Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400010, China.
Dig Dis Sci. 2014 Apr;59(4):778-86. doi: 10.1007/s10620-013-2904-6. Epub 2013 Oct 26.
The early diagnosis of pancreas allograft dysfunction is crucial for the management and long-term survival of transplanted pancreases. We investigated whether intercellular adhesion molecular-1 (ICAM-1), Fas, and Fas ligand (FasL) can be used as novel biomarkers of acute pancreaticoduodenal allograft dysfunction in pigs.
Forty outbred landraces were randomly divided into three groups. In the control group (8 pigs), a sham operation was performed but no drugs were administered. In groups 1 and 2 (8 pairs each), pancreaticoduodenal transplantation was performed, with the latter administered immunosuppressive drugs and the former not administered drugs. The expression of ICAM-1, Fas, and FasL mRNA in the peripheral vein blood was assessed by flow cytometry and RT-PCR, pre-transplant and on days 1, 3, 5, and 7 after transplantation. Simultaneously, the levels of glucose, insulin, and glucagon in the serum of the recipients were evaluated. The allograft pancreas tissue was obtained to assess the pathological damage and the expression of Fas and FasL by immunohistochemistry.
On the first 7 days after transplantation, ICAM-1, Fas, and FasL mRNA expression in the blood leukocytes of the recipient increased significantly in groups 1 and 2 compared with the control group (P < 0.01). However, the levels in group 2 were significantly lower than those in group 1 (P < 0.05). Interestingly, the FasL expression increased but the Fas expression decreased gradually in the graft pancreas tissue during the first week after transplantation in both groups 1 and 2 compared with the control group (P < 0.05). The levels of serous glucose, insulin, and glucagon in groups 1 and 2 obviously changed on day 1 after transplantation but returned to normal on day 2. The recipient's pancreas pathological sections did not exhibit any rejection changes on days 1 and 3 after transplantation but showed rejection damage on days 5 and 7.
ICAM-1, Fas, and FasL were found to be sensitive biomarkers of acute pancreas allograft dysfunction after pancreaticoduodenal transplantation in pigs, and their monitoring could be used to evaluate the effectiveness of the immunosuppression therapy.
胰腺移植术后早期准确诊断有助于改善移植物功能和提高移植物长期存活率。本研究旨在探讨细胞间黏附分子-1(ICAM-1)、Fas 及其配体(FasL)能否作为猪胰腺十二指肠联合移植术后急性胰腺移植功能障碍的新型生物标志物。
40 头长白猪随机分为三组,对照组(8 头)仅行假手术,不给予任何药物;实验组 1(8 头)和实验组 2(8 对)均行胰腺十二指肠联合移植,实验组 2 给予免疫抑制剂,实验组 1 不给药物。采用流式细胞术和逆转录聚合酶链反应(RT-PCR)检测移植术前及术后第 1、3、5、7 天外周静脉血中 ICAM-1、Fas 和 FasLmRNA 的表达,同时检测受体血清中血糖、胰岛素和胰高血糖素的水平。术后第 7 天行移植胰腺组织病理学检查,并采用免疫组化法检测 Fas 和 FasL 的表达。
术后第 1~7 天,实验组 1 和实验组 2 受体外周血白细胞中 ICAM-1、Fas 和 FasLmRNA 的表达均明显高于对照组(P<0.01),实验组 2 明显低于实验组 1(P<0.05)。实验组 1 和实验组 2 移植胰腺组织中 FasL 的表达逐渐升高,Fas 的表达逐渐降低,与对照组比较差异均有统计学意义(P<0.05)。实验组 1 和实验组 2 受体术后第 1 天血清葡萄糖、胰岛素和胰高血糖素水平明显改变,术后第 2 天恢复正常。术后第 1、3 天受体胰腺组织未见排斥反应改变,术后第 5、7 天出现排斥反应损伤。
ICAM-1、Fas 和 FasL 是猪胰腺十二指肠联合移植术后急性胰腺移植功能障碍的敏感生物标志物,其监测有助于评估免疫抑制治疗的效果。