Sipka Sándor, Bráth Endre, Tóth Ferenc F, Aleksza Magdolna, Kulcsár Andrea, Fábián Akos, Baráth Sándor, Balogh Péter, Sipka Sándor, Furka István, Mikó Irén
Department of Operative Techniques and Surgical Research, Medical and Health Science Center, University of Debrecen, Hungary.
Transpl Immunol. 2006 Aug;16(2):99-104. doi: 10.1016/j.trim.2006.03.013. Epub 2006 Apr 27.
Our department worked out a modified surgical form of spleen autotransplantation earlier, named "spleen apron method" introduced already into the clinical practice. Recently we tested the immunological changes in a group of patients autotransplanted with about 10-15% of their spleen, what was the at least always implantable amount after the severe splenic injuries. In the current work we aimed at measuring some cellular and serological changes in the peripheral blood of splenectomized and spleen autotransplanted inbred mice two and eight months after the operations in order to get more unambiguous results than that we could obtain in our patients with this technique.
We divided 96 two months old Balb/c female mice into eight groups (n = 12/group). The group of controls, sham operated, splenectomized and autotransplanted animals with two and eight months of survival time after the operations. During the autotransplantation we inserted the same amount of spleen, five slices, "chips," about 10-15% of total mass of spleen, into the greater omentum similarly as it was used in the patients. The concentration of serum proteins were measured by laser nephelometry. The lymphocyte subsets were analyzed by flow cytometry.
We found that two months after the operations the number of CD 19+ B-cells increased in the splenectomized but decreased in the autotransplanted animals. Eight months after the operations the number of both CD3+ T and CD19+ B lymphocytes decreased both in the splenectomized and autotransplanted animals compared to the controls and sham operated mice. However, the numbers of T and B cells were slightly but not significantly higher in the autotransplanted than in the splenectomized mice. The serum level of IgM was also decreased in the splenectomized and autotransplanted mice at both time points, however, eight months after the operations the concentration of IgM was significantly higher in the autotransplanted group than in the splenectomized animals.
The effects of autotransplanted "chips" were different at the various ages of the animals. Additionally, they showed some immunological benefit being quantitatively in accordance to the amount of the transplanted spleen. The elevated level of serum IgM what we found in the autotransplanted mice even with this amount of transplanted spleen eight months after the operations, however, might have the potentially greatest importance compared to splenectomy. These experiments can prove that the attempts for autotransplantation may have real perspectives but their efficacy depends on the amount of the successfully transplanted (saved) mass of spleen.
我们科室早前制定了一种改良的脾脏自体移植手术方式，即“脾围裙法”，已应用于临床实践。最近，我们检测了一组接受约10 - 15%脾脏自体移植患者的免疫变化，这是严重脾损伤后至少总能移植的量。在当前研究中，我们旨在测量脾切除和脾脏自体移植的近交系小鼠术后两个月和八个月外周血中的一些细胞和血清学变化，以便获得比用该技术在患者中得到的更明确的结果。
我们将96只两个月大的雌性Balb/c小鼠分为八组（每组n = 12）。包括对照组、假手术组、脾切除组以及术后存活两个月和八个月的自体移植组动物。在自体移植过程中，我们像在患者中那样，将相同量的脾脏，即五片“薄片”，约占脾脏总质量的10 - 15%，植入大网膜。通过激光散射比浊法测量血清蛋白浓度。通过流式细胞术分析淋巴细胞亚群。
我们发现术后两个月，脾切除组动物的CD19 + B细胞数量增加，而自体移植组动物的该细胞数量减少。术后八个月，与对照组和假手术组小鼠相比，脾切除组和自体移植组动物的CD3 + T细胞和CD19 + B淋巴细胞数量均减少。然而，自体移植组小鼠的T细胞和B细胞数量略高于脾切除组小鼠，但差异不显著。在两个时间点，脾切除组和自体移植组小鼠的血清IgM水平也均降低，不过术后八个月，自体移植组的IgM浓度显著高于脾切除组动物。
自体移植“薄片”在动物的不同年龄阶段产生的效果不同。此外，它们显示出一些免疫益处，在数量上与移植脾脏的量相关。然而，我们在术后八个月的自体移植小鼠中发现，即使移植的脾脏量如此，血清IgM水平升高，这与脾切除相比可能具有潜在的最大重要性。这些实验可以证明自体移植的尝试可能具有实际前景，但其疗效取决于成功移植（保存）的脾脏量。
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