Significance Of CD20Positive B Lymphocyte Infiltrating In Renal Allograft Tissue

In recent decades, with the progress of the matching technology,surgicalskills and immunosuppressants, the rate of acute renal transplant rejection issignificantly reduced, the short-term survival of the transplanted kidney has asubstantial increase.But the rejection after renal transplantation remains themajor risk factors affecting the long-term survival of transplanted kidneycurrently.How to improve the survival time and quality of life of thetransplanted kidney recipients is still needs of the important issues in the fieldof kidney transplantation.In recent years, the study found that CD20positive B lymphocytes do notexpress in normal kidney tissue, but highly express and aggregation of infiltrateduring the occurrence of kidney allograft rejection. The infiltration of CD20positive B lymphocyte associated with prognosis and long-term survival of thetransplanted kidney. However, research in this area is relatively little and still inthe controversial stage.Thus, the study is main to systematically study the infiltration ofCD20-positive B lymphocyte in the transplanted kidney biopsy tissue, and thenexplore the significance of CD20positive B lymphocyte infiltrating in renalallograft tissue. Objective: To investigate and research the significance of CD20positive Blymphocyte infiltrating in renal allograft tissue.Methods: This study selected70cases of renal transplant patients thatconsidering existent renal allograft rejection in clinic to receive transplantedkidney biopsy,these patients who come to undergo kidney transplantion andregularly follow-up during postoperation in urinary system disease diagnosisand treatment center of Bethune First Hospital of Jilin University in January2010to March2012. They are divided into six groups by Banff criteria asfollow: there were20cases of acute cellular rejection,8cases of acutehumoral rejection,15cases of chronic cellular rejection,7cases of chronichumoral rejection,8cases of renal allograft borderline lesion group and12cases of the other group. It’s to observe the situation of CD20positive Blymphocyte infiltrating in transplanted renal biopsy tissues through theimmunohistochemical staining; combined pathological diagnosis and clinicaldata of the selected cases to explore the Significance of CD20positive Blymphocyte infiltrating in renal allograft tissue.Results:1. the diagnosis results of transplanted kidney biopsy and statistical analysisof general information of the patients.These cases were divided into6groups according to Banff pathologicaldiagnostic criteria, the results is above. Rejection group is50cases, non-rejection group is20cases. In the rejection group, acute rejection groupis28patients and chronic rejection group is22patients; cellular rejection groupis35patients, humoral rejection group is15patients. Depending on the degreeof rejection, the mild rejection group is20cases, the severe rejection group is30cases. Which selected cases in age,sex,weight,primary disease,the differencewas not statistically significant (P>0.05).2. The situation of CD20positive B lymphocyte infiltrating in renalallograft tissueSelected transplant renal biopsyspecimens were CD20immunohistochemicalstaining. According to the degree of CD20positive B lymphocyte infiltrating inrenal allograft tissue, these cases were divided into Group A,the negative group(CD20-positive B lymphocytes infiltrating accounting tubulointerstitial area<10%)26patients; Group B,the moderate infiltration Group (CD20-positiveB lymphocyte infiltration accounted tubulointerstitial area10%~50%)26casesand Group C,the severe infiltration Group (CD20positive B lymphocyteinfiltration accounted the tubulointerstitial Area>50%)18cases. Accordingto Statistical analysis, CD20positive B lymphocyte infiltrating in renalallograft tissue is associated with renal allograft rejection,this could promptrenal allograft rejection, but regardless of the type of rejection, at the sametime, the degree of infiltration is related to the level of renal allograft rejection.3. The situation of C4d depositing in renal allograft tissue According to the grading rules of C4d and the method of positivedetermining that determined in the2007Banff meeting, these cases weregrouped into the negative group (group D), the focal positive group(group E),the diffuse positive group(group F). After statistical analysis, CD20positive Blymphocytes infiltrating is small correlated with C4d depositing. But the degreeof CD20positive B lymphocytes infiltrating is related to the degree of C4ddepositing.4. The relation of CD20positive B lymphocyte infiltrating in renal allografttissue with the prognosis of transplanted kidney,and the affect of the degree ofthe infiltration to the prognosis.The average level of creatinine of the CD20negative group,moderateinfiltration group and severe invasive group before transplanted kidneypuncture were320.26士212.36umol/L,263.18士160.38umol/L and355.47士242.54umol/L;the level of creatinine of the three groups in six months afterpuncture respectively were308.24士214.78umol/L,270.42士168.37umol/Land371.58士253.96umol/L;the level of creatinine of the three groups in oneyear after puncture respectively were274.29士209.28umol/L,343.75士258.36umol/L and445.74士316.52umol/L. The level of creatinine of the threegroups in before the puncture and six months after the puncture was nosignificant difference between CD20-positive and negative groups, but thelevel of creatinine of the three groups in before the puncture and one yearafter the puncture has an average statistical difference. It suggest that CD20 positive B lymphocyte infiltrating in renal allograft tissue is related to theprognosis of transplanted kidney,suggesting a poor prognosis of transplantedkidney. And the higher the degree of infiltration, the worse the prognosis.Conclusion:1. CD20positive B lymphocytes infiltrating in renal allograft tissue isrelated to renal allograft rejection,It could prompt to diagnosis the renalallograft rejection; but CD20-positive B lymphocytes infiltrating is nocorrelation with the type of renal allograft rejection (acute and chronic rejection;cells, vascular rejection);at the same time, the degree of infiltration isassociated with the severity of rejection.2. There was no correlation between CD20-positive B lymphocyteinfiltrating and C4d deposited in rejected renal allograft. But It was found thatthe degree of CD20-positive infiltrating is related to the degree of peritubularC4d deposition.3. CD20-positive B lymphocyte infiltrating in renal transplantation isrelated to the prognosis of transplanted kidney,suggesting a poor prognosisof transplanted kidney, and the higher the degree of infiltration, the worse theprognosis.