Akst Lee M, Dan Olivia, Strome Marshall
Head and Neck Institute, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
Am J Otolaryngol. 2006 Jan-Feb;27(1):13-7. doi: 10.1016/j.amjoto.2005.05.013.
Lifelong immunosuppression carries significant morbidity, and techniques to reduce or eliminate such immunosuppression might expand laryngeal transplantation. This study investigates the ability of donor-specific transfusion to establish tolerance in a rat model of laryngeal transplantation. A total of 289 transplants were performed from Lewis-Brown-Norway donors to Lewis recipients. Donor-specific transfusion was provided as single intravenous injections of donor splenocytes 1 hour before transplantation. Different combinations of in vitro irradiation of donor larynges and postoperative cyclosporine doses provided additional immunomodulation. Allograft rejection was scored histologically at sacrifice 15 or 30 days posttransplant. Multivariate analysis was performed across all groups, and paired analyses compared groups with and without donor-specific transfusion. Donor-specific transfusion did not improve rejection score, although increased cyclosporine dose did (P < .001). Donor splenocyte injection on the day of transplantation does not establish tolerance to laryngeal allografts or permit reduction of other immunosuppression. Other immunomodulatory strategies to establish tolerance in rat laryngeal transplantation require further investigation.
终身免疫抑制会带来显著的发病率，而减少或消除这种免疫抑制的技术可能会扩大喉移植的应用。本研究调查了供体特异性输血在大鼠喉移植模型中建立免疫耐受的能力。总共进行了289例从Lewis-Brown-Norway供体到Lewis受体的移植手术。在移植前1小时，通过单次静脉注射供体脾细胞进行供体特异性输血。对供体喉进行体外照射和术后环孢素剂量的不同组合提供了额外的免疫调节。在移植后15天或30天处死时，通过组织学对同种异体移植排斥反应进行评分。对所有组进行多变量分析，并对有和没有供体特异性输血的组进行配对分析。尽管增加环孢素剂量可改善排斥反应评分（P <.001），但供体特异性输血并未改善排斥反应评分。在移植当天注射供体脾细胞不能建立对喉同种异体移植的耐受性，也不能减少其他免疫抑制。在大鼠喉移植中建立耐受性的其他免疫调节策略需要进一步研究。
