环孢菌素A抑制小鼠同种心脏移植急性排斥反应中Lymphotactin表达的研究

目的：研究小鼠同种心脏移植急性排斥反应中淋巴细胞趋化因子（lptn）的表达情况及环孢菌素A（cyclosporine A, CsA）的抑制作用。 方法： 改良Banff评分系统判断同种小鼠移植心急性排斥反应程度，RT-PCR检测移植心组织内淋巴细胞趋化因子表达水平，ELISA方法检测心脏移植小鼠脾细胞活化T细胞核因子(NFAT)活性。 结果： C57BL/6-Balb/c急性排斥组小鼠移植术3 d后脾脏显著增大。术后第5、7 d移植心肌间淋巴细胞浸润程度评分分别为2.667±0.577和2.333±0.577。C57BL/6-Balb/c+CsA组小鼠移植术后脾脏肿大明显减轻，术后第5、7 d心肌间淋巴细胞浸润程度评分分别为1.000±0.000和1.333±0.577。急性排斥组和CsA处理组小鼠移植心脏在术后第5 d和第7 d都可检测到Lptn mRNA阳性表达，但CsA处理组Lptn mRNA的表达明显弱于急性排斥组。治疗剂量的CsA可以完全抑制NFATc1活性。 结论： Lptn在早期移植免疫事件中具有重要的作用，CsA仅能部分抑制Lptn mRNA的表达。活化T细胞Lptn的表达调控存在NFAT以外的途径。     

雷帕霉素对实验性自身溶血性贫血小鼠抗自身红细胞抗体产生的抑制作用

作者介绍了一种自身免疫病的实验模型,并研究了抗真菌抗生素雷帕霉素（rapamycin;RPM）对实验性自身溶血性贫血小鼠产生抗自身红细胞抗体的预防和治疗作用、结果表明,口服2.5～10mg/kg的RPM可有效预防小鼠实验性抗自身红细胞抗体滴度的升高,并维持在1:32左右,且停药后不存在反跳现象。同时RPM也能在一定程度上抑制抗大鼠红细胞抗体的产生。此外RPM还表现了很好的治疗作用,它能使已升高的抗自身红细胞抗体滴度显著降低。与环孢菌素相比.雷帕霉素具有更强的抑制抗自身红细胞抗体产生的作用。     

重组hIL-10抗家兔皮肤移植反应中CC、IL-8/CXCL8趋化因子的变化

目的:检测家兔皮肤移植经rhIL-10作用后,血清中CC、IL-8/CXCL8趋化因子的变化,探讨CC、IL-8/CXCL8趋化因子在rhIL-10抗免疫排斥机制中的作用。方法:皮肤移植家兔分6组:①rhIL-10低剂量,②rhIL-10高剂量,③CsA低剂量,④CsA高剂量,⑤rhIL-10+CsA低剂量联合和⑥生理盐水组;每只家兔均于术前1天开始肌注给药,连续注射10天;各组分别于术前1天、术后1、4、7、14、21、28天取外周血,分离血清,以ELISA法检测移植家兔血清CC、IL-8/CXCL8趋化因子水平。结果:(1)术后各组IL-8水平均升高,术后4天、7天⑥组IL-8水平高于各组(P<0.05)。(2)术后各组MCP-1水平明显升高,术后1天、4天,⑥组MCP-1水高于各组(P<0.05),术后7天⑥组MCP-1水平高于①组、⑤组(P<0.05);术后7天、14天CsA抑制组高于联合组(P<0.05)。(3)术后各组MIP-1α明显升高,术后4天⑥组MIP-1α水平高于①、③、⑤组,术后7天⑥组MIP-1α水平高于各组(P<0.05);(4)术后各组MIP-1β水平升高,但同时间段组间比较差异无统计学意义(P>0.05)。结论:CC、IL-8/CXCL8趋化因子在皮肤移植后明显升高,表明在急性排斥反应中发挥了重要作用,随排斥反应加重而进一步增高,皮片排斥后下降,可作为观察和诊断移植排斥的合适标志物。     

铁离子沉积与心脏移植急性排斥反应相关性研究

目的：探讨铁离子在心脏移植急性排斥反应的作用。 方法： 建立小鼠颈部异位心脏移植模型，实验分为同系移植组（C57BL/6→C57BL/6）和同种异体移植组（BALB/c→C57BL/6），普鲁士蓝染色观察铁离子在心肌组织的沉积情况，免疫组化法观察HO-1在心肌组织的表达。 结果： 铁离子在浸润的巨噬细胞中沉积，HO-1主要在浸润的炎性细胞中表达，两者随急性排斥反应的加重表达上调。 结论： 铁离子沉积与心脏移植急性排斥反应的病理过程相关，且可作为心脏移植急性排斥反应的监测指标。     

纳曲酮对移植排异反应的抑制作用

以小鼠心肌组织异位移植和混合淋巴细胞反应为整体和离体模型，观察了阿片受体阻断剂纳曲酮对移植排异反应的影响。结果显示：给动物从术前开始腹腔注射纳曲酮共１０天（每日二次，每次５ｍｇ／ｋｇ）可明显延长移植心肌组织的存活时间；加入纳曲酮（１０－４～１０－８ｍｏｌ／Ｌ）对混合淋巴细胞反应有抑制作用并呈量效关系。同时还观察到，给正常小鼠腹腔注射纳曲酮３天以上，可引起动物脾细胞由ＣｏｎＡ诱导的淋巴细胞转化反应受抑制。以上结果说明纳曲酮可抑制移植排异反应，此作用有可能是通过阻断内源性阿片肽所致。     

应用抗CD137L单克隆抗体阻断CD137/CD137L信号通路抑制小鼠SGVHD的发生

目的：探讨抗CD137L单克隆抗体阻断CD137/CD137L信号通路在小鼠同基因型移植物抗宿主病（SGVHD）诱导中的作用,以阐明SGVHD的发生机制.方法：用致死剂量的X射线照射受体小鼠后,移植同基因骨髓细胞,从移植的当天开始连续21天腹腔注射环孢素A（CsA）诱导SGVHD.于诱导的第10天起给治疗组小鼠腹腔注射抗CD137L单克隆抗体进行干预治疗.观察各组小鼠的临床症状（体重下降,腹泻）、组织病理学和细胞因子改变.结果：抗CD137L单克隆抗体治疗组小鼠SGVHD的发生率明显低于诱导组小鼠SGVHD的发生率（25% vs 67%）,两者差异具有统计学意义（P＜0.01）.SGVHD小鼠肝脏和结肠组织病理学呈严重炎症细胞浸润,组织中细胞因子IL-12、IFN-γ、TNF-α mRNA水平升高.而抗体治疗组小鼠织病理学呈轻度炎症细胞浸润,组织中细胞因子IL-12、IFN-γ、TNF-α mRNA水平较低或检测不到.结论：单独用抗CD137L单克隆抗体阻断CD137/CD137L信号通路可明显抑制小鼠SGVHD的发生,提示CD137/CD137L信号通路在小鼠SGVHD免疫反应中是较为重要的通路之一.     

短期运用免疫抑制药物对非去髓异基因骨髓移植方案诱导的混合嵌合体和移植耐受的影响

目的 探讨免疫抑制药物对CTLA4-FasL重组腺病毒和供者骨髓移植联合方案诱导的混合嵌合耐受的影响.方法 将BALB/c（H-2d）小鼠皮肤移植于C57BL/6（H-2b,B6）小鼠,同时经尾静脉给B6小鼠注射BALB/c小鼠骨髓细胞和腺病毒AdCTLA4-FasL,B6小鼠接受皮肤移植术后4周内每天注射环孢素A（CsA）或霉酚酸酯（MMF）或这两种药物同时注射;然后观察移植皮肤存活情况,通过流式细胞仪测定受体外周血Vβ11^＋的T细胞的水平和供体来源细胞的嵌合水平,通过单向混合淋巴细胞反应了解对供体抗原的耐受状态.结果 在CTLA4-FasL重组腺病毒和供者骨髓移植联合方案诱导的混合嵌合耐受模型中,短期运用免疫抑制药物均促进早期供体骨髓细胞植入,但注射CsA或CsA与MMF联用的受体小鼠在皮肤移植后140 d时混合嵌合降低到很低水平,且单用CsA或CsA与MMF联用的受体小鼠中供体皮肤平均生存时间显著低于不用免疫抑制药物或用MMF的受体小鼠（P＜0.05）;皮肤移植后21 d时单用CsA或CsA与MMF联用的受体小鼠Vβ11^＋的T细胞水平显著高于不用免疫抑制药物或用MMF的受体小鼠（P＜0.05）;皮肤移植后150 d时单用CsA或CsA与MMF联用的受体小鼠脾细胞未显示对同种抗原特异性耐受.结论 CsA或含CsA的免疫抑制方案对CTLA4-FasL重组腺病毒和供者骨髓移植联合方案诱导的混合嵌合耐受有抑制作用,其机理可能与早期外周供体特异性T细胞删除减少有关;而MMF与该嵌合耐受方案兼容.     

苦参碱对病毒性心肌炎小鼠蛋白激酶B表达的影响

目的 评价苦参碱对柯萨奇B3型病毒（CVB3）感染的病毒性心肌炎（VMC）小鼠心肌组织蛋白激酶B（Akt）表达的影响,以探讨苦参碱保护心肌的作用机制.方法 实验采用雄性Balb/c小鼠连续3 d腹腔注射0.2ml 100TCID50的CVB3的方法制备VMC的动物模型.分为6组：苦参碱每日80 mg/kg、40 mg/kg、20 mg/kg治疗组,利巴韦林组、病毒组及正常对照组.药物于末次注射病毒的60 min后开始,连续腹腔注射10 d,正常组给予同体积的生理盐水.分别于给药后第5天和第10天处死小鼠,应用Tunel标记法检测各组心肌细胞凋亡情况;于给药后第10天应用免疫组化及Western Blot法检测心肌组织磷酸化AktSer-473蛋白的表达.结果 与正常组比较,病毒组心肌组织凋亡明显增加（P＜0.05）;与病毒组比较,苦参碱各剂量组心肌组织凋亡明显减少（P＜0.05）.于给药后第10天,苦参碱每日40 mg/kg组磷酸化AktSer-473蛋白的表达明显上调（P＜0.05）.结论 苦参碱可能通过促进磷酸化AktSer-473蛋白的表达,抑制CVB3感染的VMC小鼠心肌组织凋亡.     

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。     

免疫抑制状态下小鼠MD-1表达的影响因素及其在皮肤移植中的效应

目的 探讨免疫抑制状态下小鼠MD-1表达的影响因素及在皮肤移植中的效应。方法采用小鼠同种皮肤移植模型，以环孢霉素A（CsA）、他克莫司（FK506）、霉酚酸酯（MMF）或雷帕霉素（SRL）为免疫抑制手段。结果CsA和MMF能抑制脾细胞的MD-1表达和增殖反应强度，下调血清IL-2水平和上调IL-10水平，并显著延长皮肤移植物平均存活时间（MST）；FK506对IL-10水平无明显影响；而SRL对MD-1表达及IL-2与IL-10水平均无明显影响。MD-1表达水平与脾细胞增殖反应强度和血清IL-2水平呈极显著正相关，和IL-10水平呈极显著负相关。结论CsA、FK506和MMF能抑制小鼠MD-1的表达，其作用与血清IL-2水平下调有关。在免疫抑制状态下，MD-1表达下调与同种皮肤移植物存活时间延长有关，而其表达上调对排斥反应的发生具有一定的指示作用。     

Effect of rifampin on the immune response in mice.

In an investigation of the effect of rifampin on the immune response in mice, the cellular immunity was evaluated with the split-heart allograft technique. The survival time of the heart in animals treated with rifampin at a dose of 20 mg/kg per day from the day of the transplantation until the graft was rejected was longer (33.7 days, P less than 0.001) than that of animals not treated with antibiotics (14.5 days). When rifampin was given at a dose of 5 mg/kg per day for the same period, the mean survival time of allografts was 19.5 days. The number of demonstrable plaques of hemolysis and the humoral antibodies to sheep erythrocytes were also reduced by a human therapeutic dose (20 mg/kg per day). However, the suppression of the humoral immune response was probably of more limited biological significane, suggesting a differential sensitivity to rifampin. In contrast to rifampin, benzylpenicillin had no noteworthy inhibiting effect on the cellular or humoral immune response.     

Monoclonal Antibody Treatment (Anti-CD4 and Anti-Interleukin-2 Receptor) combined with Cyclosporin A has a Positive but not Simple Dose-Dependent Effect on Rat Renal Allograft Survival

The use of monoclonal antibodies (MoAbs) in experimental and clinical organ transplantation is of increasing interest since this treatment seems to offer an opportunity for specific immunomodulation. In a rat kidney allograft model, Cyclosporin A (CyA) treatment (12.5 mg/kg/d, day 0-14) was combined with murine anti-rat CD4 (MRC OX-38) and murine anti-rat IL-2R (MRC OX-39) MoAbs at doses of 100 or 300 micrograms/kg/d (day 0-7) and plasma concentrations of the murine MoAb were determined. In both groups receiving combined treatment with CyA and MoAb, graft survival was prolonged to an average of 65 days, compared to a graft survival of 9-10 days in non-treated recipients. Further, the data showed a beneficial effect of CyA + MoAb treatment versus CyA alone (graft survival 32 days). The threefold increased MoAb dose did not seem to improve graft survival or function. Treatment with OX-38 + OX-39 at a dose of 100 micrograms/kg/d each resulted in plasma levels of 280 ng/ml 14 days after transplantation. Corresponding values after the administration of 300 micrograms/kg/d were 1800 ng/ml in graft recipients as well as controls. These findings indicate that the effect of MoAbs in complex organ transplantation models is not simply dose dependent and that in vitro assays are of limited value in predicting the effect of a given MoAb when used in vivo. The determination of MoAb plasma levels, however, may be a useful tool in defining optimal MoAb administration and to monitor therapeutically effective plasma levels.     

A combination of anergic cells' adoptive transfer and rapamycin therapy prolongs cardiac allograft survival in mice

The in vivo immunoregulatory effect of anergic cells induced by blocking the costimulatory pathway was investigated in this study. Anergic cells were generated in vitro by mixed culture of murine splenic cells from BALB/c and C3H/HeJ under the blockade of anti-CD154 and anti-CD80 monoclonal antibodies, and the in vitro activity of anergic cells were observed. The 3.0 Gy gamma-irradiated BALB/c mice received cardic allografts from C3H/HeJ, and anergic cells were intravenously injected immediately after transplantation. Recipient mice injected with anergic cells also received rapamycin therapy (1 mg/kg/day) for 14 days. On day 7 after transplantation, the subsets of peripheral blood T lymphocytes, the pathology of grafts and the infiltration of lymphocytes in grafts were analysed. Untreated gamma-irradiated animals showed a graft median survival time (MST) of 9 days. Animals injected with anergic cells only or receiving rapamycin therapy alone showed MST of 11 and 17 days, respectively. MST of allograft in mice treated with control cells plus rapamycin therapy was 9 days. Animals injected with anergic cells plus rapamycin therapy, but receiving third-party allografts (C57BL/6J), showed an MST of 15 days. However, anergic cell injection plus rapamycin therapy prolonged allograft survival significantly (MST 28 days, P < 0.01). The rejection was mild and tissue architecture was preserved in recipient mice receiving anergic cell injection plus rapamycin therapy. Furthermore, anergic cells and rapamycin therapy decreased the percentage of peripheral blood CD4+ and CD8+ T cells (including CD25+, CD152+, CD154+ and CD28+ subsets) and greatly reduced the infiltrating lymphocytes in allografts (including CD3+, CD4+, CD8+ and CD25+ T cells). In conclusion, the treatment based on anergic cells' adoptive transfer plus rapamycin therapy demonstrated a significant prolongation of murine cardiac allograft survival in a donor antigen-specific manner. This therapeutic protocol alleviated allograft rejection to solid allograft in vivo.     

Additive effects of leflunomide and tacrolimus in prevention of islet xenograft rejection

Leflunomide is a low molecular weight immunosuppressive drug which inhibits the enzymes dehydroorotate dehydrogenase and protein tyrosine kinase, both of which are important components in the immune response. As the mechanisms of action of leflunomide and tacrolimus are different, we postulated an additive or synergistic effect of the two drugs and investigated the effects of leflunomide alone, or in combination with a suboptimal dose of tacrolimus, on xenogeneic islet transplantation in a rat-to-mouse model. A total of 1200-1500 rat islets were transplanted under the left kidney capsule of streptozotocin-induced diabetic BALB/c mice. The median survival time (MST) of the untreated group was 6 days. Leflunomide at 5, 10 and 20 mg/kg/d administrated for 10 days significantly prolonged MST to 10, 16 and 20 days. A dose of tacrolimus (2 mg/kg/d) was associated with a graft survival of 9 (range 6-12) days; most grafts rejected during ongoing therapy. When tacrolimus (2 mg/kg/d) was combined with leflunomide (10 mg/kg/d), the survival time of the islet xenografts was increased further to 22 days, significantly longer than with leflunomide or tacrolimus alone. In summary, our findings demonstrate that leflunomide prolonged xenogeneic islet graft survival, and that its immunosuppressive effect was improved when combined with tacrolimus.     

Active enhancement of rat cardiac allografts induced by donor specific semisoluble antigens

Active enhancement was induced in inbred rats with cardiac allografts using semisoluble antigens. The optimal time of antigen pretreatment and optimal dose of semisoluble antigens were examined. The presence of serum blocking factors in the sera of rats having had allografts for a long time was examined with a macrophage migration inhibition test and lymphocyte microcytotoxicity assay. Since the blocking factors of macrophage migration inhibition were increasing on the 7th day, that day was determined to be the optimal time of antigen pretreatment. The mean survival time (MST) of cardiac allografts in untreated rats was 17.2 +/- 7.5 days. Semisoluble antigens were administered at 2 mg/kg body weight 7 days before the graft, 4 mg/kg 7 days before the graft and 2 mg/kg divided over three days, 15, 8 and 1 day before the graft, and the MSTs of cardiac allografts of rats receiving these treatments were 71.2 +/- 39.9, 62.6 +/- 42.2 and 79.3 +/- 31.0 days, respectively. The MST in each group of the treated rats was significantly longer than that of the control group (p less than 0.01). Rejection of the allograft, however, was accelerated in a group treated with 8 mg/kg 7 days before the graft (MST: 8.4 +/- 3.2 days). Serum blocking factors were detected in the sera of approximately half of the rats having cardiac allografts which survived a long time.     

Microcirculatory changes during skin allograft rejection and prolongation of survival time by antiplatelet agents

The process of rejection of skin first-set-allograft transplantation was pursued by observing the microcirculation of living mice, in comparison with that of the isograft transplantation (BALB/C vs. BALB/C). The vascular connection of the skin allograft between the host (BALB/C) and graft (R III) was established on day 8, in just the same pattern as in isograft skin, but the blood flow slowed down on day 9, and the formation of microthrombi was observed in the arterioles and later in the venules and capillaries at the sites slightly inside the graft from the margin on day 10. Thereafter each small vessel of the host formed a loop and the blood flow from the host did not enter the graft. The thrombus formation was confirmed by light and electron microscopy. The importance of the thrombus formation in the rejection process was further strengthened by prolongation of the cessation of the blood flow at the boundary from day 10 to days 14-15, after daily administration from days 2 to 9 of OKY-1581 (0.4 mg/g i.p.), a selective thromboxane synthetase inhibitor, or ticlopidine (0.3 mg/10 g p.o.), an inhibitor of platelet aggregation, in combination with a subthreshold dose (0.4 mg/10 g i.p.) of azathioprine. None of these drugs alone significantly prolonged the survival time.     

New avenues in the use of cyclosporine for transplantation. Graft and donor pretreatment

Modification of graft immunogenicity using graft (GPTX) and donor pretreatment (DPTX) has been pursued in an attempt to modify allograft immunogenicity using various immunosuppressive agents. The murine skin allograft and canine renal allograft models were used to study the efficacy of Cyclosporine (Cy A) as a DPTX and GPTX prior to transplantation. Tail skin allografts from C3HHeN male mice were grafted to Balb/c female mouse recipients. Minimal immunosuppression was given to all skin graft recipients. Skin allograft were either GPTX with Cy A, DPTX with either Cy A, methylprednisolone (MP), or cyclophosphamide (CP), or Cy A GPTX and DPTX with the three drugs alone or in combination. Cy A GPTX alone of skin allografts did not significantly prolong survival. DPTX with Cy A significantly prolonged skin graft survival, however, CP or MP alone did not. The various combinations of MP, Cy A, and CP as DPTX and MP, Cy A, and CP DPTX used together with Cy A GPTX also significantly prolonged murine skin allograft survival. Kidney allografts used unrelated mongrel dogs as donors or recipients. Renal transplant experimental groups were either: Non-pretreated and immediately transplanted, nonpretreated and hypothermically stored (HS) for 24 hours in Collins (C-2) solution, GPTX with 12.5 mg Cy A during 24 hr. HS in C-2, DPTX with Cy A (25 mg/Kg), or Cy A DPTX (15 mg/kg) and GPTX during 24 hrs. HS in C-2. Cy A GPTX during HS was sometimes effective in prolonging kidney allograft survival greater than 30 days using only minimal immunosuppression with azathioprine. Cy A DPTX prolonged survival somewhat, but not significantly. Improved results were seen, however, when Cy A DPTX was used together with Cy A graft pretreatment. These results indicate the potential for the successful use of Cy A as a donor and/or graft pretreatment, however, further studies will be necessary to optimize the use of Cy A in these modalities.     

Immunosuppression of triptolide and its effect on skin allograft survival.

In this study the immunosuppressive properties of triptolide were evaluated. Triptolide was found to inhibit skin allograft rejection in a dose-dependent manner. This inhibitory effect was time dependent. Triptolide at 0.1 mg/kg/day significantly prolonged the graft survival when triptolide was given for 9 days after transplantation, but not before transplantation. In vitro studies showed that triptolide markedly suppressed cytotoxic T-lymphocyte (CTL) induction and mixed lymphocyte reaction (MLR) at concentrations ranging from 0.08 to 10 ng/ml. The inhibition on MLR was also significant when triptolide was added to the cultures at 36 h after initial incubation. Furthermore, exogenous IL-2 did not reverse this inhibitory effect of triptolide. Our results suggest that triptolide inhibits lymphocyte activation at a relatively late stage, and its effect on immune response is not exerted through altering IL-2 production.     

喘可治延长小鼠异基因移植皮片存活时间与CD4+CD25+调节性T细胞相关性研究

目的：研究喘可治抑制小鼠异基因皮片移植排斥作用与小鼠体内CD4+CD25+ 调节性T细胞（CD4+CD25+Tr）变化的相关性。 方法： 建立小鼠同种异基因与同基因皮片移植模型，通过腹腔注射给药喘可治(CKZ)观察其对皮片移植存活时间的影响，并利用3色免疫荧光标记和流式细胞术分析受鼠外周血CD4+CD25+ Tr变化规律。 结果： 同种异基因移植CKZ组的移植皮片存活时间显著长于同种异基因移植对照组，分别为（195±23）d和（102±22）d，P＜001；在同种异基因皮片移植后，受体外周血CD4+CD25+ Tr占CD4+T细胞百分率明显升高，术后8 d达到高峰（P＜001），然后出现下降趋势，其中同种异基因移植对照组在术后13 d时已回落至正常水平，而同种异基因移植CKZ组在术后23 d时仍维持在高于移植前水平；在同基因皮片移植后，CKZ组与对照组外周血CD4+CD25+ Tr水平均无明显升高（P＞005）。 结论： 喘可治可延长小鼠同种异基因移植皮片存活时间，通过升高CD4+CD25+ Tr水平而发挥免疫抑制效应可能是其机制之一。