Study on apoptosis of tubular epithelial cells and lymphocyte in acute rejection of renal allograft after steroid pulse therapy

    ZHANG Bo, WANG He, ZHANG Shaoª²Zeng, WU Guoª²Jun, LI Xin, YANG Xiaoª²Jian, YU Lei, ZHANG Geng

    Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi¡¯an 710033, China

    ¡¾Abstract¡¿ AIM: To explore the changes of apoptosis of tubular epithelial cells and lymphocyte in acute rejection of renal allograft after steroid pulse therapy. METHODS: Renal biopsy specimens of 64 transplant recipients with acute rejection were examined for apoptosis. Biopsies were performed after steroid pulse therapy and were compared with 40 transplant biopsies with unspecific organ injury of lymphocyte infiltration. Apoptosis cells of grafts were monitored by terminal deoxynucleotidyltransferaseª²mediated dUTPª²digoxigenin nick end labeling (TUNEL) analysis. RESULTS: The TUNEL showed that in the 64 cases of the acute rejection group, apoptosis of lymphocytes was found in 44 cases, that of tubular epithelial cells in 34 cases and no apoptosis in 20 cases. In the 40 cases of the control group, 24 biopsies showed tubular epithelial apoptosis (P£½0.2351) and 4 cases showed lymphocyte apoptosis (P£½0.000). According to the Banff classification, 16 cases were grade¢ñof acute rejection, 34 grade ¢òand 14 grade ¢ó. lymphocyte apoptosis were found in 14 cases, 22cases and 8 cases, respectively (P=0.1530). CONCLUSION: In the acute rejection of renal allograft after steroid pulse therapy, lymphocyte apoptosis is a phenomenon predominantly restricted to rejection processes, which may be related to the prognosis of acute rejection. ......