Rd. Chan et al., ANALYSIS OF ADHESION MOLECULE EXPRESSION BY TUBULAR EPITHELIAL-CELLS USING URINE IMMUNOCYTOLOGY, Acta cytologica, 39(3), 1995, pp. 435-442
On their surface, renal tubular cells present intercellular adhesion m
olecule-1 (ICAM-1) during acute renal allograft rejection. We propose
that the extent of ICAM-1 expression by renal tubular cells can be est
imated from urine immunocytology. To test this hypothesis, we obtained
52 samples of urine from 32 renal transplant recipients with either a
cute tubular necrosis, rejection or stable renal function. Cytocentrif
uged aliqtrots of urinary sediment were incubated with monoclonal anti
bodies to ICAM-1 in an avidin-biotin-peroxidase technique. To corrobor
ate our findings, biopsy specimens were obtained for conventional and
immunohistology one hour following vascular anastomosis and during rej
ection episodes. The proportion of renal tubular cells that expressed
ICAM-1 was low in patients with acute tubular necrosis (23.8 +/- 3.6%)
and high in patients with rejection (53.1 +/- 4.4% [SEM]) (P <.002).
In 11 patients who recovered from rejection, the proportion of ICAM-1-
positive renal tubular cells decreased from 55.9 +/- 5.6% to 25.5 +/-
4.3% (P <.05). In two patients who initially had acute tubular necrosi
s and then rejected their transplants, the expression of ICAM-1 on ren
al tubular cells tended to increase (from 27.5 +/- 2.5% to 60.0 +/- 20
.0%, P=.12). In eight patients with acute tubular necrosis who never r
ejected their transplants, ICAM-1 expression remained low (23.1 +/- 3.
8%). Immunocytology correlated well with immunohistology and the clini
cal diagnosis. Our findings suggest that urine immunocytology may be u
seful in monitoring adhesion molecule expression by renal tubular cell
s.