title: Histology of intestinal allografts: lymphocyte apoptosis and phagocytosis of lymphocytic apoptotic bodies are diagnostic findings of acute rejection in addition to crypt apoptosis.
abstract: Acute rejection of a small-bowel transplant is often difficult to diagnose due to complicated immune responses. The present study aimed to elucidate the specific immune responses involved in intestinal transplant rejection. We correlated immunohistologic findings with an increase in crypt apoptosis, which has been commonly accepted as a criterion for the diagnosis of acute cellular rejection (ACR). Of 8 patients who received an intestinal allograft at Kyoto University Hospital, biopsy specimens from 7 patients were assessed immunohistologically with antibodies against 20 types of lymphocytic antigens including CD3, CD4, CD8, CD79a, CD20, IgG, and T-cell receptor, along with assessment of the patients' clinical courses. It was revealed that, in addition to apoptotic crypts, T-lymphocyte apoptosis and phagocytosis of apoptotic bodies in the lamina propria of villi were findings of ACR; both were observed in all cases. Immunostaining of the Fas ligand, one of the apoptosis-inducing molecules, was useful for the identification of the apoptotic bodies in the lamina propria of villi. Apoptotic body phagocytosis may be a surrogate diagnostic finding of grafts undergoing ACR.
authors.affiliation: Department of Diagnostic Pathology, Graduate School of Medicine, Kyoto University, Kyoto, Japan. tsuruyam@kuhp.kyoto-u.ac.jp
authors.forename: Tatsuaki
authors.initials: T
authors.lastname: Tsuruyama
authors.forename: Shinya
authors.initials: S
authors.lastname: Okamoto
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Fujimoto
authors.forename: Atsushi
authors.initials: A
authors.lastname: Yoshizawa
authors.forename: Elena
authors.initials: E
authors.lastname: Yoshitoshi
authors.forename: Hiroto
authors.initials: H
authors.lastname: Egawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakase
authors.forename: Wulamujiang
authors.initials: W
authors.lastname: Aini
authors.forename: Masashi
authors.initials: M
authors.lastname: Miyao
authors.forename: Keiji
authors.initials: K
authors.lastname: Tamaki
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Yamabe
authors.forename: Hironori
authors.initials: H
authors.lastname: Haga
authors.forename: Shinji
authors.initials: S
authors.lastname: Uemoto
mesh_terms: D000208:Acute Disease; D015703:Antigens, CD / Q000378:metabolism; D017209:Apoptosis / Q000276:immunology*; D015415:Biomarkers / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D053222:Fas Ligand Protein / Q000378:metabolism; D005260:Female; D006084:Graft Rejection / Q000175:diagnosis* / Q000276:immunology; D006085:Graft Survival / Q000187:drug effects; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D007413:Intestinal Mucosa / Q000473:pathology*; D007421:Intestine, Small / Q000276:immunology / Q000637:transplantation*; D008297:Male; D010587:Phagocytosis / Q000276:immunology*; D013601:T-Lymphocytes / Q000276:immunology / Q000473:pathology*; D014184:Transplantation, Homologous; D055815:Young Adult
chemical_list: D015703:Antigens, CD; D015415:Biomarkers; D053222:Fas Ligand Protein; D007166:Immunosuppressive Agents