雷公藤多甙对同种异体神经移植免疫抑制作用的实验研究

背景用于异体神经移植中的免疫抑制剂-环胞素A价格昂贵;而相关文献报道,中药雷公藤制剂具有免疫抑制作用.目的探讨同种异体神经移植雷公藤多甙替代环孢素A(cyclosporinA,CSA)进行免疫抑制可行性.设计随机分组双盲设计.地点和对象实验在武汉大学人民医院完成,对象为健康雄性SD大鼠48只,Wistar大鼠18只,SPF级,体质量180～210g,购自武汉大学医学动物实验中心.干预方法取Wistar大鼠坐骨神经为供体,于SD大鼠上制备坐骨神经移植模型,随机分为4组,即自体移植组,行自体神经原位移植;CSA组,异体神经移植应用CSA5 mg/(kg·d)5周;雷公藤组,异体神经移植应用雷公藤多甙5 mg/(kg·d)5周;对照组,单纯异体神经移植而无免疫抑制剂.主要观察指标移植术后12周移植段神经形态学观察,神经运动诱发电位潜伏期、神经运动诱发电位峰值、神经传导速度和振幅积分,腓肠肌称重及再生轴突计数.结果12周时,自体移植、CSA、雷公藤组的潜伏期峰值、诱发电位、传导速度、振幅积分、肌肉湿质量、肌肉湿质量恢复度、轴突数目各项检测指标明显优于对照组(q=3.95～8.32,P＜0.01),再生神经形态与功能恢复良好.结论同种异体神经移植时,雷公藤多甙可以替代CSA发挥有效的免疫抑制作用.

Experimental study of the immuno-suppressive effect of tripterygium on nerve allograft

BACKGROUND: Cyclosprone A( CSA ), an immuno-suppressive agent used in peripheral nerve allograft, is of high price. However, tripterygium,a traditional Chinese medicine, was previously reported to have the function of immuno-suppression.OBJECTIVE: To verify the possibility of using tripterygium as a substitution of CSA in nerve allografts.DESIGN: Double blinded and randomized design.SETTING and PARTICIPANTS: Adult healthy male SD(48) and Wistar rats(18) of SPF grade, weighing 180 -210 g,were provided by the Medical Animal experimental Center of Wuhan University.INTERVENTIONS: Forty-eight SD rats as recipients of sciatic nerve allograft were randomly assigned into one of the following groups: Autograft Group; CSA Group, allograft with CSA 5mg/kg per day for 5 weeks;Tripterygium Group, allograft with tripterygium 5mg/kg per day for 5 weeks; and Control Group, allograft withnot immune treatment. Eighteen Wistar rats were the donors of the sciatic nerve allograft.MAIN OUTCOME MEASURES: Observation was done under light microscope and electron microscope examination 12 weeks post-operatively.The number of axons in the middle segment of the allogeneic graft was counted, double sides of gastrocnemius muscle were weighed and electrophysiological parameters were also measured.RESULTS: At 12 weeks after transplantation, latent period peak of tripterygium Groups , evoked potential nerve conduction velocity , accumulated points of amplitude, the wet mass of muscle, the recovery degree of muscle's wet mass and the number of axis-cylinder recovered of the autograft, CSA and tripterygium group were better than those of their control counterpart(q=3.95-8.32, P ＜ 0.01) .There were good regenerate nervus form and functional recovery.CONCLUSIONS: Tripterygium as an immuno-suppressant has the similar effect to CSA on nerve allograft.