Akl E S, Latif N, Dunn M J, Rose M L, Yacoub M H
Department of Cardiothoracic Surgery, National Heart and Lung Institute, London, UK.
Eur J Cardiothorac Surg. 1992;6(9):503-7. doi: 10.1016/1010-7940(92)90249-w.
One-dimensional sodium dodecyl sulphate polyacrylamide gel electrophoresis of myocardial proteins followed by Western blotting is a sensitive method for the detection of antiheart antibodies after cardiac transplantation. In a previous study we found that the majority of patients made antiheart antibodies after cardiac transplantation. It is possible that these antibodies were formed in response to cardiac damage caused during the surgical procedure rather than being specific to the transplantation situation. In this study we have evaluated the role of open cardiac surgery in the formation of antiheart antibodies for the first 9 months of the postoperative period using the Western blotting technique and correlated that with the development of post-pericardiotomy syndrome. Only 25% (9/36) of patients showed any increase in the pre-existing level of antiheart antibodies or developed antiheart antibodies with new reactivities. None of the patients in the study developed manifestations specific for post-pericardiotomy syndrome during the period of follow-up. The results support the contention that the high incidence of antiheart antibodies formed after cardiac transplantation is due to a humoral immune response to the presence of alloantigens on the grafted heart rather than as a result of the surgical procedure itself.
对心肌蛋白进行一维十二烷基硫酸钠聚丙烯酰胺凝胶电泳，随后进行蛋白质印迹分析，是检测心脏移植后抗心脏抗体的一种灵敏方法。在之前的一项研究中，我们发现大多数患者在心脏移植后产生了抗心脏抗体。这些抗体有可能是对手术过程中造成的心脏损伤产生的反应，而非移植情况所特有的。在本研究中，我们使用蛋白质印迹技术评估了心脏直视手术在术后头9个月抗心脏抗体形成过程中的作用，并将其与心包切开术后综合征的发生情况相关联。仅有25%（9/36）的患者抗心脏抗体的原有水平出现任何升高，或产生了具有新反应性的抗心脏抗体。在随访期间，该研究中的患者均未出现心包切开术后综合征的特异性表现。这些结果支持了这样的观点，即心脏移植后形成抗心脏抗体的高发生率是由于对移植心脏上同种异体抗原的存在产生体液免疫反应，而非手术过程本身所致。
