assay were used to detect expression of galectin-7 in tissue and serum, respectively.RESULTS AND CONCLUSION: Results of immunohistochemistry staining showed that under light microscope, in the control group, galectin-7 distributed in the surface microvilli of proximal tubule epithelial cells, but not in glomeruli, distal tubule, collecting duct and vein; in the acute rejection group, renal arteriole intima edema, tube wall fibrinoid necrosis, infiltration of renal glomerulus and tubule cells and mononuclear cells were found and galectin-7 only expressed in the surface microvilli of proximal tubule epithelial cells as well as in the arterial smooth muscle. The number of galectin-7 positive cells in the acute rejection group was significantly higher than that in the control group(P < 0.1). Western blot assay results showed that the protein expression of serum galectin-7 in the acute rejection group was higher than that in the control group(P < 0.05). These findings indicate that renal puncture for renal transplantation is safe and reliable, has no adverse effect on the patients and renal transplant. Galectin-7 detection has an important guiding significance for the auxiliary diagnosis of renal dysfunction during the perioperative period after renal transplantation.
BACKGROUND: The role of galactose lectin family proteins in transplantation immunity has been proposed, but there is currently no galectin-7 detection for auxiliary diagnosis of renal dysfunction in the perioperative period after renal transplantation. For renal transplant recipients, monitoring of galectin-7 may contribute to early diagnosis of renal dysfunction after renal transplantation, and buy time for clinical treatment. OBJECTIVE: To detect the expression of galactose-7 in acute antibody mediated rejection after renal transplantation. METHODS: Twenty-seven patients who were diagnosed as having acute antibody mediated rejection after renal transplantation by renal biopsy were enrolled, and another 10 patients without acute antibody mediated rejection after renal transplantation were selected as controls. Immunohistochemical staining and western blot assay were used to detect expression of galectin-7 in tissue and serum, respectively.RESULTS AND CONCLUSION: Results of immunohistochemistry staining showed that under light microscope, in the control group, galectin-7 distributed in the surface microvilli of proximal tubule epithelial cells, but not in glomeruli, distal tubule, collecting duct and vein; in the acute rejection group, renal arteriole intima edema, tube wall fibrinoid necrosis, infiltration of renal glomerulus and tubule cells and mononuclear cells were found and galectin-7 only expressed in the surface microvilli of proximal tubule epithelial cells as well as in the arterial smooth muscle. The number of galectin-7 positive cells in the acute rejection group was significantly higher than that in the control group(P < 0.1). Western blot assay results showed that the protein expression of serum galectin-7 in the acute rejection group was higher than that in the control group(P < 0.05). These findings indicate that renal puncture for renal transplantation is safe and reliable, has no adverse effect on the patients and renal transplant. Galectin-7 detection has an important guiding significance for the auxiliary diagnosis of renal dysfunction during the perioperative period after renal transplantation.
引文
[1]韩永,郭晖,蔡明,等.移植肾活检:病理及组织学的早期诊断价值[J].中国组织工程研究,2013,17(5):785-790.
[2]Suryawanshi A,Cao Z,Thitiprasert T,et al.Galectin-1-mediated suppression of Pseudomonas aeruginosa-induced corneal immunopathology.J Immunol.2013;190(12):6397-6409.
[3]Perone MJ,Bertera S,Shufesky WJ,et al.Suppression of autoimmune diabetes by soluble galectin-1.J Immunol.2009;182(5):2641-2653.
[4]Ye Y,Yan S,Jiang G,et al.Galectin-1 prolongs survival of mouse liver allografts from Flt3L-pretreated donors.Am J Transplant.2013;13(3):569-579.
[5]Chen X,Song CH,Liu ZQ,et al.Intestinal epithelial cells express galectin-9 in patients with food allergy that plays a critical role in sustaining allergic status in mouse intestine.Allergy.2011;66(8):1038-1046.
[6]雒真龙,周鸿敏,黄霞,等.Galectin-7在人和鼠同种异体心脏移植物中的表达及其意义[J].实用医学杂志,2013,29(10):1567-1569.
[7]Koller H,Steurer W,Mark W,et al.Clearance of C4d deposition after successful treatment of acute humoral rejection in follow-up biopsies:a report of three cases.Transpl Int.2004;17(4):177-181.
[8]Hokama A,Mizoguchi E,Mizoguchi A.Roles of galectins in inflammatory bowel disease.World J Gastroenterol.2008;14(33):5133-5137.
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[10]Vijayakumar S,Peng H,Schwartz GJ.Galectin-3 mediates oligomerization of secreted hensin using its carbohydraterecognition domain.Am J Physiol Renal Physiol.2013;305(1):F90-99.
[11]Takeuchi T,Tamura M,Nishiyama K,et al.Mammalian galectins bind galactoseβ1-4fucose disaccharide,a unique structural component of protostomial N-type glycoproteins.Biochem Biophys Res Commun.2013;436(3):509-513.
[12]Vizzini A,Parrinello D,Sanfratello MA,et al.Inducible galectins are expressed in the inflamed pharynx of the ascidian Ciona intestinalis.Fish Shellfish Immunol.2012;32(1):101-109.
[13]Magnaldo T,Bernerd F,Darmon M.Galectin-7,a human14-kDa S-lectin,specifically expressed in keratinocytes and sensitive to retinoic acid.Dev Biol.1995;168(2):259-271.
[14]Nio J,Kon Y,Iwanaga T.Differential cellular expression of galectin family mRNAs in the epithelial cells of the mouse digestive tract.J Histochem Cytochem.2005;53(11):1323-1334.
[15]Young PP,Modur V,Teleron AA,et al.Enrichment of genes in the aortic intima that are associated with stratified epithelium:implications of underlying biomechanical and barrier properties of the arterial intima.Circulation.2005;111(18):2382-2390.
[16]韩永,黄海燕,许晓光,等.移植肾穿刺组织病理学检查及临床分析[J].中华实用诊断与治疗杂志[J].2010,24(12):1173-1178.
[17]石炳毅.应进一步提高肾脏移植排斥反应的无创诊断水平[J].中华医学杂志,2011,91(48):3385-3387.
[18]郭晖.抗体介导的排斥反应病理学研究概要[J].中华移植杂志,2012,6(2):138-143.
[19]Tyan DB,Li VA,Czer L,et al.Intravenous immunoglobulin supprcssion of HLA alloant ibody in highly sensit ized transplant candidat es and transplant at ion w ith a hist oincompat ible organ.Trans plantat ion.1994;57(4):553-562.
[20]Montgomery RA,Zachary AA,Racusen LC,et al.Plasmepheresis and intravenous immune globulin p rovides effective rescue therapy for refractory humoral rejection and allows kidneys to be succeddfully transp lanted into cross2match2positive recip ients.Transp lantion.2000;70(6):887-895.
[21]Casadei D,Rial M,Argento J,et al.Preliminary results from a randomized and prospective study of high-dose immunoglobulin versus monoclonal antibody in the rescue of steroid-resistant rejections.Transplant Proc.1998;30(5):2164.
[22]John R,Konvalinka A,Tobar A,et al.Determinants of long-term graft outcome in transplant glomerulopathy.Transplantation.2010;90(7):757-764.
[23]邹万忠.发展和提高我国的肾活检病理检查水平[J].中华肾脏病杂志,2005,21(6):303-305.
[24]向雪宝.肾移植围手术期目标导向性液体治疗进展[J].器官移植,2014,5(3):191-193.
[25]John R,Konvalinka A,Tobar A,et al.Determinants of long-term graft outcome in transplant glomerulopathy.Transplantation.2010;90(7):757-764.
[2]Suryawanshi A,Cao Z,Thitiprasert T,et al.Galectin-1-mediated suppression of Pseudomonas aeruginosa-induced corneal immunopathology.J Immunol.2013;190(12):6397-6409.
[3]Perone MJ,Bertera S,Shufesky WJ,et al.Suppression of autoimmune diabetes by soluble galectin-1.J Immunol.2009;182(5):2641-2653.
[4]Ye Y,Yan S,Jiang G,et al.Galectin-1 prolongs survival of mouse liver allografts from Flt3L-pretreated donors.Am J Transplant.2013;13(3):569-579.
[5]Chen X,Song CH,Liu ZQ,et al.Intestinal epithelial cells express galectin-9 in patients with food allergy that plays a critical role in sustaining allergic status in mouse intestine.Allergy.2011;66(8):1038-1046.
[6]雒真龙,周鸿敏,黄霞,等.Galectin-7在人和鼠同种异体心脏移植物中的表达及其意义[J].实用医学杂志,2013,29(10):1567-1569.
[7]Koller H,Steurer W,Mark W,et al.Clearance of C4d deposition after successful treatment of acute humoral rejection in follow-up biopsies:a report of three cases.Transpl Int.2004;17(4):177-181.
[8]Hokama A,Mizoguchi E,Mizoguchi A.Roles of galectins in inflammatory bowel disease.World J Gastroenterol.2008;14(33):5133-5137.
[9]Troncoso MF,Elola MT,Croci DO,et al.Integrating structure and function of'tandem-repeat'galectins.Front Biosci(Schol Ed).2012;4:864-887.
[10]Vijayakumar S,Peng H,Schwartz GJ.Galectin-3 mediates oligomerization of secreted hensin using its carbohydraterecognition domain.Am J Physiol Renal Physiol.2013;305(1):F90-99.
[11]Takeuchi T,Tamura M,Nishiyama K,et al.Mammalian galectins bind galactoseβ1-4fucose disaccharide,a unique structural component of protostomial N-type glycoproteins.Biochem Biophys Res Commun.2013;436(3):509-513.
[12]Vizzini A,Parrinello D,Sanfratello MA,et al.Inducible galectins are expressed in the inflamed pharynx of the ascidian Ciona intestinalis.Fish Shellfish Immunol.2012;32(1):101-109.
[13]Magnaldo T,Bernerd F,Darmon M.Galectin-7,a human14-kDa S-lectin,specifically expressed in keratinocytes and sensitive to retinoic acid.Dev Biol.1995;168(2):259-271.
[14]Nio J,Kon Y,Iwanaga T.Differential cellular expression of galectin family mRNAs in the epithelial cells of the mouse digestive tract.J Histochem Cytochem.2005;53(11):1323-1334.
[15]Young PP,Modur V,Teleron AA,et al.Enrichment of genes in the aortic intima that are associated with stratified epithelium:implications of underlying biomechanical and barrier properties of the arterial intima.Circulation.2005;111(18):2382-2390.
[16]韩永,黄海燕,许晓光,等.移植肾穿刺组织病理学检查及临床分析[J].中华实用诊断与治疗杂志[J].2010,24(12):1173-1178.
[17]石炳毅.应进一步提高肾脏移植排斥反应的无创诊断水平[J].中华医学杂志,2011,91(48):3385-3387.
[18]郭晖.抗体介导的排斥反应病理学研究概要[J].中华移植杂志,2012,6(2):138-143.
[19]Tyan DB,Li VA,Czer L,et al.Intravenous immunoglobulin supprcssion of HLA alloant ibody in highly sensit ized transplant candidat es and transplant at ion w ith a hist oincompat ible organ.Trans plantat ion.1994;57(4):553-562.
[20]Montgomery RA,Zachary AA,Racusen LC,et al.Plasmepheresis and intravenous immune globulin p rovides effective rescue therapy for refractory humoral rejection and allows kidneys to be succeddfully transp lanted into cross2match2positive recip ients.Transp lantion.2000;70(6):887-895.
[21]Casadei D,Rial M,Argento J,et al.Preliminary results from a randomized and prospective study of high-dose immunoglobulin versus monoclonal antibody in the rescue of steroid-resistant rejections.Transplant Proc.1998;30(5):2164.
[22]John R,Konvalinka A,Tobar A,et al.Determinants of long-term graft outcome in transplant glomerulopathy.Transplantation.2010;90(7):757-764.
[23]邹万忠.发展和提高我国的肾活检病理检查水平[J].中华肾脏病杂志,2005,21(6):303-305.
[24]向雪宝.肾移植围手术期目标导向性液体治疗进展[J].器官移植,2014,5(3):191-193.
[25]John R,Konvalinka A,Tobar A,et al.Determinants of long-term graft outcome in transplant glomerulopathy.Transplantation.2010;90(7):757-764.