Qi Zhan, Yang Da-Yun, Wang Rui, Wang Shan-Zheng, Ping Yu-Min
Department of Thoracic Surgery, Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, China.
Zhonghua Wai Ke Za Zhi. 2007 Feb 15;45(4):262-6.
To establish an animal model of obliterative bronchiolitis (OB) after lung transplantation and investigate the pathogenesis preliminarily.
Tracheal segments (5 cartilaginous rings each) were transplanted from SD rats to SD rats (Group I) or to Wistar rats (Group II and III). Grafts were implanted into an abdominal cavity and wrapped in the omentum. Animals in Group I and II did not receive CsA, animals in Group III received CsA daily by gastro-tube at 10 mg.kg(-1).d(-1) from beginning to end. Grafts were harvested on day 3, 14, 28 after transplantation as representative time points for 3 phases of injury in the evolution of allograft airway obliteration, then examined histological changes and gene expression of T-helper 1-and T-helper 2-type cytokines [Th1: interleukin-2 (IL-2), interferon-gamma (IFN-gamma); Th2: interleukin-4 (IL-4), interleukin-10 (IL-10)] in grafts. At the same time, effects of CsA were observed on the above-mentioned indices.
There was no significant difference in histological changes on day 3 after transplantation among 3 groups (P > 0.05). Tracheas in Group I approached to normal morphology on day 14 after transplantation. Airway epithelium of Group II and III almost lost completely on day 14 after transplantation. There was no significant difference between Group II and Group III (P > 0.05), but there were significant differences between Group I and Group II or Group III. The cross-sectional area of the tracheal lumen was narrowed by approximately (5.0 +/- 1.2)%, (28.5 +/- 5.0)% and (19.4 +/- 2.9)% respectively on day 14 after transplantation in Group I, II and III, there were significant differences among 3 groups. On day 14 after transplantation, tracheas in Group I revealed few lymphocytic infiltration, but it showed dense lymphocytic infiltration in Group II. Tracheas in Group III have much more lymphocyte infiltration than that in Group I, but much less than that in Group II. There were significant differences among 3 groups, too (P < 0.01). The tracheal lumen revealed almost total luminal obstruction (94.8 +/- 3.6)% on day 28 after transplantation in Group II. The cross-sectional area of the tracheal lumen was narrowed by approximately (3.7 +/- 0.8)% and (36.6 +/- 7.6)% respectively in Group I and III on day 28. There were significant differences among 3 groups (P < 0.01). Compared with that on day 14, lymphocytic infiltration had decreased gradually on day 28 in Group II and III. There were significant differences among 3 groups all the same (P < 0.01). In Group II, expression of IL-2, IFN-gamma, IL-4, and IL-10 were much higher than that in Group I. Expression of Th1 cytokines was increased to a greater extent than that of Th2 cytokines in Group II compared with Group I. Allografts in Group III expressed significantly less IL-2 gene transcripts than that in Group II over all the points. There was no significant difference between Group II and III in IFN-gamma, IL-4, and IL-10 gene expression.
Compared with isografts, allografts have more obvious changes, such as epithelial damage, fibroproliferation and lymphocytic infiltration. Th1 and Th2 lymphocyte subtypes contribute to the development of obliterative bronchiolitis in heterotopic trachea transplant model of rat, and changes of their cytokines gene expression may be involved in the pathogenesis. CsA could reduce the development of fibroproliferation and lymphocyte infiltration markedly, but it could not protect airway epithelium. CsA inhibits IL-2 gene transcripts, so it can reduce development of the pathologic lesion of obliterative bronchiolitis to a certain degree.
建立肺移植后闭塞性细支气管炎(OB)动物模型并初步探讨其发病机制。
将气管段(各含5个软骨环)从SD大鼠移植至SD大鼠(Ⅰ组)或Wistar大鼠(Ⅱ组和Ⅲ组)。移植物植入腹腔并用大网膜包裹。Ⅰ组和Ⅱ组动物未接受环孢素A(CsA),Ⅲ组动物自始至终每天经胃管给予10mg·kg⁻¹·d⁻¹的CsA。在移植后第3、14、28天收获移植物,作为同种异体移植气道闭塞演变过程中3个损伤阶段的代表性时间点,然后检查移植物的组织学变化以及辅助性T细胞1型和辅助性T细胞2型细胞因子[Th1:白细胞介素-2(IL-2)、干扰素-γ(IFN-γ);Th2:白细胞介素-4(IL-4)、白细胞介素-10(IL-10)]的基因表达。同时,观察CsA对上述指标的影响。
移植后第3天,3组间组织学变化无显著差异(P>0.05)。Ⅰ组移植后第14天气管形态接近正常。Ⅱ组和Ⅲ组移植后第14天气道上皮几乎完全丧失。Ⅱ组和Ⅲ组间无显著差异(P>0.05),但Ⅰ组与Ⅱ组或Ⅲ组间有显著差异。移植后第14天,Ⅰ、Ⅱ、Ⅲ组气管腔横截面积分别缩小约(5.0±1.2)%、(28.5±5.0)%和(19.4±2.9)%,3组间有显著差异。移植后第14天,Ⅰ组气管淋巴细胞浸润较少,Ⅱ组则显示密集的淋巴细胞浸润。Ⅲ组气管的淋巴细胞浸润比Ⅰ组多,但比Ⅱ组少。3组间也有显著差异(P<0.01)。Ⅱ组移植后第28天气管腔几乎完全阻塞(94.8±3.6)%。移植后第28天,Ⅰ组和Ⅲ组气管腔横截面积分别缩小约(3.7±0.8)%和(36.6±7.6)%。3组间有显著差异(P<0.01)。与第14天相比,Ⅱ组和Ⅲ组移植后第28天淋巴细胞浸润逐渐减少。3组间仍有显著差异(P<0.01)。Ⅱ组中IL-2、IFN-γ、IL-4和IL-10的表达均高于Ⅰ组。与Ⅰ组相比,Ⅱ组中Th1细胞因子的表达升高幅度大于Th2细胞因子。Ⅲ组移植物在所有时间点IL-2基因转录物的表达均显著低于Ⅱ组。Ⅱ组和Ⅲ组在IFN-γ、IL-4和IL-10基因表达上无显著差异。
与同基因移植相比,异基因移植有更明显的变化,如上皮损伤、纤维增生和淋巴细胞浸润。Th1和Th2淋巴细胞亚群在大鼠异位气管移植模型闭塞性细支气管炎的发生发展中起作用,其细胞因子基因表达的变化可能参与发病机制。CsA可显著减少纤维增生和淋巴细胞浸润的发生,但不能保护气道上皮。CsA抑制IL-2基因转录物,因此可在一定程度上减少闭塞性细支气管炎病理病变的发展。