Fu F, Li W, Lu L, Thomson A W, Fung J J, Qian S
Thomas E. Starzl Transplantation Institute and Department of Surgery, University of Pittsburgh, Pennsylvania 15213, USA.
Transplantation. 1999 Feb 15;67(3):444-50. doi: 10.1097/00007890-199902150-00018.
The aim was to determine whether sublethal donor total body irradiation (TBI) might be as effective as lethal TBI in preventing mouse second-set liver allograft rejection, and to evaluate the role of passenger leukocytes, donor major histocompatibility complex (MHC) antigens, and host effector mechanisms in the response to livers from sublethally irradiated donors.
B10 (H2b) donors received various doses of TBI at different times before their livers were transplanted orthotopically into normal or donor skin-presensitized C3H (H2k) recipients. The influence of irradiation on graft non-parenchymal cells (NPC) was determined by monoclonal antibody staining, and flow cytometric analysis. Hematopoietic cells within the grafts were reconstituted by intravenous infusion of syngeneic or third-party bone marrow cells. Allograft survival was determined in recipients that received no treatment, or that were given spleen cells from either normal B10 donors, or MHC class I - or class II-deficient mice syngeneic with the donors. Cytotoxic activity of graft-infiltrating cells and host spleen cells, and complement-dependent cytotoxic alloantibody titers were determined by isotype release assays.
The protective effect of donor TBI was observed both at lethal (9.5 Gy) and sublethal doses (5 and 3 Gy; graft median survival time: >100 days). Extended delay in liver transplantation, allowing hematopoietic recovery and graft reconstitution eliminated the effect. Liver NPC were reduced about 80% within 24 hr of 3 Gy TBI, with a selective reduction in the incidence of B cells. The NPC-depleted livers underwent accelerated rejection when donor (but not third-party) spleen cells (5 x 10(7) were administered systemically to the recipient immediately after graft revascularization. Spleen cells from MHC class I-deficient (but not MHC class II-deficient) mice failed to fully restore accelerated rejection of TBI liver grafts. Freshly isolated graft NPC, or spleen cells from TBI liver recipients, harvested 4 days after transplantation, exhibited lower, donor-specific cytotoxic activity than cells from mice given normal livers. Recipients of TBI livers also showed much lower serum complement-dependent cytotoxic alloantibody titers.
By substantially depleting "passenger leukocytes," sublethal donor TBI undermines anti-donor cell-mediated and humoral immune reactivity and inhibits second-set liver allograft rejection in presensitized recipients. The interval between irradiation and transplantation is important in conferring resistance to rejection. Expression of MHC class I on donor leukocyte infusions is important for overcoming resistance to second-set rejection induced by donor irradiation.
目的是确定亚致死剂量的供体全身照射(TBI)在预防小鼠二次肝移植排斥反应方面是否与致死剂量的TBI同样有效,并评估过客白细胞、供体主要组织相容性复合体(MHC)抗原以及宿主效应机制在对亚致死剂量照射供体肝脏的反应中的作用。
B10(H2b)供体在其肝脏原位移植到正常或预先经供体皮肤致敏的C3H(H2k)受体之前的不同时间接受不同剂量的TBI。通过单克隆抗体染色和流式细胞术分析确定照射对移植非实质细胞(NPC)的影响。通过静脉输注同基因或第三方骨髓细胞来重建移植物中的造血细胞。在未接受治疗或接受来自正常B10供体、或与供体同基因的MHC I类或II类缺陷小鼠的脾细胞的受体中确定同种异体移植物的存活情况。通过同型释放试验确定移植物浸润细胞和宿主脾细胞的细胞毒性活性以及补体依赖性细胞毒性同种异体抗体滴度。
在致死剂量(9.5 Gy)和亚致死剂量(5 Gy和3 Gy;移植物中位存活时间:>100天)时均观察到供体TBI的保护作用。肝移植的延长延迟,允许造血恢复和移植物重建消除了这种作用。3 Gy TBI后24小时内肝脏NPC减少约80%,B细胞发生率选择性降低。当在移植物血管再通后立即向受体全身给予供体(而非第三方)脾细胞(5×10⁷)时,NPC减少的肝脏发生加速排斥。来自MHC I类缺陷(而非MHC II类缺陷)小鼠的脾细胞未能完全恢复TBI肝移植物的加速排斥。移植后4天收获的新鲜分离的移植物NPC或TBI肝受体的脾细胞,与给予正常肝脏的小鼠的细胞相比,表现出较低的供体特异性细胞毒性活性。TBI肝受体的血清补体依赖性细胞毒性同种异体抗体滴度也低得多。
通过大量清除“过客白细胞”,亚致死剂量的供体TBI破坏了抗供体细胞介导的和体液免疫反应性,并抑制了预先致敏受体中的二次肝移植排斥反应。照射与移植之间的间隔对于赋予抗排斥抗性很重要。供体白细胞输注上MHC I类的表达对于克服供体照射诱导的二次排斥抗性很重要。