Epstein R B, Min K W, Anderson S L, Syzek L
University of Oklahoma Health Science Center, Department of Medicine, Oklahoma City 73190.
Transplantation. 1992 Jul;54(1):12-6. doi: 10.1097/00007890-199207000-00002.
Hepatic venoocclusive disease is a frequent lethal complication of bone marrow transplantation. It has also been associated with hepatic irradiation and administration of chemotherapeutic agents without BMT. The pathogenesis and therapy of VOD are unclear. The present studies were directed at developing a canine model for VOD. Three groups of dogs were studied. Group one consisted of 8 dogs in which monocrotaline (MC) was administered at 125 mg/kg orally on an intermittent schedule. In 7 of the 8 dogs 6 to 9 doses of drug were administered between 42 and 110 days. Group 2 consisted of 6 dogs receiving busulfan 2 mg/kg/day for 17-25 days, when platelet counts decreased to less than 5 x 10(4)/mm3 or clinical bleeding occurred. Group 3 consisted of 2 dogs receiving 24 Gy and 4 dogs receiving 36 Gy of whole-liver irradiation. Seven of 8 dogs in group 1 developed significant liver function abnormalities and evidence of portal hypertension. Histologic findings of VOD were present at autopsy. Group 2 dogs failed to develop clinical or laboratory liver abnormalities, but 3 of 6 animals had minimal histologic evidence of VOD. Three of 6 dogs in group 3 receiving 36 Gy developed hepatic dysfunction and had findings of fibrosis at autopsy. It was concluded that MC administration produced consistent clinical and histologic features of VOD in dogs. Changes occurring after busulfan or total-liver irradiation administration were less reproducible. Dogs are a suitable large-animal model for studies of VOD.
肝静脉闭塞病是骨髓移植常见的致命并发症。它也与肝脏放疗以及未进行骨髓移植时使用化疗药物有关。肝静脉闭塞病的发病机制和治疗方法尚不清楚。目前的研究旨在建立一种犬肝静脉闭塞病模型。对三组犬进行了研究。第一组由8只犬组成,以125mg/kg的剂量间歇性口服野百合碱(MC)。8只犬中的7只在42至110天内接受了6至9次药物给药。第二组由6只犬组成,当血小板计数降至低于5×10⁴/mm³或出现临床出血时,给予白消安2mg/kg/天,持续17 - 25天。第三组由2只接受24Gy全肝照射的犬和4只接受36Gy全肝照射的犬组成。第一组8只犬中的7只出现了明显的肝功能异常和门静脉高压的证据。尸检时发现有肝静脉闭塞病的组织学表现。第二组犬未出现临床或实验室肝脏异常,但6只动物中有3只在组织学上有轻微的肝静脉闭塞病证据。第三组接受36Gy照射的6只犬中有3只出现肝功能障碍,尸检时有纤维化表现。结论是,给予野百合碱可在犬身上产生一致的肝静脉闭塞病临床和组织学特征。给予白消安或全肝照射后出现的变化重复性较差。犬是研究肝静脉闭塞病合适的大型动物模型。