Department of Nephrology and Hemodialysis, Rouen University Hospital, Rouen, France.
Transplantation. 2011 Jan 15;91(1):35-41. doi: 10.1097/TP.0b013e3181fe12d6.
Whether mycophenolate mofetil (MMF) can prevent the vascular endothelial dysfunction related to the administration of calcineurin inhibitor after organ transplantation remains unknown.
Four groups of Lewis rats, grafted with Brown Norway donor aortic abdominal allograft, received since the transplantation cyclosporine A (CsA, 5 mg/kg/day), MMF (40 mg/kg/day), CsA+MMF, or vehicle (control) for 2 weeks.
Fifteen days after transplantation, all immunosuppressive regimens were equally effective in preventing graft rejection. When compared with control rats, the endothelium-dependent relaxation to acetylcholine was reduced, and the vasoconstrictor effect of phenylephrine was enhanced in thoracic aorta of CsA-treated rats but not in rats treated with MMF alone or combined with CsA without difference for the endothelium-independent relaxation to sodium nitroprusside. The relaxation to acetylcholine was abolished by the nitric oxide (NO)-synthase inhibitor N-nitro-l-arginine in all groups. Moreover, the endothelial NO-synthase protein dimer:monomer ratio in the thoracic aorta and the plasma nitrites concentrations, an indicator of NO availability, were decreased in CsA-treated rats but not in rats treated with MMF alone or combined with CsA.
This study demonstrates that MMF prevents systemic endothelial dysfunction and the enhanced sensitivity to vasoconstrictors related to CsA administration in a rat allograft aortic model through an increase in NO availability related to the improvement of endothelial NO-synthase functionality.
霉酚酸酯(MMF)是否能预防器官移植后钙调磷酸酶抑制剂治疗引起的血管内皮功能障碍尚不清楚。
4 组接受 Brown Norway 供体主动脉腹主动脉移植的 Lewis 大鼠,自移植后每天给予环孢素 A(CsA,5mg/kg/天)、MMF(40mg/kg/天)、CsA+MMF 或载体(对照)2 周。
移植后 15 天,所有免疫抑制方案在预防移植物排斥方面均同样有效。与对照组大鼠相比,CsA 治疗大鼠的胸主动脉对乙酰胆碱的依赖性舒张作用减弱,对苯肾上腺素的血管收缩作用增强,但 MMF 单独或与 CsA 联合治疗的大鼠则无差异,对硝普钠的非依赖性舒张作用无差异。所有组中,一氧化氮(NO)-合酶抑制剂 N-硝基-L-精氨酸均可消除乙酰胆碱的舒张作用。此外,CsA 治疗大鼠的胸主动脉内皮型一氧化氮合酶蛋白二聚体:单体比值和血浆硝酸盐浓度(NO 可用性的指标)降低,但 MMF 单独或与 CsA 联合治疗的大鼠则无此变化。
本研究表明,MMF 通过增加与内皮型一氧化氮合酶功能改善相关的 NO 可用性,预防大鼠同种异体主动脉模型中 CsA 治疗引起的全身内皮功能障碍和对血管收缩剂的敏感性增强。