细胞间黏附分子1与血管细胞黏附分子1在心脏移植慢性排斥反应中的表达及意义

目的研究细胞间黏附分子1（ICAM-1）与血管细胞黏附分子1（VCAM-1）在心脏移植慢性排斥反应中的表达及作用。方法采用供体脾细胞（SPC）和环磷酰胺（CP）预处理移植受体,然后行异位心脏移植术,免疫组织化学检测移植心脏中VCAM-1和ICAM-1的表达。结果SPC和CP预处理后,移植心脏中ICAM-1、VCAM-1的表达水平明显减低,而ICAM-1和VCAM-1在急性排斥反应和环孢素A（CsA）治疗组中的表达明显增强（均P〈0．05）。急性排斥反应与CsA治疗组比较差异无统计学意义。结论ICAM-1和VCAM-1的表达水平与心脏移植排斥反应的程度密切相关。

Expression of intercellular adhesion molecule-1 and vascular cell adhesion molecule in cardiac allografts and significance thereof: experiment with rats

OBJECTIVE: To investigate the expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in allograft with chronic rejection (CR) after heart transplantation. METHODS: Seventy-two SD rats receiving transplantation of the heats of 71 Wistar rats were divided into 4 equal groups: Group A, undergoing heterotopic cervical heart transplantation (transplanted with donor's heart subcutaneously at the neck) and receiving none intervention, and with the transplanted hearts taken out 3 d after transplantation to the end of CR; Group B, injected intravenously with the splenocytes (SPCs) of the donors on day 0, injected with cyclophomide (CP) on d2, transplanted with the donor hearts on d15, with the transplanted hearts taken out 15 - 120 days after transplantation; Group C, transplanted with the donor's heart and injected intraperitoneally with cyclosporine A (Cs A) 10 mg/kg every other day for 8 - 10 times, and with the transplanted hearts taken out 60 d after transplantation to the end of CR; and Group D, injected intravenously with the SPCs of the donors on day 0, injected with CP on d2, transplanted with the donor hearts on d15, with the transplanted hearts taken out 150 - 420 days after transplantation. Immunohistochemical method was used to detect the expression of ICAM-1 and VCAM-1 in the allografts. RESULTS: The cardiac allograft survival time of Group B was the longest. Less ICAM-1 and VCAM-1 expression and lymphocyte infiltration were observed in SPC and CP-pretreated group. Reversely, protein expression levels of ICAM-1 and VCAM-1 were both high and significant lymphocyte infiltration was seen in Groups B and D. There was no significant difference in the expression of ICAM-1 and VCAM-1 between Groups A and C (P > 0.05). CONCLUSION: The expression levels of ICAM-1 and VCAM-1 are associated with the occurrence and development of rejection and have positive correlation with the severity of graft rejection. Determination of ICAM-1 and VCAM-1 can predict the function of allograft and provide evidence for early diagnosis and prevention of CR.