Inaki Noriyuki, Tsunezuka Yoshio, Kawakami Kazuyuki, Sato Hiroshi, Takino Takahisa, Oda Makoto, Watanabe Go
Department of General and Cardiothoracic Surgery, School of Medicine, Kanazawa University, Kanazawa, Japan.
J Heart Lung Transplant. 2004 Feb;23(2):218-27. doi: 10.1016/S1053-2498(03)00112-8.
Bronchiolitis obliterans syndrome (BOS) is the most common long-term cause of morbidity and mortality after heart-lung or lung transplantation. One pathologic feature of BOS is infiltration of fibroblasts and connective tissue products into the airway lumen, which form a fibrous, collagen-rich occlusion. Heterotopically transplanted allogeneic murine tracheal stenosis resemble BOS in the development of obliterans airway disease. Matrix metalloproteinases (MMPs) are key enzymes involved in tissue remodeling and, clinically, have several roles in pulmonary diseases. Among the MMP family, type IV collagenases, MMP-2 and MMP-9, have high gelatinolytic activity and are thought to play a role in several pulmonary diseases. Membrane type 1 MMP (MT1-MMP) activates the zymogen of MMP-2 (proMMP-2, 72 kd), and activated MMP-2 (active MMP-2, 62 kd) degrades type IV collagen and plays an important role in clinical pulmonary disease. In this study, we examine the expression of MMP-2, its activator MT1-MMP and MMP-9 in BOS using murine trachea transplantation models.
Rats were divided into 5 experimental groups (n = 10 in each group). Group I was a control group with intact tracheas. Animals with tracheal grafts underwent heterotopically syngeneic (Groups II and III) or allogeneic (Groups IV and V) transplantation. The recipient rats were killed 7 days (Groups II and IV) or 28 days (Groups III and V) after transplantation. The harvested tracheal grafts were examined histologically. MMP activity was assessed using gelatin zymography analysis, and MMP-2 and MT1-MMP gene expression was examined by quantitative real-time polymerase chain reaction analysis. Distribution of gelatinolytic activity was studied using in situ zymography.
There was little histologic change in the intact trachea (Group I) and in all isografts (Groups II and III). Fibrotic tissues in Group V significantly occluded the tracheal lumen, and there was severe lymphocyte infiltration in Group IV. According to gelatin zymography, proMMP-9 was faint at 7 days, but activated MMP-9 was not present in all groups. The MMP-2 gelatinolytic bands were predominant; the activation in Group V was significantly greater than that in Group IV, and in Group III it was significantly greater than that in Group II. Gene expression of both MMP-2 and MT1-MMP were significantly higher in Group V than in the other groups (p < 0.01), and MMP-2 was clearly activated. Gelatinolytic activity was localized in the fibrotic tissues or lymphocytes of thickening lumen after destruction of the epithelium by stenosis.
These results demonstrate that MMP-2, together with its activator MT1-MMP, may have an important role in the development of BOS, which is associated with destruction of the tracheal epithelium, leading to fibrosis.
闭塞性细支气管炎综合征(BOS)是心肺或肺移植后最常见的长期发病和死亡原因。BOS的一个病理特征是成纤维细胞和结缔组织产物浸润到气道腔,形成富含纤维和胶原蛋白的阻塞。异位移植的同种异体小鼠气管狭窄在闭塞性气道疾病的发展过程中类似于BOS。基质金属蛋白酶(MMPs)是参与组织重塑的关键酶,在临床上,其在肺部疾病中发挥多种作用。在MMP家族中,IV型胶原酶、MMP-2和MMP-9具有高明胶酶活性,被认为在多种肺部疾病中起作用。膜型1 MMP(MT1-MMP)激活MMP-2的酶原(proMMP-2,72 kd),而活化的MMP-2(活性MMP-2,62 kd)降解IV型胶原,并在临床肺部疾病中起重要作用。在本研究中,我们使用小鼠气管移植模型研究了BOS中MMP-2、其激活剂MT1-MMP和MMP-9的表达。
将大鼠分为5个实验组(每组n = 10)。I组为气管完整的对照组。接受气管移植的动物进行异位同基因(II组和III组)或异基因(IV组和V组)移植。移植后7天(II组和IV组)或28天(III组和V组)处死受体大鼠。对收获的气管移植物进行组织学检查。使用明胶酶谱分析评估MMP活性,并通过定量实时聚合酶链反应分析检测MMP-2和MT1-MMP基因表达。使用原位酶谱研究明胶酶活性的分布。
完整气管(I组)和所有同基因移植组(II组和III组)几乎没有组织学变化。V组的纤维化组织显著阻塞气管腔,IV组有严重的淋巴细胞浸润。根据明胶酶谱分析,proMMP-9在7天时较淡,但所有组均未出现活化的MMP-9。MMP-2明胶酶条带占主导;V组的活化明显大于IV组,III组的活化明显大于II组。V组中MMP-2和MT1-MMP的基因表达均显著高于其他组(p < 0.01),且MMP-2明显被激活。在狭窄破坏上皮后,明胶酶活性定位于增厚管腔的纤维化组织或淋巴细胞中。
这些结果表明,MMP-2及其激活剂MT1-MMP可能在BOS的发展中起重要作用,这与气管上皮的破坏导致纤维化有关。