移植物细胞因子表达与小肠移植排斥反应相关性的实验和临床病例研究

目的结合移植物细胞因子表达的实验和临床病例研究，探索早期诊断小肠移植急性排斥反应的细胞因子相关的敏感指标。方法①两例短肠综合症患者接受活体小肠移植术。定期或病情变化时随时行内镜组织学检查并测定受体大鼠移植物sIL-2R、IL-4、IL-6和IFN-γ表达水平。②BN-LEW大鼠部分小肠移植，A组：SBT（n=20）；B组：SBT＋FK506（2．5mg／kg，n=20），术后第1、4、7、14和30天测定受体大鼠移植物sIL-2R、IL-4、IL-6和IFN-γ水平同时取移植肠黏膜行病理组织学检查。结果首例术后67d发生排斥反应，第2例于术后20d和80d分别发生强烈排斥反应。发生排斥反应相应时相均发生IL-2Rα、IFN-γ表达的显著升高，排斥反应控制后IL-2Rα迅速恢复，但IFN-γ仍在较高水平维持较长时间。A组大鼠术后第1天始即显示IL-2Rα、IFN-γ和IL-6表达的显著升高，于术后7d达到最高，移植后14d仍在高水平。B组仅术后第1天出现IL-2Rα、IFN-γ和IL-6表达的迅速升高，第4天已恢复至基本正常。结论移植物IL-2Rα、IFN-γ表达的升高与小肠移植急性排斥反应密切相关，有望成为早期诊断小肠移植急性排斥反应的敏感指标。     

移植前诱导抗独特型抗体对小鼠皮肤排斥反应的抑制作用

目的 探讨抗独特型抗体诱导对异品系小鼠皮肤移植排斥反应的影响。方法 以C57BL／6小鼠脾细胞免疫Balb/c小鼠制备抗同种异品系抗体（Ab1),将Ab1与KLH交联后，免疫Balb/c小鼠诱导产生抗独特型多克隆抗体（Ab2),并以之为受体，观察Ab2对小鼠皮肤移植排斥反应的影响。结果Ab1交联KLH加弗氏佐剂免疫可有效地诱导抗独特型抗体（Ab2)产生。与对照组相比较，Ab2诱导组小鼠移植物存活时间明显延长。结论 移要有在受体体内诱导产生以移植物抗原为模拟抗原的抗独特型抗体，可对移植排斥反应产生有效的抑制作用。     

移植物抗宿主反应在免疫介导再生障碍贫血发病中的作用

本实验通过大体和组织学观察,脾指数、腘窝淋巴结称重试验以及~(125)I-UdR掺入试验,探讨移植物抗宿主反应(GvHR)在免疫介导小鼠再障模型发病中的作用。从腘窝淋巴结称重试验和~(125)I-UdR掺入试验结果表明,DBA/2小鼠淋巴细胞输给BALB/c小鼠可以引起GvHR,而且呈细胞量依赖关系,但再障小鼠的皮肤、肠、肝、脾组织学检查均未发现GvHR,脾指数毫无例外地明显降低,而且再障小鼠并不因输入细胞量增加而表现发病率增加,存活期缩短现象,提示GvHR在免疫介导小鼠再障中不起重要作用。     

肾移植中抗体介导的移植物抗宿主反应

移植物抗宿主反应(GVHR)是在骨髓移植中经常遇到的难以解决的问题。GVHR虽然主要由T淋巴细胞介导,但临床和实验资料表明抗体也参与其反应。Gleichmann等人通过动物模型证明,抗体能造成广泛的损伤,尤其是当供体和宿主的抗原性差异较大,对辅助T淋巴细胞的刺激较强并出现慢性疾病过程的时候。人们以前很少注意移植组织中的供体淋巴细胞能引起GVHR。1953年Simonsen曾提出,在移植的狗肾间质中的浆细胞可能来源于供体,但当他后来用同位素标记实验证     

腹部大器官移植的免疫病理学

器官移植自古以来是人类梦寐以求的愿望。但人类真正将异体器官移植用于治疗疾病源于20世纪50年代。然而，由于当时缺乏免疫抑制剂，器官移植后很快出现排异反应导致移植失败。1963年，享有“当代器官移植之父”美誉的美国starzl教授成功地实施了人类第1例同种异体原位肝移植手术，并将“硫唑嘌呤 类固醇”用于免疫抑制治疗。     

骨髓间质干细胞降低大鼠移植物抗宿主反应的实验研究

目的 探讨MSCs对GVHD的作用及其机制.方法 建立大鼠同种异体骨髓移植模型,同时输入供者的T淋巴细胞诱导出移植物抗宿主反应,联合或不联合移植供体来源的MSCs,观察受鼠的生存时间,同时利用RT-PCR法研究Th1/Th2淋巴细胞亚群的比例,用ELISA法检测移植后体内IL-4细胞因子的浓度.结果 GVHD组的平均生存时间为(17.30±2.33)天,实验组的平均生存时间为(24.10±2.36)天 , 与单独移植HSCs相比,MSCs与HSCs共移植明显延长的受鼠的生存时间.同时,GVHD组Th1/Th 2 细胞比值为1.29±0.06,IL-4因子的浓度平均为(14.84±2.59) pg/mL,实验组Th1/Th 2细胞比值为(0.77±0.14),IL-4因子的浓度平均为(40.09±13.99) pg/mL.MSCs与 HSCs 共移植降低了体内Th1/Th2淋巴细胞亚群的比例,提高了体内IL-4细胞因子的浓度.结论 MSCs与HSCs共移植能有效抑制HSCs移植后致死性GVHD的发生,延长生存时间,同时MSCs 可能通过作用于体内Th1/Th2淋巴细胞亚群的比例,促进体内IL-4细胞因子的分泌从而间接发挥了抑制GVHD的作用.     

抗B7-1和抗CD40L单抗延长小鼠皮肤移植物存活实验研究

将C57BL/6小鼠腹部全层皮肤移植于BALB/c小鼠中段背部,实验分组(每组7只小鼠):1.B7-1功能性单抗(4E5)治疗组;2.抗CD40L单抗(4F1)治疗组;3.4E5+4F1治疗组,各单抗以20㎎/㎏的剂量注入腹腔内;4.空白对照组,只注射同等量的生理盐水。注射时间为移植后0﹑1﹑3﹑5d,观察移植皮肤排斥情况。于术后第6天分别杀死各组受体和供体鼠,取受体脾细胞与供体作混合淋巴细胞反应(MLR)。收集培养6d的初次反应细胞,检测再次MLR。结果发现,与对照组相比,各单抗治疗组皮肤移植物存活时间延长(P<0.05﹚;与各单独应用4F1和4E5相比,联合使用4F1和4E5产生一定的协同作用,但未能进一步延长移植物的寿命(P>0.05)。初次单向MLR:4F1﹑4E5和4F1+4E5治疗组受体T淋巴细胞在MLR中表现对供体淋巴细胞特异性低反应性,能有效抑制T细胞对同种异体抗原的初次应答。再次单向MLR:4F1﹑4E5﹑4F1+4E5对供体淋巴细胞在再次反应中仍保持着对同种抗原的反应性,与对照组无显著差异,未能诱导特异性免疫耐受。综上结果证实,anti-CDB7-1mAb(4E5)和anti-CD40LmAb(4F1)作为新型免疫抑制剂,在一定程度上抑制细胞免疫应答,干预排斥反应。     

TLSFJM抑制大鼠心脏移植排斥反应的作用

目的　在同种异体大鼠异位心脏移植模型中 ,探讨TLSFJM对急性移植排斥反应的抑制作用及机制。方法　以F344大鼠作为心脏移植受体 ,以LOU/CN大鼠作为心脏移植供体 ,建立大鼠异位心脏移植模型。受体大鼠分为 3组 ,于移植前后分别施以RPMI16 4 0、CsA或TLSFJM。每天观察移植心脏跳动情况 ,并于停跳当天或之前解剖观察。分别取供体大鼠脾细胞作为刺激细胞 ,取受体大鼠脾细胞作为反应细胞 ,进行单向混合淋巴细胞反应。结果　TLSFJM可明显延长大鼠异位移植心脏的存活时间 :RPMI16 4 0对照组移植心脏的存活期全部为 6d ,TLSFJM治疗组最长均可存活 2 7d ,高剂量 (15mg/kg·d)CsA治疗组存活期超过 2 7d。TLSFJM治疗组大鼠脾细胞增殖的cpm值均低于对照组。结论　TLSFJM具有良好的抗急性移植排斥反应作用。TLSFJM对同种异体抗原诱导T细胞增殖的明显抑制 ,可能是其发挥免疫抑制作用的机制之一     

抗CD25单克隆抗体预防肾移植术后急性排异反应的研究

目的 :研究抗CD2 5单克隆抗体预防肾移植术后急性排异反应的作用。方法 :71例肾移植患者随机分为抗CD2 5单克隆抗体治疗组 2 6例与对照组 4 5例 ,治疗组于肾移植手术前后应用抗CD2 5单克隆抗体 2次 ,对术后急性排异反应发生率、移植肾功能及外周血T细胞亚群进行动态监测。结果 :术后 1、3、6、12个月时急性排异反应的发生率治疗组为 7.7%、19 .2 %、2 3.1%、30 .8% ,对照组为 15 .6 %、2 8.9%、35 .6 %、4 6 .7% ,两组比较有显著性差异 (P <0 .0 5 ) ;术后 1、6及 12个月时治疗组移植肾功能优于对照组 (P <0 .0 5 ) ;术后两组CD3+ 与CD4 + 的表达均下降 ,但两组间无显著差异 (P >0 .0 5 )。结论 :抗CD2 5单克隆抗体可以明显降低肾移植术后急性排异反应的发生率 ,而对T细胞亚群无明显影响。     

抗CD3单克隆抗体在预防肾移植术后急性排斥反应中的作用

目的 :观察抗CD3单克隆抗体在预防肾移植术后急性排斥反应的作用。方法 :16 4例肾移植患者分为两组 ,4 2例移植术后应用抗CD3单克隆抗体 (5mg d)为治疗组 ;其它 12 2例为对照组。观察移植术后人 肾存活率、急性排斥反应及CMV感染的发生率。结果 :治疗组 1年、2年及 3年人存活率与对照组无显著差异 ,而治疗组移植肾存活率明显高于对照组(P <0 0 5 )。治疗组急性排斥反应发生率 (18 6 % )比对照组 (2 8 7% )低 ,P <0 0 5 ,且首次急性排斥反应发生时间明显延长 ,对MP冲击治疗效果好。治疗组CMV感染的发生率 (33 3% )高于对照组 ,P <0 0 5。结论 :肾移植术后预防性使用抗CD3单克隆抗体对提高移植肾存活率 ,降低急性排斥反应发生率有较好的作用 ;用药期间应注意预防及治疗CMV感染。     

Pharmacokinetic and pharmacodynamic study of a clinically effective anti-CD2 monoclonal antibody

The humanized IgG1κ monoclonal antibody siplizumab and its rat parent monoclonal IgG2b antibody BTI-322 are directed against the CD2 antigen. Siplizumab is species-specific, reacting with human and chimpanzee cells but not with cells from any other species, including other non-human primates. Because siplizumab treatment has recently shown great potential in clinical transplantation, we now present the results of our previous pharmacokinetic, pharmacodynamic and safety studies of both antibodies. Fourteen chimpanzees received 1-3 doses of 0.143 to 5.0 mg/kg iv The effects were followed with flow cytometry on peripheral lymphocytes and staining of lymph nodes. Side effects were recorded. Serum antibody concentrations were followed. Across the doses, a rapid, transient depletion of CD2, CD3, CD4 and CD8 lymphocytes and NK cells was observed for both antibodies. Immune reconstitution was more rapid for BTI-322 compared to siplizumab. Paracortical lymph node T cell depletion was moderate, estimated at 45% with doses of >0.6 mg/kg. Restoration of lymph node architecture was seen after two weeks to two months for all animals. All four subjects receiving BTI-322 experienced AEs on the first dosing day, while the eight subjects dosed with siplizumab experienced few mild, transient AEs. Infusion with siplizumab and BTI-322 resulted in rapid depletion of CD2⁺ cells in circulation and tissue. Siplizumab had a longer t_1/2 and fewer AEs compared to BTI-322.     

The effects of hormone replacement therapy on homocysteine and vascular histopathological changes

Abstract The aim of the present study was to examine the effects of hormone replacement therapy on homocysteine and its relationship with atherosclerotic changes. Twenty Wistar albino rats were deployed in the study. An artificial menopause was created. Rats were randomly assigned to 2 groups. The first group received 6 cycles of 0.01 mg/kg/day conjugated equine oestrogen and the second group received the same dose of placebo. After the treatment, vitamin B₁₂, folate and homocysteine levels were measured. Carotid arteries were removed for histopathological examination of vascular effects. Homocysteine levels were 3.35±0.22 and 2.28±0.12 μmol/l, vitamin B₁₂ levels were 699±87.51 and 631±97.85 pg/ml and folate levels were 71.83±4.03 and 84.79±6.58 ng/ml in Groups 1 and 2, respectively. Statistical analyses revealed no significant differences between Group 1 and Group 2 with regard to vitamin B₁₂ and folate levels. Homocysteine was found to be significantly elevated in Group 1 (P=0.001). Histopathological examination did not reveal any pathological finding in vascular sections in either group. Even though postmenopausal HRT is not used as a means of cardiovascular protection, it is the only treatment available for vasomotor symptoms and prevention of urogenital atrophy during menopause. Until the relationships between menopause, HRT, homocysteine, folate and vitamin B₁₂ are clearly elucidated with more comprehensive studies, including all the details leading to plasma homocysteine increment in homocysteine metabolism, we recommend that menopausal women should be provided with accurate information and risk/benefit analysis on HRT treatment and the decision should be made by the patient.     

The effects of raloxifene and tibolone on homocysteine and vascular histopathological changes

The aim of the present study was to examine the effects of raloxifene (RLX) and tibolone (TBN) on plasma homocysteine (Hcy) levels and their relationship with atherosclerotic changes in the walls of the carotid artery in ovariectomised rats. Thirty surgically ovariectomised Wistar albino rats after a menopausal period of 6 cycles were randomly assigned to receive RLX 0.01 mg/kg/day (n=10), TBN 0.04 mg/kg/day (n=10) and the same dose of placebo (n=10) for 6 cycles. Serum levels of vitamin B12, folate and Hcy were measured and carotid arteries were examined histopathologically following the termination of treatment. Hcy levels were 3.27±0.97, 2.57±0.32 and 2.28±0.12 μmol/l, Vitamin B12 levels were 901.90±239.76, 694.70±112.20 and 631±309.44 pg/ml and folate levels were 73.80±12.71, 72.51±7.05 and 84.79±20.82 ng/ml in receiving RLX, TBN and placebo respectively. Hcy levels were increased by RLX vs. placebo (P=0.006) but not by TBN vs. placebo (P=0.070). Vitamin B12 levels were found to be elevated by TBN vs. the control group (P=0.041) but not by RLX vs. placebo (P=0.059). Histopathological examination of carotid arteries from rats receiving both RLX and TBN revealed no difference vs. placebo. Data obtained from the study support the view that neither RLX nor TBN appears to have a primary protective effect on vascular disease by effecting the metabolism of Hcy at menopause.     

Histopathology of spleen allograft rejection in miniature swine

Spleen transplantation (SpTx) has established donor-specific tolerance in rodents, but not in large animals or humans. We report the histopathology of rejection in an established model of SpTx in major histocompatibility complex (MHC)-defined miniature swine. Of the 17 SpTx, rejection was observed in two grafts transplanted into untreated, MHC-matched, minor antigen-disparate recipients (group 1, n=4), but not in the two that received a 12-day course of cyclosporin A (CyA). Rejection also occurred in five grafts transplanted into fully MHC-disparate recipients (group 2, n=12), one of which was untreated and four of which received some form of immunosuppressive therapy. One recipient of an MHC class-I-mismatched spleen treated with 12 days of CyA did not show rejection. Following biopsy and/or necropsy, fixed allograft tissue sections were treated with multiple stains, immunohistochemical markers and TUNEL assay. Common features of rejection occurred in grafts from both groups, but with varying time courses. Necrosis developed as early as day 8 in group 2 and day 27 in group 1, ranging from focal fibrinoid necrosis of arteriolar walls and sinusoids to diffuse liquefactive necrosis, usually associated with haemorrhage. Other features of rejection included white pulp expansion by atypical cells and decreased staining of basement membranes and reticular fibres. A doubling of the baseline TUNEL index preceded histologically identifiable rejection. This study establishes histologic guidelines for diagnosing and, perhaps, in future studies, predicting acute rejection of splenic allografts transplanted across known histocompatibility barriers in a large-animal model.     

抗CD71人-鼠嵌合抗体对活化淋巴细胞的效应

目的　通过体外实验探讨抗CD71人 鼠嵌合抗体对活化淋巴细胞效应的影响 ,并与其鼠源性单克隆抗体进行比较。方法　以丝裂原诱导的人外周血单个核细胞 (PBMC)为靶细胞 ,测定嵌合抗体和鼠源性单抗对其增殖抑制率 ;在新鲜补体存在下 ,测定补体依赖性嵌合抗体介导的细胞毒效应(CDC)。以EBV转化的B细胞为刺激细胞 ,测定两种抗体对其诱导的同种异体PBMC的增殖抑制率 ;以同种异体的PBMC为刺激细胞 ,测定两种抗体在单向、双向混合淋巴细胞培养 (MLC)中的增殖抑制率。结果　嵌合抗体和鼠源性单抗均可明显抑制丝裂原诱导的PBMC的增殖反应 ,且二者抑制率差异无显著性(P >0 .0 5 ) ,其抑制作用随抗体浓度增加而增强 ,PBMC和丝裂原共同孵育 12h后加入抗体的增殖抑制效应最明显 ;在新鲜补体存在下 ,嵌合抗体对丝裂原诱导增殖的PBMC具有CDC作用 ,而鼠源性单抗CDC作用较弱 ;两种抗体对混合淋巴细胞培养反应有明显的抑制作用 ,且嵌合抗体组抑制率明显高于鼠源性单抗组 (P <0 .0 5 )。结论　抗CD71人 鼠嵌合抗体在体外实验中可抑制淋巴细胞的活化及其效应 ,其作用明显强于抗CD71鼠源性单克隆抗体。     

抗独特型抗体对小鼠心肌移植耐受的诱导作用

目的探讨抗独特型抗体对小鼠移植耐受的诱导作用.方法以C57BL/6小鼠脾细胞免疫Balb/c小鼠制备抗同种异品系抗体(Ab1),Ab1交联KLH后,免疫Balb/c小鼠诱导产生抗独特型多克隆抗体(Ab2),以之为移植受体,观察Ab2对小鼠心肌移植耐受的诱导作用.结果Ab1交联KLH和弗氏佐剂免疫可以有效诱导抗独特型抗体(Ab2),和对照组相比,Ab2诱导组的小鼠移植物的存活时间明显延长.结论移植前在受体体内诱导产生以移植物抗原为模拟抗原的抗独特型的抗体,可以对小鼠特异性低免疫反应状态起到有效的诱导作用.     

Tissue reactions induced by different embolising agents in cerebral arteriovenous malformations: a histopathological follow-up

AIMS: Comparative histopathological analysis was performed in 47 incompletely embolised and resected cerebral arteriovenous malformations (AVMs). METHODS: Thirty-three AVMs were embolised with n-butyl-cyanoacrylate (NBCA), four with iso-butyl-cyanoacrylate (IBCA), seven with polyvinyl alcohol particles (PVA), one with a fibrin mixture, one with silicon pellets, and one with microcatheter balloons. Maximum exposure time (MET) of the embolising agent (interval between embolisation and surgery) ranged from <24 hours to 80 months. All AVMs were investigated regarding angionecrosis, angiofibrosis, acute inflammation, chronic inflammation, foreign-body reactions, vascular calcification, blood admixture to embolising cast, and capillary recanalisation within the AVMs. These parameters were correlated with MET, comparing different embolising agents, age, and sex. RESULTS: A typical sequence of events depending on MET is observed in all embolised AVMs: acute inflammation with mural angionecrosis is soon replaced by prominent chronic granulomatous vasculitis, which remains stable and is detectable for a very long time, even in AVMs with a MET of more than 6 years. CONCLUSION: Capillary recanalisation is always present in incompletely embolised AVMs, detectable after 3 months of MET, irrespective of the embolising agent used. Age and sex does not influence pattern and time course of tissue lesions and recanalisation in incompletely embolised AVMs.     

青藤碱对大鼠心脏移植排斥反应期间ICAM-1和IL-2的影响

目的：观察大鼠同种异位心脏移植排斥反应期间的病理特征，探讨青藤碱对大鼠心脏移植排斥反应的影响及其发生机制。方法：SD健康大鼠为供体，Wistar大鼠为受体，建立大鼠异位心脏移植模型。实验分4组：A组为健康SD大鼠心脏作对照组，B组为SD大鼠到SD大鼠的同基因移植组，C组为SD大鼠到Wistar大鼠异基因移植组，D组为清藤碱治疗组。以ELISA、免疫组织化学检测移植心组织中IL-2和ICAM-1的表达。结果：A、B组未见排斥反应发生，心脏组织中的ICAM-1和IL-2表达水平很低；C组有明显的炎症反应并见大量淋巴细胞浸润，组织中ICAM-1和IL-2的表达水平明显升高（P〈0．05）；D组炎症反应有所减轻，同时少有淋巴细胞浸润；组织仅微弱表达ICAM-1和IL-2。结论：移植心脏ICAM-1和IL-2的表达水平与排斥反应的发生和发展有关，青藤碱能显著抑制移植心ICAM-1和IL-2的表达和淋巴细胞的浸润，减轻排斥反应，明显延长移植物的存活。