雪旺细胞移植改善心肌梗死后副交感/交感神经重塑  

Remodeling of parasympathetic/sympathetic ratio in the infarcted myocardium after Schwann cell transplantation

作　　者：金培峰[1] 张浩[2] 陆地[1] 翁家侃[1] 姜盛[1] 孙成超[1] 

机构地区：[1]温州医科大学附属第一医院心胸外科,浙江温州325015 [2]中国医学科学院阜外心血管病医院,北京100037

出　　处：《温州医科大学学报》2016年第1期13-18,共6页Journal of Wenzhou Medical University

基　　金：浙江省自然科学基金资助项目(Y2110641)

摘　　要：目的:对心肌梗死后的心脏进行雪旺细胞(Schwann cells)移植,从而改善心肌梗死的心脏神经的重塑,降低心肌梗死后室性心律失常易感性,以达到雪旺细胞移植治疗心肌梗死后心率失常的目的。方法:利用结扎Lewis大鼠冠状动脉前降支的方法建立急性大鼠心肌梗死模型,并将心肌梗死的大鼠随机分为细胞移植组(n=31)和对照组(n=30)。雪旺细胞取自大鼠坐骨神经,经爬片S100染色鉴定雪旺细胞表面标记物。并将经体外培养扩增后的雪旺细胞(5×106)通过注射的方式移植于心肌梗死周边区,并在细胞移植后的2周用免疫荧光及免疫组织化学方法检测心肌梗死边缘区副交感、交感神经,动态心电图和程序性电刺激(PES)检测室性心律失常的易感性。结果:通过S100染色发现,培养获得的雪旺细胞纯度达到95%以上,在雪旺细胞移植后的2周,免疫组织化学和免疫荧光结果显示,雪旺细胞移植能够显著改善心肌梗死边缘区副交感/交感神经的比例,并且能够显著降低动态心电图频域检测中低频/高频的比值,同时显著降低了室性心律失常的易感性。结论:雪旺细胞移植能够有效改善心肌梗死部位副交感/交感神经的比例,从而降低心肌梗死后室性心律失常的发生率。Objective： To investigated the feasibility of remodeling nervous system regeneration after myocardial infarction and the efficacy by which it may prevent ventricular arrhythmia following Schwann cells transplantation. Methods： Myocardial infarction was induced by left anterior descending artery ligation in syn- genic Lewis rats, then the rats were randomized into cell transplantation group （n=31） and control group （n=0 Schwann cell were isolated from sciatic nerves, and immunohistochemical of S100 was carried out for the iden- tification of Schwann cells. 5× 106 Schwann cell were intramyocardially injected into the border zone of infarct region. The density of sympathetic and parasympathetic nerves and growth-associated protein 43 in the infarct region were stained by immunohistochemical method and immunofluorescence at 2 weeks after Schwann cells transplantation. Meanwhile, dynamic electrocardiography and programmed electric stimulation were also performed to detect the susceptibility of ventricular arrhythmias. Results： More than 95% of cells were S-100-positive Schwann cells during the entire culture process. Immunohistochemical and immunofluorescence staining illustrated increases in sympathetic and parasympathetic nerves in both groups. However, Schwann cells transplan- tation significantly increased the parasympathetic/sympathetic ratio at 2 weeks after cell injection. In addition, the Schwann cells also significantly decreased the low-/high-frequency ratio and susceptibility of programmed electric stimulation-induced ventricular arrhythmia at 2 weeks after cell injection. Conclusion： Transplanted Schwann cells in the infarcted myocardium can alter the ratio of parasympathetic/sympathetic nerve density to normalize irritable myocardium.

关 键 词：心肌梗死 室性心律失常 雪旺细胞 细胞移植 

分 类 号：R541.7[医药卫生—心血管疾病]