中华实验外科杂志
中華實驗外科雜誌
중화실험외과잡지
CHINESE JOURNAL OF EXPERIMENTAL SURGERY
2012年
10期
1934-1937
,共4页
孙煦勇%秦科%农江%赖彦华%董建辉%聂峰%蔡文娥%黄莹%曹嵩%于立新%刘小友
孫煦勇%秦科%農江%賴彥華%董建輝%聶峰%蔡文娥%黃瑩%曹嵩%于立新%劉小友
손후용%진과%농강%뢰언화%동건휘%섭봉%채문아%황형%조숭%우립신%류소우
肝肾联合移植%急性排斥反应%T淋巴细胞%共刺激分子
肝腎聯閤移植%急性排斥反應%T淋巴細胞%共刺激分子
간신연합이식%급성배척반응%T림파세포%공자격분자
Combined liver and kidney transplantation%Acute rejective reaction%T lymphocyte%Co-stimulatory molecules
目的 观察大鼠肝肾联合移植(CLKT)术后移植肝对移植肾的保护作用,并探讨其机制.方法 实验分为3组实验,每组7对.A组为CLKT组,B组为肾移植(OKT)组,CLKT及OKT组实验均以Wistar大鼠为供体,雄性SD大鼠为受体.分别施行肝肾联合移植和肾移植手术,术后第5天取移植肾组织并染色,光镜下观察病理改变,进行急性排斥反应严重程度的半定量评分,比较CLKT及OKT两组评分的差异.C组为对照组,3组分别在术后第5天处死后抽取外周血应用流式细胞仪分析T淋巴细胞亚群的变化及其共刺激分子CD28、CD152的比例.结果 A组病理评分为(1.42±0.53)分,B组病理评分为(4.14±0.69)分,两组差异有统计学意义(P＜0.01).A、B、C3组的CD3百分比分别为(71.31±14.21)％、(72.63±14.96)％、(68.30±12.40)％,3组间差异无统计学意义(P＞0.05)；CD4+ CD3+/CD3+(％)3组分别为44.38±7.28、61.61±5.67、35.68±5.26,3组间差异有统计学意义(P＜0.05)；3组的CD8+ CD3+/CD3+分别为(21.12±4.03)％、(25.62±5.67)％、(20.06±4.08)％,A组和C组CD8+CD3+T淋巴细胞差异无统计学意义(P＞0.05),但均显著低于OKT组(P＜0.05)；3组CD4+/CD8+分别为(2.11±0.11)％、(2.41±0.23)％、(1.80±0.11)％.各组T细胞亚群上共刺激分子表达,CD28分别为(45.95±7.85)％、(73.42±9.41)％、(24.50±5.02)％,3组间差异有统计学意义(P＜0.05)；CD152的表达3组分别为5.15±1.73、2.08±0.58、0.09±0.04,差异有统计学意义(P＜0.05).结论 肝肾联合移植术后,移植肝对移植肾具有保护作用,能降低移植肾排斥反应的程度；在肝肾联合移植术后,T淋巴细胞的成熟、活化受到抑制,同时抑制了正性共刺激分子CD28的表达,促进负性共刺激分子CD152的表达,在排斥反应的启动阶段起到保护移植肾的作用.
目的 觀察大鼠肝腎聯閤移植(CLKT)術後移植肝對移植腎的保護作用,併探討其機製.方法 實驗分為3組實驗,每組7對.A組為CLKT組,B組為腎移植(OKT)組,CLKT及OKT組實驗均以Wistar大鼠為供體,雄性SD大鼠為受體.分彆施行肝腎聯閤移植和腎移植手術,術後第5天取移植腎組織併染色,光鏡下觀察病理改變,進行急性排斥反應嚴重程度的半定量評分,比較CLKT及OKT兩組評分的差異.C組為對照組,3組分彆在術後第5天處死後抽取外週血應用流式細胞儀分析T淋巴細胞亞群的變化及其共刺激分子CD28、CD152的比例.結果 A組病理評分為(1.42±0.53)分,B組病理評分為(4.14±0.69)分,兩組差異有統計學意義(P＜0.01).A、B、C3組的CD3百分比分彆為(71.31±14.21)％、(72.63±14.96)％、(68.30±12.40)％,3組間差異無統計學意義(P＞0.05)；CD4+ CD3+/CD3+(％)3組分彆為44.38±7.28、61.61±5.67、35.68±5.26,3組間差異有統計學意義(P＜0.05)；3組的CD8+ CD3+/CD3+分彆為(21.12±4.03)％、(25.62±5.67)％、(20.06±4.08)％,A組和C組CD8+CD3+T淋巴細胞差異無統計學意義(P＞0.05),但均顯著低于OKT組(P＜0.05)；3組CD4+/CD8+分彆為(2.11±0.11)％、(2.41±0.23)％、(1.80±0.11)％.各組T細胞亞群上共刺激分子錶達,CD28分彆為(45.95±7.85)％、(73.42±9.41)％、(24.50±5.02)％,3組間差異有統計學意義(P＜0.05)；CD152的錶達3組分彆為5.15±1.73、2.08±0.58、0.09±0.04,差異有統計學意義(P＜0.05).結論 肝腎聯閤移植術後,移植肝對移植腎具有保護作用,能降低移植腎排斥反應的程度；在肝腎聯閤移植術後,T淋巴細胞的成熟、活化受到抑製,同時抑製瞭正性共刺激分子CD28的錶達,促進負性共刺激分子CD152的錶達,在排斥反應的啟動階段起到保護移植腎的作用.
목적 관찰대서간신연합이식(CLKT)술후이식간대이식신적보호작용,병탐토기궤제.방법 실험분위3조실험,매조7대.A조위CLKT조,B조위신이식(OKT)조,CLKT급OKT조실험균이Wistar대서위공체,웅성SD대서위수체.분별시행간신연합이식화신이식수술,술후제5천취이식신조직병염색,광경하관찰병리개변,진행급성배척반응엄중정도적반정량평분,비교CLKT급OKT량조평분적차이.C조위대조조,3조분별재술후제5천처사후추취외주혈응용류식세포의분석T림파세포아군적변화급기공자격분자CD28、CD152적비례.결과 A조병리평분위(1.42±0.53)분,B조병리평분위(4.14±0.69)분,량조차이유통계학의의(P＜0.01).A、B、C3조적CD3백분비분별위(71.31±14.21)％、(72.63±14.96)％、(68.30±12.40)％,3조간차이무통계학의의(P＞0.05)；CD4+ CD3+/CD3+(％)3조분별위44.38±7.28、61.61±5.67、35.68±5.26,3조간차이유통계학의의(P＜0.05)；3조적CD8+ CD3+/CD3+분별위(21.12±4.03)％、(25.62±5.67)％、(20.06±4.08)％,A조화C조CD8+CD3+T림파세포차이무통계학의의(P＞0.05),단균현저저우OKT조(P＜0.05)；3조CD4+/CD8+분별위(2.11±0.11)％、(2.41±0.23)％、(1.80±0.11)％.각조T세포아군상공자격분자표체,CD28분별위(45.95±7.85)％、(73.42±9.41)％、(24.50±5.02)％,3조간차이유통계학의의(P＜0.05)；CD152적표체3조분별위5.15±1.73、2.08±0.58、0.09±0.04,차이유통계학의의(P＜0.05).결론 간신연합이식술후,이식간대이식신구유보호작용,능강저이식신배척반응적정도；재간신연합이식술후,T림파세포적성숙、활화수도억제,동시억제료정성공자격분자CD28적표체,촉진부성공자격분자CD152적표체,재배척반응적계동계단기도보호이식신적작용.
Objective To investigate the protection of the kidney from rejection by the liver in combined liver and kidney transplantation (CLKT).Methods Three groups were set up in this study:CLKT group,kidney transplantation (OKT) group and control group.Wistar and male SD rats were used as donors and SD rats as recipients in all groups.The graft specimens were harvested at 5th day postoperatively.They were examined histologically after sectioning and staining.Acute rejection was diagnosed according to the Banff 97 classification,and scored according to the method stated by Watanabe.The semiquantitative scores were compared between CLKT and OKT groups.Fluorescein-labeled monoclonal antibodies and flow cytometry were employed to determine the T-cell subsets and the expression of CD28 and CD152 in venous blood T cells among CLKT,OKT and control groups.Results The semiquantitative scores in CLKT group and OKT group were (1.43 ± 0.53) and (4.14 ± 0.69),respectively (P ＜ 0.01).The total number of CD3+ T lymphocytes in CLKT group,OKT group and contr group was (71.31 ±14.21)％,(72.63 ± 14.96)％ and (68.30 ± 12.40)％ respectively (P ＞0.05),but there were significant difference in the total number of CD4 + CD3 + T lymphocytes among the three groups:that in OKT group was the greatest,followed by CLKT group,and lowest in control group (P ＜ 0.05).There was no significance difference in CD8 + CD3 + T lymphocytes between CLKT group and control group (P ＞ 0.05),but the number of CD8 + CD3 + T lymphocytes was significantly reduced in CLKT group as compared with OKT group (P ＜ 0.05).The CD4 +/CD8 + ratio was highest in OKT group,followed by CLKT group,and lowest in control group (P ＜ 0.05).The CD28％ was highest in OKT group,followed by CLKT group,and lowest in control group (P ＜ 0.05).The CD152％ was highest in CLKT group,followed by OKT group,and lowest in control group (P ＜ 0.05).Conclusion Liver graft had protective effects on kidney graft in CLKT,and decreased its rejection intensity.The maturity and activation of T lymphocytes were inhibited in CLKT,and CLKT could also inhibit the expression of positive co-stimulatory molecule CD28,and promote the expression of negative co-stimulatory molecule CD152,which contributed to the protective effects of the liver graft on the kidney graft.
