Lee W P, Yaremchuk M J, Pan Y C, Randolph M A, Tan C M, Weiland A J
Microsurgical Research Laboratory, Johns Hopkins University School of Medicine, Baltimore, Md.
Plast Reconstr Surg. 1991 Mar;87(3):401-11. doi: 10.1097/00006534-199103000-00001.
At present, the transplantation of vascularized limb-tissue allografts can be achieved only with generalized host immunosuppression, which results in significant systemic toxicity, thereby precluding their clinical use. A better understanding of the immunogenic mechanisms of these allografts may permit less toxic and thus clinically applicable means of host immunosuppression. In this study, individual vascularized limb tissues (skin, subcutaneous tissue, muscle, bone, and blood vessels) and a whole limb were transplanted microsurgically across a strong histocompatibility barrier in rats. The respective cell-mediated and humoral immune responses generated in the hosts were determined by means of mixed lymphocyte cultures by radioactive 51Cr release assays and compared. No single tissue predominated in the elicited immune response. Rather, the various tissue components interacted with the host immune system in a complex but predictable pattern with differing timing and intensity. Surprisingly, the whole-limb allograft elicited less immune response than did allografts of its individual components. The data presented here also serve as a foundation for further elucidation of the immunogenic mechanisms of vascularized limb-tissue allografts.
目前，血管化肢体组织同种异体移植仅能通过全身性宿主免疫抑制来实现，这会导致显著的全身毒性，从而妨碍其临床应用。更好地了解这些同种异体移植的免疫原性机制可能会使毒性较小且临床上适用的宿主免疫抑制方法成为可能。在本研究中，将单个血管化肢体组织（皮肤、皮下组织、肌肉、骨骼和血管）以及整个肢体通过显微外科手术移植到大鼠的强组织相容性屏障上。通过放射性51Cr释放测定的混合淋巴细胞培养法确定宿主中产生的各自的细胞介导免疫反应和体液免疫反应，并进行比较。在引发的免疫反应中没有单一组织占主导地位。相反，各种组织成分与宿主免疫系统以复杂但可预测的模式相互作用，时间和强度各不相同。令人惊讶的是，整个肢体同种异体移植引发的免疫反应比其各个组成部分的同种异体移植要少。此处呈现的数据也为进一步阐明血管化肢体组织同种异体移植的免疫原性机制奠定了基础。
