气道上皮再生对肺移植后闭塞性气道疾病的影响
기도상피재생대폐이식후폐새성기도질병적영향
Role of reepithelization in the development of obliterative airway disease after lung transplantation
  • 万方数据
    中华器官移植杂志 중화기관이식잡지
    CHINESE JOURNAL OF ORGAN TRANSPLANTATION
    2008年 5期 286-289 ,共4页

    徐保彬%陈昶%高文%魏宁%郑卉%张容轩

    서보빈%진창%고문%위저%정훼%장용헌

    细支气管炎%闭塞性%气管%移植%上皮%再生 細支氣管炎%閉塞性%氣管%移植%上皮%再生
    세지기관염%폐새성%기관%이식%상피%재생
    Bronchiolitis,obliterans%Trachea%Tissue transplantation%Epithelium%Regeneration
    目的 探讨气道上皮再生对肺移植后闭塞性气道疾病(OAD)的影响.方法 以Balb/c小鼠的气管和左主支气管构成的连续气道为移植物,原位移植给C57BL/6小鼠,供者的气管与受者头侧的气管断端行端端吻合,供者的右支气管残端与受者气管的另一断端行端端吻合,左主支气管的残端结扎,形成盲端(非结扎组),部分受者在此基础上将其左主支气管起始部也予以结扎(结扎组).术后28 d切取移植物,HE染色评价OAD的发生情况、气道上皮的完整性和分化程度、黏膜下炎症细胞浸润和纤维组织增生情况;应用形态学定量分析软件测量固有层与软骨的比值(LCR)、黏膜下层纤维组织的面积(以象素表示)以及气道上皮中纤毛上皮的比例;免疫组织化学染色鉴定气道上皮的表型.结果 两个组的气管段以及非结扎组的支气管管腔通畅,上皮完整,黏膜下可见炎症细胞浸润和纤维组织增生,未见OAD改变;而结扎组的支气管中可见大量纤维组织增生致管腔完全闭塞,上皮消失.软骨塌陷,呈现明显OAD改变.非结扎组的气管和支气管以及结扎组的气管的LCR明显高于正常气管(P＜0.01);结扎组的气管和支气管、非结扎组的气管和支气管固有膜内的纤维组织面积明显超过正常气管(P＜0.05),结扎组的支气管固有膜内的纤维组织面积明显大于非结扎组的支气管(P＜0.05);非结扎组的气管和支气管以及结扎组的气道上皮中纤毛上皮的比例明显低于正常气管上皮(P＜0.05);非结扎组的支气管纤毛上皮比例明显低于非结扎组的气管和结扎组的气管(P＜0.01).两个组的气管和非结扎组的支气管上皮为受者上皮表型,而结扎组支气管无受者上皮存在.结论 移植气道的上皮经再上皮化,其上皮表型改变,抗原性降低,并且由于该再生的上皮对黏膜下纤维组织的增生有抑制作用,从而预防了OAD的发生.
    목적 탐토기도상피재생대폐이식후폐새성기도질병(OAD)적영향.방법 이Balb/c소서적기관화좌주지기관구성적련속기도위이식물,원위이식급C57BL/6소서,공자적기관여수자두측적기관단단행단단문합,공자적우지기관잔단여수자기관적령일단단행단단문합,좌주지기관적잔단결찰,형성맹단(비결찰조),부분수자재차기출상장기좌주지기관기시부야여이결찰(결찰조).술후28 d절취이식물,HE염색평개OAD적발생정황、기도상피적완정성화분화정도、점막하염증세포침윤화섬유조직증생정황;응용형태학정량분석연건측량고유층여연골적비치(LCR)、점막하층섬유조직적면적(이상소표시)이급기도상피중섬모상피적비례;면역조직화학염색감정기도상피적표형.결과 량개조적기관단이급비결찰조적지기관관강통창,상피완정,점막하가견염증세포침윤화섬유조직증생,미견OAD개변;이결찰조적지기관중가견대량섬유조직증생치관강완전폐새,상피소실.연골탑함,정현명현OAD개변.비결찰조적기관화지기관이급결찰조적기관적LCR명현고우정상기관(P＜0.01);결찰조적기관화지기관、비결찰조적기관화지기관고유막내적섬유조직면적명현초과정상기관(P＜0.05),결찰조적지기관고유막내적섬유조직면적명현대우비결찰조적지기관(P＜0.05);비결찰조적기관화지기관이급결찰조적기도상피중섬모상피적비례명현저우정상기관상피(P＜0.05);비결찰조적지기관섬모상피비례명현저우비결찰조적기관화결찰조적기관(P＜0.01).량개조적기관화비결찰조적지기관상피위수자상피표형,이결찰조지기관무수자상피존재.결론 이식기도적상피경재상피화,기상피표형개변,항원성강저,병차유우해재생적상피대점막하섬유조직적증생유억제작용,종이예방료OAD적발생.
    Objective To investigate the role of airway reepithelization in the development of obliterative airway disease (OAD) after lung transplantation. Methods Donor allograft was obtained as Balb/c trachea and its connecting left bronchi, and it was subsequently orthotopically transplanted into recipient C57BL/6 mouse. Both ends of the donor trachea were anastmosed to the recipient in endto-end mode, and the bronchial branch was ligated distally. In the ligated group, the proximal end of the bronchi was ligated; it was otherwise left open in the unligated group. Allografts were harvested on postoperative day 28, and were examined for OAD manifestations, epithelium integrity and differentiation, submucous lymphocyte infiltration, and fibroproliferation. LCR, submucous fibrous tissue area and ciliated epithelium proportion were measured with computerized morphometry. Epithelium phenotype was examined by immunohistochemical stain. Results Tacheal allografts and unligated bronchi maintained luminal patency and integrated epithelium, while ligated bronchial allografts were obliterated with fibrous tissue, which was characteristic of OAD. LCR and lamina propria of the donor trachea and unligated bronchi were significantly higher than normal tracha (P＜0. 01 and P ＜ 0. 05 ). However,ciliated epithelium proportion of the tracheal allografts was intermediate between normal trachea and ligated bronchi (P＜0. 05 and P＜0. 01). Immunohistochernical stain revealed recipient phenotype in both the tracheal and unligated bronchial allografts; no recipient phenotype expression was noted in the ligated bronchial allografts. Conclusion Reepithelization with recipient-drived mucosa prevents OAD development in orthotopic tracheal and unligated bronchial allografts by changing the epithelium phenotype and regulating fibroblasts proliferation in the lamina propria.
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