Immunofluorescence Caused by Cyclosporine in Urinary Exfoliative Cytology in Renal Transplant Recipients

Larsen, Arden E.

doi:10.1097/00007890-198612000-00027

Cited by 2 publications

(1 citation statement)

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“…Thus, in the concept of transplant glomerulopathy [20,21], prominent glomerular infiltrates [4][5][6]8] and endotheliitis [9,21] have gradually been regarded as signs of an unfavorable prognosis. However, little has been published on the effect of pharmacological immunosuppression in the control of immunological rejection phenomena in situ [22], With regard to CsA, although intrarenal deposits of this drug have been associated with morphological phe nomena of nephrotoxicity [16,[23][24][25], no detailed de scriptions have appeared on the influence of intrarenal CsA deposits on the inflammatory infiltrate in the rejec tion reaction. A previous study [16] found no relation between CsA deposits and CD8-positive cytotoxic sup pressor lymphocytes which have been associated with a poor prognosis [5,6,8], However, the occurrence in heart and pulmonary transplant patients of rejection reactions with a poor prognosis, probably related to CsA resistance phenomena in CD4-positive lymphocytes and/or macro phages [17,18], has opened new research avenues.…”

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confidence: 99%

Influence of Intrarenal Deposits of Ciclosporin A on Acute Renal Transplant Rejection

Gómez‐Morales

Bustos

Montes

et al. 1995

Nephron

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Immunohistochemical techniques were used to study the presence of ciclosporin A (CsA) and leukocyte subsets in 36 posttransplant renal biopsy specimens histologically diagnosed as acute graft rejection. Glomeruli from patients with CsA deposits contained more leukocytes (p < 0.05) than glomeruli from tissues without deposits. In contrast, the interstitium from patients without deposits contained significantly more B lymphocytes than interstitia from kidneys with CsA deposits. In both glomeruli and interstitia, the CD4/CD8 ratios were higher in tissues without deposits, although the difference was not significant. The plasma levels of creatinine increased with the intensity of renal CsA deposits, and significantly more patients on hemodialysis had deposits as compared with patients not on hemodialysis. Our findings suggest two types of acute nonvascular rejection: (1) predominantly interstitial, with a good prognosis, characterized by low numbers of intrarenal CsA deposits and a predominance of B lymphocytes and (2) predominantly glomerular, with a poor prognosis, characterized by high levels of intrarenal CsA and a predominance of CD8-positive cells and macrophages.

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