小型猪胰腺移植缺血/再灌注损伤早期腺泡细胞凋亡的发生及意义

目的探讨小型猪单纯胰腺移植缺血/再灌注损伤早期腺泡细胞凋亡的发生及意义.方法共建立20例小型猪单纯胰腺移植模型,于移植手术不同时段分别取胰腺组织行光镜组织病理学、透射电镜超微结构检查,Bcl-2、Bax免疫组化,TUNEL法原位凋亡检测.于再灌注0、30min、1h取外周血测血清淀粉酶和脂肪酶.结果移植胰腺组织离体后、冷缺血2h及再灌注1h与原位灌注前比,凋亡指数明显增加(P< 0.01),组织病理学评分明显升高(P< 0.01),Bcl-2表达明显减低(P< 0.01),Bax表达明显增强(P< 0.01);再灌注30min、1h血清淀粉酶和脂肪酶比再灌注0min明显升高(P< 0.01).结论细胞凋亡是移植胰腺缺血/再灌注损伤早期的主要表现,抗凋亡治疗在防治移植胰腺缺血/再灌注损伤中应该得到重视.

Acinar cell apoptosis induced by early ischemia/reperfusion injury in miniature swine pancreas transplantation

Objective By establishing a model of swine pancreas transplantation, we sought to clarify the occurrence of apoptosis of pancreatic acinar cell during early ischemia/reperfusion injury.Methods Experiments of pancreas transplantation with enteric drainage were performed in 20 miniature swine. Biopsies were taken from the pancreatic tail before perfusion in situ, after pancreas removal, 2h after cold ischemia and 1h after reperfusion. Target parameters were measured, including apoptosis detected by TUNEL, morphological damage examined by light and transmission electron microscopy, immunohistochemistry for Bcl-2 and Bax protein. Blood samples were taken exactly 0 min, 30 min, and 1h after reperfusion for measuring the serum amylase and lipase.Results The pancreatic tissue taken after pancreas removal, 2h after cold ischemia, 1h after reperfusion versus before perfusion in situ showed strikingly increasing numbers of apoptotic cells quantified by AI(P<0.01), significantly higher damage scores (P<0.01), significantly decreasing levels of expression of Bcl-2 (P<0.01) and increasing expression of Bax (P<0.01). The levels of serum amylase and lipase significantly increased 30 min, 1h after reperfusion (P<0.01). Conclusion Apoptosis of pancreatic cells happened during the process of pancreas transplantation may be one of the specific features of early ischemia/reperfusion injury. Antiapoptosis treatment should be emphasized for preventing ischemia/reperfusion injury in pancreas transplantation.