| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
American Journal of Pathology, Vol 129, 119-132, Copyright © 1987 by American Society for Investigative Pathology
REGULAR ARTICLES |
TV Tuazon, EE Schneeberger, AK Bhan, RT McCluskey, AB Cosimi, RT Schooley, RH Rubin and RB Colvin
Department of Pathology, Massachusetts General Hospital, Boston 02114.
A distinctive glomerular lesion of renal allografts, acute allograft glomerulopathy (AAG), is characterized by hypercellularity and endothelial cell hypertrophy and injury. For elucidating the pathogenesis of this lesion, the infiltrating cells were analyzed by light- and electron-microscopic immunoperoxidase techniques with monoclonal antibodies and compared with those in cellular rejection without AAG (non-AAG). Substantial numbers of T lymphocytes (CD3+,Leu- 4+) were detected in the glomeruli in AAG (11.4 +/- 2.4 cells per glomerular cross-section), whereas very few were found in non-AAG (1.4 +/- 1.8, P less than 0.001). In AAG the CD8+ (Leu-2a) subset accounted for essentially all of the intraglomerular T cells, which had a lower CD4/CD8 ratio than the corresponding peripheral blood lymphocytes (P less than 0.03). AAG also differed from non-AAG by the accumulation of intraglomerular mononuclear cells that expressed HNK-1 antigen (Leu-7) and mononuclear phagocytes, which were identified by the presence of the monocyte fibronectin receptor (A6F10). Intraglomerular mononuclear cells were positive for the interleukin-2 receptor (IL2R) and HLA Class II antigens (HLA-DR). The glomeruli in AAG stained more intensely for HLA Class I antigens than the tubules, in contrast to non-AAG cases (P less than 0.03). The interstitial infiltrates in AAG grafts were less intense than in non-AAG of similar duration (P less than 0.01) and had a lower CD4/CD8 ratio, whereas arterial intimal infiltrates were more severe in AAG (P less than 0.03) and consisted of CD8+, but not CD4+, cells. Pathologic features that correlated with poor graft survival were increased numbers of intraglomerular CD8+ cells (both AAG and non- AAG), fewer interstitial T cells (AAG), and more interstitial CD8+ cells (non-AAG) (all P less than 0.05). Cytomegalovirus (CMV) infection was detected in all (8/8) patients with AAG who were studied for infection before or within 3 weeks after the biopsy, compared with 3 of 9 patients with non-AAG. It is proposed that acute allograft glomerulopathy is a distinct form of T-cell-mediated allograft rejection, sometimes associated with CMV infection, in which the glomerular endothelium, often with the arterial endothelium, becomes the principal target of CD8+ T cells.
This article has been cited by other articles:
 |
|
 |
|
  G. Browne, C. Whitworth, C. Bellamy, and M. M. Ogilvie Acute allograft glomerulopathy associated with CMV viraemia Nephrol. Dial. Transplant., April 1, 2001; 16(4): 861 - 862. [Full Text] [PDF]
|
|
|
|
 |
|
 G. W. Haller, N. Esnaola, K. Yamada, A. Wu, A. Shimizu, A. Hansen, V. R. Ferrara, K. S. Allison, R. B. Colvin, M. Sykes, et al. Thymic Transplantation Across an MHC Class I Barrier in Swine J. Immunol., October 1, 1999; 163(7): 3785 - 3792. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. A. van Gorder, P. Della Pelle, J. W. Henson, D. H. Sachs, A. B. Cosimi, and R. B. Colvin Cynomolgus Polyoma Virus Infection : A New Member of the Polyoma Virus Family Causes Interstitial Nephritis, Ureteritis, and Enteritis in Immunosuppressed Cynomolgus Monkeys Am. J. Pathol., April 1, 1999; 154(4): 1273 - 1284. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. Yamada, P. R. Gianello, F. L. Ierino, T. Lorf, A. Shimizu, S. Meehan, R. B. Colvin, and D. H. Sachs Role of the Thymus in Transplantation Tolerance in Miniature Swine. I. Requirement of the Thymus for Rapid and Stable Induction of Tolerance to Class I-mismatched Renal Allografts J. Exp. Med., August 18, 1997; 186(4): 497 - 506. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
