Kompoliti Katie, Chu Yaping, Shannon Kathleen M, Kordower Jeffrey H
Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois 60612, USA.
Mov Disord. 2007 Aug 15;22(11):1630-3. doi: 10.1002/mds.21528.
To date, there is no clinicopathological correlation of adrenal medullary transplant cases in patients with survival beyond a few years. Postmortem examination of a brain from a patient with Parkinson's disease (PD), 16 years after autologous adrenal medullary transplant, was performed using tyrosine hydroxylase (TH) and chromogranin A. The patient experienced a four-year initial improvement in motor function followed by resumption of the progressive nature of her disease that continued until her death. She expired 16 years following grafting. At autopsy, TH stain of the brain revealed severe loss of TH-immunoreactivity in the substantia nigra and Lewy bodies, confirming the diagnosis of PD. The transplant site was identified by the presence of scarring and there was complete absence of any TH staining cells at the site of the transplant. There were few surviving cells staining with chromogranin A. The absence of TH-staining cells in the transplant 16 years after surgery provides further evidence that adrenal medullary transplants do not survive in the long term.
迄今为止,对于存活超过数年的肾上腺髓质移植患者,尚无临床病理相关性研究。在一名帕金森病(PD)患者自体肾上腺髓质移植16年后,对其大脑进行了尸检,采用酪氨酸羟化酶(TH)和嗜铬粒蛋白A进行检测。该患者运动功能最初改善了四年,随后病情恢复进展直至死亡。移植16年后患者死亡。尸检时,大脑的TH染色显示黑质和路易小体中TH免疫反应性严重丧失,证实为PD诊断。通过瘢痕形成确定了移植部位,移植部位完全没有任何TH染色细胞。仅有少数存活细胞对嗜铬粒蛋白A染色。术后16年移植部位缺乏TH染色细胞,进一步证明肾上腺髓质移植不能长期存活。