We performed dual immunohistochemistry for CD163/CD34 and CD68/CD34 in 108 renal transplant indication biopsies to investigate the presence and distribution of macrophages in various renal compartments. All Banff scores and diagnoses were revised according to the Banff 2019 classification. CD163 and CD68 positive cell counts (CD163pos and CD68pos) were evaluated in the interstitium, glomerular mesangium, and, within glomerular and peritubular capillaries. The diagnosis was antibody-mediated rejection (ABMR) in 38 (35.2%), T-cell mediated rejection (TCMR) in 24 (22.2%), mixed rejection in 30 (27.8%), and no rejection in 16 (14.8%). Banff lesion scores t, i, and ti were correlated with both CD163 and CD68 interstitial inflammation scores (r > 0.30; P < 0.05). Glomerular total CD163pos was correlated to Banff lesion scores g and cg (r > 0.30; P < 0.05). Glomerular total, mesangial, and intracapillary CD68pos were correlated with g (r > 0.30; P < 0.05). Both glomerular total and peritubular capillary CD68pos were correlated with peritubular capillaritis (r > 0.30; P < 0.05). Glomerular CD163pos were significantly higher in ABMR compared with no rejection, in mixed rejection compared with no rejection and TCMR. CD163pos in peritubular capillaries was significantly higher in mixed rejection compared with no rejection. Glomerular CD68pos was significantly higher in ABMR compared with no rejection. CD68pos per peritubular capillary was higher in mixed rejection, ABMR, and TCMR compared with no rejection. In conclusion, compared with CD68 positive macrophages, localization of CD163 positive macrophages in various renal compartments seems to be different among rejection subtypes and their glomerular infiltration seems to be more specific for the presence of ABMR component.

我们在 108 个肾移植适应症活检中对 CD163/CD34 和 CD68/CD34进行了双重免疫组织化学，以研究巨噬细胞在不同肾区室中的存在和分布。所有班夫分数和诊断均根据班夫 2019 年分类进行了修订。在间质、肾小球系膜以及肾小球和管周毛细血管内评估 CD163 和 CD68 阳性细胞计数（CD163pos 和 CD68pos）。诊断为抗体介导排斥反应(ABMR) 38 例 (35.2%)，T 细胞介导排斥反应 (TCMR) 24 例 (22.2%)，混合排斥反应 30 例 (27.8%)，无排斥反应 16 例 (14.8%) . 班夫病变评分t、i和ti与 CD163 和 CD68 间质炎症评分相关（r > 0.30；P < 0.05）。肾小球总 CD163pos 与 Banff 损伤评分g和 cg相关（ r > 0.30；P < 0.05）。肾小球总数、系膜和毛细血管内 CD68pos 与g相关（r > 0.30；P < 0.05）。肾小球总和管周毛细血管 CD68pos 均与管周毛细血管炎相关 ( r > 0.30; P <0.05）。肾小球 CD163pos 在 ABMR 中显着高于无排斥，在混合排斥中显着高于无排斥和 TCMR。与无排斥相比，混合排斥中管周毛细血管中的 CD163pos 显着更高。ABMR 中的肾小球 CD68pos 显着高于无排斥反应。与无排斥相比，混合排斥、ABMR 和 TCMR 中每个管周毛细血管的 CD68pos 更高。总之，与 CD68 阳性巨噬细胞相比，CD163 阳性巨噬细胞在不同肾区室中的定位似乎因排斥亚型而异，并且它们的肾小球浸润似乎对 ABMR 成分的存在更具特异性。