URINE CYTOLOGY AND THE DIAGNOSIS OF RENAL-ALLOGRAFT REJECTION .2. STUDIES USING IMMUNOSTAINING

BACKGROUND: Urine immunocytology may provide a noninvasive method of i nvestigating the antigens expressed by renal tubular cells. In previou s investigations of patients with acute renal allograft rejection (AR) , we showed that the adhesion molecule ICAM-1 is expressed by voided t ubular cells. The up-regulation of ICAM-1, in turn, may be due to high circulating levels of interferon-gamma and/or TNF-alpha. We investiga ted the regulation of receptors for these cytokines and found a correl ation between their expression and clinical events. STUDY DESIGN: For 10 patients who received transplants consecutively, freshly voided ali quots of urine were obtained on each hospital clay and on each outpati ent visit for a mean of 52.8+/-26.2 (SD) days. After cytocentrifugatio n, the samples were prepared by the avidin - biotin - immunoperoxidase technique in order to detect the presence or absence of ICAM-1, inter feron-gamma receptor and TNF-alpha receptor (p 80) on the tubular cell s. RESULTS: In nonrejecting patients, the tubular cells expressed the interferon-gamma receptor bur not ICAM-1 or the TNF-alpha receptor. In patients with AR, the pattern was different. The tubular cells expres sed ICAM-1 and the TNF-a receptor but not the interferon-gamma recepto r. CONCLUSION: Urine immunocytochemistry may be were obtained on each hospital clay and on each outpatient visit for a mean of 52.8+/-26.2 ( SD) days. After cytocentrifugation, the samples were prepared by the a vidin - biotin - immunoperoxidase technique in order to detect the pre sence or absence of ICAM-1, interferon-gamma receptor and TNF-alpha re ceptor (p 80) on the tubular cells. RESULTS: In nonrejecting patients, the tubular cells expressed the interferon-gamma receptor bur not ICA M-1 or the TNF-alpha receptor. In patients with AR, the pattern was di fferent. The tubular cells expressed ICAM-1 and the TNF-alpha receptor but not the interferon-gramma receptor. CONCLUSION: Urine immunocytoc hemistry may be useful to demonstrate the expression of cytokine recep tors by renal epithelia.