[HTML][HTML] Monocytes and peritubular capillary C4d deposition in acute renal allograft rejection

AB Magil, K Tinckam - Kidney international, 2003 - Elsevier
AB Magil, K Tinckam
Kidney international, 2003Elsevier
Monocytes and peritubular capillary C4d deposition in acute renal allograft rejection.
Background Peritubular capillary (PTC) deposition of complement split factor C4d in renal
allografts has been shown to be closely associated with circulating antidonor antibodies and
a marker for relatively poor graft survival. Monocyte/macrophage (MO) infiltration of renal
allografts has been shown to adversely affect graft survival. The purpose of this study was to
assess whether the two phenomena are related. Methods Twenty-three biopsies (from 15 …
Monocytes and peritubular capillary C4d deposition in acute renal allograft rejection.
Background
Peritubular capillary (PTC) deposition of complement split factor C4d in renal allografts has been shown to be closely associated with circulating antidonor antibodies and a marker for relatively poor graft survival. Monocyte/macrophage (MO) infiltration of renal allografts has been shown to adversely affect graft survival. The purpose of this study was to assess whether the two phenomena are related.
Methods
Twenty-three biopsies (from 15 patients) demonstrated diffuse strong staining of PTC for C4d (C4d+ group) and acute tubular injury with or without significant cellular rejection, while 28 biopsies (with acute rejection) but negative for PTC C4d served as controls (C4d- group).
Results
The C4d+ group demonstrated significantly greater glomerular and interstitial MO infiltration than did the C4d- group [3.4 ± 2.0 vs. 0.2 ± 0.3 mO/glomerulus, P < 0.0001; 12.9 ± 9.2 vs. 6.5 ± 5.0 mO/high power field (hpf), P = 0.0030]. Neutrophilic (PMN) infiltration of glomeruli and PTC was also significantly greater in the C4d+ group than in the C4d- one (0.8 ± 0.6 vs. 0.3 ± 0.3 PMN/glomerulus, P = 0.0003; 0.9 ± 0.8 vs. 0.4 ± 0.3 PTC PMN/hpf, P = 0.0035).
Conclusion
The results indicate a close association between PTC C4d deposition and MO infiltration, particularly glomerular, and confirm previous observations regarding the correlation of PTC C4d staining and PMN infiltration.
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