Tanaka Masashi, Mokhtari Golnaz K, Balsam Leora B, Cooke David T, Kofidis Theo, Zwierzchonievska Monika, Robbins Robert C
Department of Cardiothoracic Surgery, Stanford University Medical Center, Stanford, California 94305, USA.
J Heart Lung Transplant. 2005 Apr;24(4):446-53. doi: 10.1016/j.healun.2004.01.022.
The effect of cyclosporine (CsA) on the development of graft coronary artery disease (GCAD) is controversial. We developed a novel allogeneic mouse model of heart transplantation and investigated the effect of CsA on acute rejection and GCAD.
Hearts of FVB mice (H-2(q)) were heterotopically transplanted into 60 C57BL/6 mice (H-2(b)). CsA was administered to recipients at 10, 20 or 30 mg/kg/day for 10 or 30 days after transplantation. Untreated recipients as well as isograft recipients served as controls. Viability of the grafts was assessed daily by palpation. Parenchymal rejection was scored in grafts surviving 30 days in the 30-day treatment groups. GCAD was evaluated by the percentage of luminal narrowing, intima/media ratio and percentage of diseased vessels. Blood CsA and creatinine levels were also evaluated. Results were evaluated statistically.
All groups except the untreated control group and the allograft groups treated with 10 or 20 mg for 10 days showed significant graft survival (>/=33% survival for 30 days). An inverse correlation was observed between CsA treatment dose, parenchymal rejection score and degree of GCAD in the 30-day treatment groups. However, graft survival in the 20-mg/kg/day group was significantly better than that in the 30-mg/kg/day group. Serum creatine levels showed no nephrotoxicity.
Relatively high-dose CsA mitigated parenchymal rejection and GCAD of the mouse cardiac allografts. In addition, a valuable mouse model mimicking the clinical course of GCAD was achieved with CsA treatment of 20 mg/kg/day for 30 days.
环孢素(CsA)对移植冠状动脉疾病(GCAD)发展的影响存在争议。我们建立了一种新型的同种异体小鼠心脏移植模型,并研究了CsA对急性排斥反应和GCAD的影响。
将FVB小鼠(H-2(q))的心脏异位移植到60只C57BL/6小鼠(H-2(b))体内。移植后10天或30天,以10、20或30mg/kg/天的剂量给受体小鼠施用CsA。未治疗的受体小鼠以及同基因移植受体小鼠作为对照。每天通过触诊评估移植物的存活情况。在30天治疗组中,对存活30天的移植物进行实质排斥反应评分。通过管腔狭窄百分比、内膜/中膜比值和病变血管百分比评估GCAD。还评估了血液中CsA和肌酐水平。对结果进行统计学评估。
除未治疗的对照组以及接受10mg或20mg治疗10天的同种异体移植组外,所有组均显示出显著的移植物存活(30天存活率≥33%)。在30天治疗组中,观察到CsA治疗剂量、实质排斥反应评分和GCAD程度之间呈负相关。然而,20mg/kg/天组的移植物存活率显著高于30mg/kg/天组。血清肌酸水平未显示肾毒性。
相对高剂量的CsA减轻了小鼠心脏同种异体移植的实质排斥反应和GCAD。此外,通过以20mg/kg/天的剂量施用CsA 30天,建立了一种模拟GCAD临床病程的有价值的小鼠模型。