Expression And Significance Of Indoleamine2,3-dioxygenase In The Kidney Allograft

Background:As technology continues to mature kidney transplant, a year patient/graft survival rate after renal transplantation has reached90%, but long-term survival after renal transplantation has not been significantly improved, which also restricted the further development of kidney transplantation the major problem. Induced renal transplant recipients achieve the ideal state of immune tolerance, on the one hand, to avoid graft recipients harmful immune response, on the other hand does not need immunosuppression to maintain a low immune status of the recipient, so that from in addition to causing the root cause of chronic renal allograft rejection incentives, avoiding immunosuppression caused by side effects, which can achieve improved long-term graft survival purposes. Indoleamine2,3dioxygenase (indoleamine2,3-dioxygenase, IDO) as the only catalyst can be outside in the liver tryptophan indole molecule epoxidation cracking along the tryptophan-kynurenine pathway catabolic rate-limiting enzyme, which can be local tissue degradation of tryptophan, thereby inhibiting the T cells, the immune cells. In recent years, the immunosuppressive effects of IDO has been widespread concern of scholars, IDO induction may be realized as a new role of transplantation tolerance targets in the field of organ transplantation to play an important role.Objective:Explore indoleamine2,3dioxygenase (indoleamine2,3-dioxygenase, IDO) in the transplanted kidney tissue and its significance, initially revealed induction of transplantation tolerance in the role.Methods:Select the First Affiliated Hospital of Zhengzhou University, as of October2012between the transplanted kidney disease management transplanted kidney biopsy specimens and resection specimens of84cases, including67cases of renal biopsy specimens, transplant nephrectomy specimens of17cases, male62cases, female22cases, patients aged21years-61years, mean37.8years, are used in postoperative tacrolimus or cyclosporine A-based, combined mycophenolate mofetil and corticosteroids triple maintenance immunosuppressive regimen Patients with renal biopsy indications for postoperative serum creatinine, decreased urine output, renal ultrasonography hard texture and prompts such as elevated renal vascular resistance, renal dysfunction symptoms. Transplant nephrectomy indications for graft loss function, graft rupture transplanted kidney can not continue to keep the situation.84patients, in accordance with the standards Banff07pathological diagnosis showed that antibody-mediated acute rejection in7cases, T cell-mediated acute rejection in28cases (13cases in which Class â… , â…¡ grade10cases,IIIgrade5cases), T cell-mediated chronic rejection in10cases, antibody-mediated chronic rejection in23cases,16cases of immunosuppression neurotoxicity. Also selected10cases of normal renal biopsy specimens as a control group, the application of IDO monoclonal mouse anti-human antibodies, according to two-step method for immunohistochemical staining, detection of renal allograft tissue IDO expression.Results and conclusions:Normal kidney tissue did not express IDO, with different pathological diagnosis of kidney transplant between IDO expression rate and expression intensity difference was statistically significant (Hc=55.623,P<0.05). Antibody-mediated acute rejection and chronic T cell-mediated rejection of IDO expression positive rate and lower intensity. In T cell-mediated acute rejection, rejection of different pathological grading of IDO expression intensity between statistically significant (Hc=13.651, P<0.05), further analysis revealed that expression of IDO-positive T-cell mediated mediated rejection level was negatively correlated (rs=-0.696, P<0.05). IDO expression in renal transplant recipients is closely related to changes in immune status, IDO involved in immune regulation after renal transplantation, and the high expression of IDO can significantly reduce the intensity of rejection, suggesting that IDO may be long-term survival and induction of renal allografthave great significance tolerance,IDOafter transplantation could be a predictor of immune status and induction of immune tolerance to achieve targets.