title: Heterogeneity in the evolution and mechanisms of the lesions of kidney allograft rejection in mice.
abstract: The natural history and pathogenesis of the pathologic lesions that define rejection of kidney transplants have not been well characterized. We studied the evolution of the pathology of rejection in mouse kidney allografts, using four strain combinations across full major histocompatibility complex (MHC) plus nonMHC disparities, to permit more general conclusions. Interstitial infiltrate, MHC induction, and venulitis appeared by day 5, peaked at day 7-10, then stabilized or regressed by day 21. In contrast, tubulitis, arteritis, and glomerulitis were absent or mild at days 5 and 7, but progressed through day 21, indicating separate regulation and homeostatic control of these lesions. Edema, hemorrhage, and necrosis also increased through day 21. All lesions were T-dependent, failing to develop in T-cell-deficient hosts. Allografts into immunoglobulin-deficient hosts manifested typical infiltration, MHC induction, and tubulitis at days 7 and 21, indicating that these lesions are alloantibody-independent. However at day 21 kidneys rejecting in immunoglobulin-deficient hosts showed decreased edema, arteritis, venulitis, and necrosis. Thus the three groups of lesions are: T-cell-mediated interstitial infiltration, MHC induction, and venulitis, which develops rapidly then stabilizes; slower but progressive T-cell-mediated tubulitis and arteritis; and late antibody-mediated endothelial injury, which contributes to late edema, arteritis, and venulitis.
authors: 1st Department of Internal Medicine, University of Luebeck School of Medicine, Luebeck, Germany.
authors: Wolfram J
authors: WJ
authors: Jabs
authors: Annette
authors: A
authors: Sedlmeyer
authors: Vido
authors: V
authors: Ramassar
authors: Luis G
authors: LG
authors: Hidalgo
authors: Joan
authors: J
authors: Urmson
authors: Marjan
authors: M
authors: Afrouzian
authors: Lin-Fu
authors: LF
authors: Zhu
authors: Philip F
authors: PF
authors: Halloran
mesh_terms: D000818:Animals; D005075:Biological Evolution; D006084:Graft Rejection / Q000276:immunology*; D007668:Kidney / Q000276:immunology / Q000473:pathology; D016030:Kidney Transplantation / Q000276:immunology*; D008285:Major Histocompatibility Complex / Q000276:immunology; D051379:Mice; D018345:Mice, Knockout; D014184:Transplantation, Homologous