静脉移植和动员骨髓间充质干细胞对胰腺炎肝肾功能损害的保护作用

目的探讨自体骨髓间充质干细胞静脉移植和骨髓干细胞动员在重症急性胰腺炎肝肾功能损害中的作用及可能机制。方法制备SAP大鼠模型240只,随机平分为对照组、SAP模型组、MSC组、G-CSF组和MSC+G-CSF组,各组术后再平分为12、24、48、72h组。MSC组在SAP模型6h后注射MSC 1.2ml,G-CSF组在SAP前3天每天预注射G-CSF 40μg/kg,MSC+G-CSF组联合使用G-CSF和MSC方法,对照组注射等量NS。比较各组病死率,观察肝脏和肾脏大体及镜下病理改变,比较血清肝肾功能指标ALT、AST、Bun、Cr、LDH和炎症因子TNF-α、IL-6、CRP含量,比较肝肾组织细胞凋亡指数。结果各组大鼠均存活超过48、72h病死率与SAP组比较差异无显著;肝、肾组织大体及镜下病理变化均轻于SAP模型组;治疗组血清肝肾功能指标,炎症细胞因子含量较SAP模型组不同程度减低,其中MSC+G-CSF组部分指标与单独治疗组比较有显著差异(P<0.05),细胞凋亡指数与单独治疗组比较有显著差异(P<0.05),但MSC与G-CSF组比较差异无统计学意义。结论静脉移植MSC和G-CSF骨髓动员均能有效保护重症急性胰腺炎时肝肾损害,其中联合治疗效果最佳,其中对炎症反应及细胞凋亡的调控机制存在。

Protection Effect of Bone Marrow Mesenchymal Stem Cells Transplantation and Bone Marrow Stem Cells Mobilization on Liver and Renal Function with Severe Acute Pancreatitis in Rats

Objective To study the probable effects of bone marrow mesenchymal stem cells mobilization combined with bone marrow stem cells transplantation on liver and renal cell function in rats with severe acute pancreatitis.Methods Totally 240 SD rats were prepared into severe acute pancreatitis model and randomly divided into sham-operated group,control group,bone marrow mesenchymal stem cell transplanted group,granulocyte colony stimulating factor(G-CSF) treated group and MSC+ G-CSF group.According to the difference of time points after operation,the rats in each group were subdivided into 12,24,48 and 72h groups.1.2ml MSC were injected to femoral vein 6 hours after SAP in MSC group.In G-CSF group,G-CSF 40μg/kg were subcutaneously injected before SAP for 3 days.In MSC+ G-CSF group,combined use of MSC and G-CSF was giren.In sham-operated group,equal volume normal saline were injected.The survival situation,pathological variation,the contents of serum ALT,AST,Bun,Cr,LDH,and cytokine TNF-α,IL-6,CRP,and apoptosis indexes of liver and renal were determined simultaneously.Results No rats diedbefore 48h.The mortality rates of reated group at 72h showed no difference compared to model group.The pathological variation of liver and renal cells were relieved compared to control group.The serum TNF-α,IL-6,ALT,AST,Bun,Cr,LDH and CRP decreased obviously compared to control group,but MSC+G-CSF group showed a more significant varition than single theat group(P<0.05).The apoptosis index showed same variation(P<0.05),no difference was found between two single treat groups.Conclusion Bone marrow mesenchymal stem cells transplantation and bone marrow stem cells mobilization can both stop damage from severe acutepancreatitis.The mechanisms of anti-inflammatory effect and apoptosis inhibition are existent.