Mast cell numbers and protease expression patterns in biopsy specimens following renal transplantation from living-related donors predict long-term graft function.
In human kidney transplantation the main cause of declining long-term graft function is chronic allograft nephropathy (CAN). Recent studies have implicated human mast cells (MC) in chronic inflammation and fibrosis, MC can be subtyped according to protease content: MC(T) containing tryptase only and MC(TC) containing both tryptase and chymase. We investigated immunohistochemically whether numbers and subtypes of MC in biopsy specimens 100 d after transplantation could predict subsequent fibrosis and graft dysfunction. The total number of MC/high-power field at 100 d after transplantation correlated significantly with change in creatinine clearance (DeltaCcr), defined as (Ccr at 100 d) - (Ccr at 3 yr) (R = 0.597, p = 0.0021); fibrosis index (FI) at 100 d (R = 0.583, p = 0.0066); and DeltaFI, defined as (FI at 3 yr) - (FI at 100 d) (R = 0.406, p < 0.05). The ratio of MC(TC) to total MC at 100 d also correlated with DeltaCcr (R = 0.491, p = 0.0148), FI at 100 d (R = 0.527, p = 0.0081), and DeltaFI (R = 0.417, p < 0.05). Thus, increases in number of total MC and the ratio of MC(TC) to total MC in early biopsy specimens were related to decline of long-term graft function and fibrosis.
Ishida
Toshiro
T
Division of Urology, Department of Organs Therapeutics, Faculty of Medicine, Kobe University Graduate School of Medicine, Kobe, Japan.
Hyodo
Yoji
Y
Ishimura
Takeshi
T
Takeda
Masashi
M
Hara
Isao
I
Fujisawa
Masato
M
D001706:Biopsy; D056649:Cathepsin G; D002403:Cathepsins / Q000378:metabolism; D002452:Cell Count; D053818:Chymases; D005355:Fibrosis; D006084:Graft Rejection / Q000378:metabolism; D006801:Humans; D007150:Immunohistochemistry; D007668:Kidney / Q000473:pathology; D016030:Kidney Transplantation; D019520:Living Donors; D008407:Mast Cells / Q000378:metabolism*; D011184:Postoperative Period; D012697:Serine Endopeptidases / Q000378:metabolism*; D013997:Time Factors; D053802:Tryptases
D002403:Cathepsins; D012697:Serine Endopeptidases; C534094:CTSG protein, human; D056649:Cathepsin G; D053818:Chymases; D053802:Tryptases