Study On The Relationship Between The Expression Of Interleukin-17and The Renal Allograft Acute Rejection And Its Clinical Significance

Acute rejection has been a progressive improvement in short-term renaltransplant survival, With the development of transplantation immunologyresearch, improvements in surgical techniques, the introduction of potentanti-rejection therapy and the improvement of the control measures ofpostoperative complications.The occurrence of an acute rejection episode,however, still remains a major determinant of late allograft dysfunction. It is animportant work to look for early, sensitive and specific monitoring indicatorsfor the early diagnosis of acute rejection. Interleukin-17(IL-17), aproinflammatory cytokine with multiple functions, plays a critical role in theregulation of cellular and humeral immune response, and even in transplantrejection reported currently.In this study, we evaluated the contribution of IL-17in the transplant renalbiopsy tissue, and analysis the relativity and its clinical significance.Objective: To investigate the expression of IL-17in renal biopsies andanalysis the relativity and its clinical significance.Methods: seventy-two renal biopsies collected in January2008to October2011are divided into4groups by Banff07criteria as follow: there were32cases of T cell-mediated rejection (TCMR),9cases of acute antibody-mediated rejection (ATMR),18cases of borderline rejection (BL), and13cases of nosignificant abnormal group. Then the immunohistochemistry staining wasperformed to detect the expressions and localizations of IL-17, and analysis therelativity and clinical significance of IL-17expression correlated to acute renalgraft rejection.Results: Immunohistochemistry results showed that, expressions ofIL-17, observed in the four groups of renal biopsy, have different levels.1、IL-17was mainly expressed in tubules and/or interstitial, occasional expressionin glomerular invasion of inflammatory cells, but no expression in vascular.2、IL-17expression rates in tubules were84.4%（27/32）、55.6%（5/9）、61.6%（11/18）and46.2%（6/13）in T cell-mediated rejection(TCMR)、acuteantibody-mediated rejection(ATMR)、borderline rejection(BL) andno significant abnormal group(NL)，there were difference between TCMR andno significant abnormal group(84.4%versus46.2%, p>0.05), while there wereno difference between ATMR and NL(55.6%versus46.2%, p>0.05), BL andNL(61.6%versus46.2%, p>0.05).3、IL-17expression rates in interstitial were81.3%（26/32）、66.7%（6/9）、55.6%（10/18）and30.8%（4/13）in T cell-mediatedrejection(TCMR)、 acute antibody-mediated rejection(ATMR)、 borderlinerejection(BL) and no significant abnormal group(NL)，there were differencebetween TCMR and no significant abnormal group(81.3%versus30.8%,p=0.004),while there were no difference between ATMR and NL(66.7%versus30.8%, p>0.05), BL and NL(55.6%versus30.8%, p>0.05).4、Combinedwith the pathological diagnosis and clinical data showed that, IL-17expressionin TCMR tubular renal tissues had correlated with the tubulitis and increasedserum creatinine（r=0.455，P=0.034and r=0.37，P=0.038）；meanwhile, IL-17expression in ATMR had correlated with the C4d deposition（r=0.45，P=0.001）.5、The follow-up data showed that, the level of IL-17has been anindependent prognostic factor in renal allograft and increased the chance ofacute rejection.Conclusion:1、IL-17was mainly expressed in Banff classification I(IA、IB) in Tcell-mediated rejection；2、IL-17expression in T cell-mediated rejection had correlation with theC4d deposition；3、 IL-17expressed in kidney transplantation allograft can helpunderstand pathological change and prognosis of allograft.