中华眼镜蛇毒结合免疫抑制剂控制异种移植排斥反应  

Research on Function of Integrated Chinese Cobra Venom and Immune Suppressive Drugs on Immune Rejection in Xenotransplantation

作　　者：戚峰[1] 朱理玮[1] 何向辉[1] 邱宇杰[1] 王鹏志[1] 

机构地区：[1]天津医科大学总医院普通外科,天津300052

出　　处：《中国中西医结合外科杂志》2010年第4期448-452,共5页Chinese Journal of Surgery of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(30500489);国家自然科学基金资助项目(30940066)

摘　　要：目的:探讨协调性和非协调性异种移植免疫排斥不同机理,寻找中华眼镜蛇毒结合免疫抑制药物的最佳治疗方案。方法:采用改良的Heron颈部套袖法分别建立小鼠对大鼠,豚鼠对大鼠异种异位心脏移植模型,受体大鼠各分为4组:1组仅行异种移植不给药;2组联合应用中华眼镜蛇蛇毒因子、环磷酰胺、FK506;3组将2组中华眼镜蛇毒剂量加倍;4组在2组用药组合基础上再加用前列腺素E1。结果:给药组移植供心存活时间明显延长,尤其在小鼠对大鼠模型给予PGE1后(小鼠4组6.92d)及豚鼠对大鼠模型蛇毒因子剂量加倍后(豚鼠3组27.33h)。两类模型给药后CH50,异种抗体IgM明显降低,并逐渐出现急性血管排斥反应改变。结论:异种移植后的超急性排斥反应和急性血管排斥反应存在着密切的相互关联,是统一的排斥过程中具有不同特点的两个阶段。中华眼镜蛇毒联合多种免疫抑制药物可控制异种排斥,尤其对非协调性异种移植有更大的作用。Objective To study the immune mechanism of concordant and discordant xenotransplantation and methods of controlling immune rejection by combined Chinese Cobra Venom and other immune suppressive drugs. Methods The mouse to rat and the guinea pig to rat heterotopic cardiac xenotransplantation models were established by improved Heron＇s cuff technique in neck, which were divided into 4 groups respectively as following： Group 1 received xenograft without treatment; Group 2 was treated with CCV,CTX,and FK506; The dose of CCV in Group 3 was doubled; Group 4 was treated with CCV,CTX,FK506,and PGE1. Results The cardiac survival time of Group 2, 3, 4 increased obviously, especially for Group 4 of mouse to rat model with PGE1 treatment（6.92 days） and for Group3 of guinea pig to rat model with double-dosed CCV（27.33hrs）. In both of the models, the levels of CH50 and xeno-IgM decreased after treatment and acute vascular rejection（AVR） gradually happened. Conclusion The HAR and AVR in xenotransplantation are closely related and interlaced without limit. Chinese Cobra Venom combined with other immune suppressive drugs can be effective in xenotransplantation, especially for discordant xenotransplantation.

关 键 词：异种移植 心脏 超急性排斥 急性血管排斥 中华眼镜蛇蛇毒因子 

分 类 号：R617[医药卫生—外科学] R541[医药卫生—临床医学]