Th1和Th2细胞因子在诱导肝肠联合移植免疫耐受中的作用  

The role of Th1 and Th2 cytokines in immunotolerance after combined liver/small bowel transplantation in rats

作　　者：肇毅[1] 陆森[1] 成峰[1] 华一兵[1] 吴文溪[1] 

机构地区：[1]南京医科大学第一附属医院普通外科,210029

出　　处：《江苏医药》2006年第10期938-940,共3页Jiangsu Medical Journal

摘　　要：目的探索肝肠联合移植时移植肝对移植小肠是否具有免疫保护作用及其部分相关机制。方法选用封闭群SD大鼠和近交系Wistar大鼠配对分3组实验:同基因小肠移植组(Wistar→Wistar,Ⅰ组);异基因小肠移植组(SD→Wistar,Ⅱ组);肝肠联合移植组(SD→Wistar,Ⅲ组)。各组术后均未用免疫抑制剂。术后5、7、14d从3组中随机取出4只大鼠,取静脉血进行血清Th1细胞因子IL-2、IFN-γ和Th2细胞因子IL-4、IL-10含量测定,取移植小肠标本进行组织病理学检查。结果Ⅰ组术后仅表现缺血-再灌注损伤的组织学改变;Ⅱ组术后5、7、14d分别表现为轻度、中度和重度排斥;而Ⅲ组术后5、7、14d分别表现为轻度和中度排斥。Ⅰ组血清中四种细胞因子浓度随术后时间延长而递减;Ⅱ组血清中上述四种细胞因子浓度逐渐增加,术后各时间段与同基因组比较均有显著性差异;Ⅲ组术后第5天时上述四种细胞因子浓度最高,术后14d时IL-2、IFN-γ浓度显著低于Ⅱ组。结论肝肠联合移植时移植肝可通过抑制Th1细胞因子的表达而发挥对移植小肠的免疫保护作用。Objective To investigate the immuoprotective effect of the transplanted liver on the transplanted small bowel after combined liver/small bowel transplantation（LSBT）. Methods Closed colony SD rats and inbred Wistar rats were paired and assigned into iso-gene small bowel transplant group（Wistar to Wistar , Ⅰ ）, aniso-gene small bowel transplant group（SD to Wiatar , Ⅱ）, and combined liver/small bowel transplant group（SD to Wistar , Ⅲ ）. No immunosupressive drugs were used after operation in all three groups. Four rats selected randomly from each group were sacrificed on the 5th, 7th, and 14th postoperative day for pathologic examination. The venous blood was taken for detecting the concentration of Th1 cytokines（IL-2, IFN-γ） and Th2 cytokines（IL-4, IL-10） at the same time points. Results The rats in group Ⅰ showed the changes of ischemia-reperfusion injury only. The mild acute rejection was seen on the 5th postoperative day, moderate acute rejection on the 7^th postoperative day and severe rejection on the 14^th postoperative day in group Ⅱ. Less serious rejection was seen in group Ⅲ compared with that in group Ⅱ. The serum concentrations of IL-2, IFN-γ, IL-4, IL-10 declined in group I and increased in group Ⅱ as time went on, which was the highest on the 5th postoperative day in group lB. The serum concentration of IL-2 and IFN-γ in group Ⅲ was siginificantly lower than that in group Ⅱ on the 14^th postoperative day. Conclusion Transplanted liver can protect the small bowel graft from rejection in LSBT by depressing the expression of Thl cytokines.

关 键 词：小肠移植 细胞因子 免疫耐受 T辅助细胞 

分 类 号：R765.21[医药卫生—耳鼻咽喉科]