Microvascular destruction in renal transplant rejection

GA Bishop, JA Waugh, DV Landers, AM Krensky… - …, 1989 - journals.lww.com
GA Bishop, JA Waugh, DV Landers, AM Krensky, BM Hall
Transplantation, 1989journals.lww.com
In normal kidneys, peritubular and glomerular capillaries can be readily identified by their
intense expression of HLA class I and class II compared to other cells within the graft. This
high density of expression of MHC, plus their exposure to activated circulating lymphocytes,
makes these cells the likely early and primary target of rejection responses. The fate of these
capillaries during renal allograft rejection was examined using an indirect
immunoperoxidase staining technique and monoclonal antibodies to class I and class II …
Abstract
In normal kidneys, peritubular and glomerular capillaries can be readily identified by their intense expression of HLA class I and class II compared to other cells within the graft. This high density of expression of MHC, plus their exposure to activated circulating lymphocytes, makes these cells the likely early and primary target of rejection responses. The fate of these capillaries during renal allograft rejection was examined using an indirect immunoperoxidase staining technique and monoclonal antibodies to class I and class II MHC antigens as well as other antigens on capillary endothelium including ICAM-1, LFA-3, and a novel antigen identified by E1. 5. Expression of HLA-DR by peritubular capillaries was decreased during rejection, and this disappearance of peritubular capillaries with severe rejection was confirmed by loss of other markers of microvascular endothelium. These studies suggest peritubular capillaries may be the major target of the acute rejection response, and the techniques described allow assessment of degree of damage to these structures in renal allograft biopsies.
Lippincott Williams & Wilkins