高危角膜移植后免疫排斥反应与颈淋巴结切除(英文)  

Cervical lymphadenectomy and immune rejection after high-risk corneal allograft

作　　者：凌士奇[1,2] 张慧[3,4] 林浩添[3] 徐建刚[3] 邝文辉[3] 

机构地区：[1]广州市儿童医院眼科 [2]中山大学中山眼科中心(眼科学国家重点试验室),广东省广州市510060 [3]中山大学中山眼科中心(眼科学国家重点试验室) [4]昆明医学院第一附属医院眼科,云南省昆明市650032

出　　处：《中国组织工程研究与临床康复》2008年第5期996-1000,共5页Journal of Clinical Rehabilitative Tissue Engineering Research

基　　金：国家自然科学基金(30700927,30600697);广东省自然科学基金(06300677);中国博士后科学基金(20050384)~~

摘　　要：背景:颈淋巴结是角膜的引流区淋巴结。角膜移植后,抗原提呈细胞随着房水经由脉络膜巩膜外途径引流至颈淋巴结而诱发角膜免疫排斥反应。目的:观察在碱烧伤的角膜植床上行角膜移植后的免疫排斥反应现象,认识颈淋巴结切除抑制角膜移植后免疫排斥的效应。设计:随机对照动物实验。单位:中山大学中山眼科中心。材料:实验于2005-05/2007-02在中山大学中山眼科中心完成(眼科学国家重点试验室。实验室编号2006DA105054)。选用SD大鼠104只,Wistar大鼠40只,均为雄性,鼠龄1～2个月,均由中山大学实验动物中心提供。实验所用的白细胞介素2和干扰素γELISA试剂盒由美国Biource International公司提供。实验过程对动物的处置符合在眼科研究使用动物的ARVO声明。方法:以SD鼠为受体,Wistar鼠为供体,所有受体大鼠均行同种异体角膜移植。受体鼠被随机分为4组:正常对照组:行正常角膜移植;B组为颈淋巴结切除组:正常大鼠切除双侧颈淋巴结;碱烧伤后角膜移植组:角膜碱烧伤后21d时行角膜移植;碱烧伤后角膜移植合并颈淋巴结切除组:角膜碱烧伤后立即行双侧颈淋巴结切除,21d后再行角膜移植;每组20只。应用ELISA法检测角膜移植后各组植片中干扰素γ、白细胞介素-2蛋白的表达,记录角膜排斥反应发生的时间并比较各组植片平均存活时间。其余24只受体鼠用于在裂隙灯下及组织切片后显微镜下观察碱烧伤后角膜炎症及新生血管的动态变化。结果:①病理组织学:正常角膜无炎症及新生血管。碱烧伤后3天时,角膜基质中存在着大量的炎症细胞浸润。3周末时无明显的炎症征象,但角膜新生血管达到高峰。碱烧伤后8周时,角膜新生血管已完全消退。②植片平均存活时间:正常对照组、颈淋巴结切除组、碱烧伤后角膜移植组、碱烧伤后角膜移植合并颈淋巴结切除组分别为(10.40±1.14),(46.30�BACKGROUND：Cervical lymph nodes are draining region of cornea. It is believed that aqueous fluid goes through a minor pathway named uveoscleral drainage, which will allow passage of antigen-presenting cells （APC） directly to the draining lymph nodes and induce allograft rejection after keratoplasty. OBJECTIVE： To explore the inhibitory effects of cervical lymphadenectomy in alkali induced high-risk corneal transplantation. DESIGN： A randomized controlled animal experiment. SETTING： State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University. MATERIALS： The experiment was performed in the State Key Laboratory of Ophthalmology （No. 2006DA105054）, Zhongshan Ophthalmic Center, Sun Yat-sen University from May 2005 to February 2007. 144 male animals （1-2 months old） including 104 SD rats and 40 Wistar rats were provided by the animal experimental center of Sun Yat-sen University. Sandwich enzyme-linked immunosorbent assay （ELISA） kits for interleukin-2 （IL-2） and interferon-γ （IFN-γ） were brought from BioSource International company （USA）. The animal treatment in the experiment was accorded with the statement in Association for Research in Vision and Ophthalmology （ARVO） for animals. METHODS： With the SD rats as recipients, and Wistar rats as donors, all rats were subjected to corneal allografting. The recipient rats were randomly divided into 4 groups （n=20）： group A （control group） which underwent corneal transplantation; group B which was subjected to bilateral cervical lymphadenectomy; group C, corneal transplantation 21 days after the alkali burn injury; group D, cervical lymphadenectomy following group C. The immune rejection of grafts was evaluated by detecting the expression of IFN-γ and IL-2 using ELISA. The time when allograft rejection occurred was recorded and mean survival time （MST） was compared among the groups. The development of corneal inflammation and new vessels was examined by slit lamp microscope and h

关 键 词：高危角膜移植 免疫排斥 颈淋巴结切除 

分 类 号：R617[医药卫生—外科学]