白细胞介素-1受体拮抗剂防治角膜移植免疫排斥反应的实验研究  

An experimental study on subconjunctival interleukin-1 receptor antagonist for promotion of corneal transplant survival

作　　者：翟长斌[1] 张文华[1] 邹留河[2] 潘志强[1] 李纳[2] 武宇影[1] 吕岚[2] 张士元[1] 马大龙[3] 

机构地区：[1]北京市眼科研究所,100005 [2]首都医科大学附属北京同仁医院眼科 [3]北京大学医学部医学免疫学重点实验室

出　　处：《中华眼科杂志》2001年第4期270-272,T003,共4页Chinese Journal of Ophthalmology

基　　金：卫生部科研基金资助项目 (96 1 30 6 )

摘　　要：目的　观察白细胞介素 1受体拮抗剂 (IL 1ra)抑制大鼠正位穿透性角膜移植术后免疫排斥反应、促进植片存活的作用。方法　将主要组织相容性系统完全不同的近交系F344大鼠的角膜植片移植到另一近交系LOU大鼠的角膜上 ,将手术成功大鼠分为实验Ⅰ、Ⅱ、Ⅲ组及对照Ⅳ组 ,均于术后第 1d起结膜下分别注射 5 0、10 0、2 0 0 μg的IL 1ra ,对照组 (Ⅳ组 )结膜下注射等量生理盐水 ,连续2周。对角膜植片存活情况进行评分 ,观察其临床效果。结果　各实验组角膜植片平均存活天数(meansurvivaltime ,MST)分别为 (11 13± 1 46 )d、(12 0 0± 1 6 0 )d及 (13 44± 1 13)d ,明显高于对照组(8 0 0± 1 2 5 )d ,差异有显著性 (t=0 0 0 ,P <0 0 1)。IL 1ra 2 0 0 μg组与 5 0 μg组间比较 ,差异有显著性(t=0 0 0 ,P <0 0 1)。结论　结膜下注射IL 1ra可抑制角膜移植术后免疫排斥反应 ,减少新生血管的生成 ,减轻免疫性炎性反应 ,延长角膜植片的存活时间。IL 1ra的剂量越大 ,效果越好。Objective To determine whether the subconjunctival application of interleukin 1 receptor antagonist (IL 1ra) can prolong the corneal graft survival in the rat model of orthotopic penetrating keratoplasty. Methods For all experiments, F344 corneas were transplanted into LOU (major histocompatibility disparate) eyes. Experimental groups received subconjunctival injection of 50, 100 and 200 μg IL 1ra respectively, and the control group received the same volume of 0.9% normal saline instead for consecutive 2 weeks. All transplants were evaluated for 4 weeks after surgery for signs of rejection. Results The mean survival time (MST) of the grafts of the experimental groups was increased significantly ( t =0 00, P <0.01) in comparison with the control group. The MST of the IL 1ra 200 μg group was increased significantly than that of the IL 1ra 50 μg group ( t =0 00, P <0.01). Furthermore, the IL 1ra treated grafts had significantly less corneal inflammation, infiltration, lower levels of opacity, edema, neovascularization and rejection index compared with the control group. Conclusions Subconjunctival treatment of IL 1ra has a significantly positive effect on promoting corneal allograft survival. And its effect is dosage dependent.

关 键 词：穿透性角膜移植 白细胞介素-1受体拮抗剂 移植物排斥 

分 类 号：R779.65[医药卫生—眼科] R392.4[医药卫生—临床医学]