Satoh S, Thomson A W, Nakamura K, Warty V, Todo S
Pittsburgh Transplantation Institute, University of Pittsburgh Medical Center, Pennsylvania 15213-2582, USA.
Transplantation. 1995 Sep 27;60(6):558-62. doi: 10.1097/00007890-199509270-00007.
Recently, soluble(s) circulating isoforms of intercellular adhesion molecule-1 (sICAM-1) and sE-selectin (formerly endothelial leukocyte adhesion molecule-1) have been described in normal human serum. Elevated levels have been reported in acute and chronic inflammatory disorders, including allograft rejection. In this study, plasma levels of sICAM-1 and sE-selectin were determined in groups of tacrolimus (FK 506)-treated adult patients following either isolated small bowel (SB), liver, or combined SB plus liver (SB/L) transplantation. Each molecule was measured at 1, 2, 4, 6, 8, and 12 weeks (all patients) and at 6, 9, and 12 months after transplantation (SB and SB/L only) by enzyme linked immunosorbent assay. Levels were compared with those of soluble interleukin-2 receptor (sIL-2R; a marker of lymphocyte activation) and soluble HLA class I (which has been reported to be elevated in liver transplant-related complications). Elevations above normal in mean plasma levels of sICAM-1 (2.4-fold), sE-selectin (1.8-fold), sIL-2R (10.6-fold), and sHLA class I (1.3-fold) were found in patients with stable isolated SB grafts during the first 12 weeks posttransplant. Except for sHLA class I, levels of each protein were subsequently reduced, up to 1 year posttransplant. However, further increases in sICAM-1 and in sIL-2R and sE-selectin levels were observed during episodes of SB rejection compared with stable grafts. Mean levels of all molecules were higher in patients with isolated SB grafts compared with those given liver or combined (SB/L) transplants, either during stable SB graft function (up to 12 weeks posttransplant) or rejection. The data demonstrate increased adhesion molecule production/shedding following SB transplantation and are suggestive of a reduced overall level of immune activation in liver and SB/L compared with isolated SB transplantation.
最近，在正常人血清中发现了细胞间黏附分子-1（sICAM-1）和sE-选择素（以前称为内皮白细胞黏附分子-1）的可溶性循环异构体。据报道，在包括同种异体移植排斥反应在内的急慢性炎症性疾病中，其水平会升高。在本研究中，对接受他克莫司（FK 506）治疗的成年患者进行了分组，这些患者分别接受了孤立小肠（SB）移植、肝脏移植或小肠联合肝脏（SB/L）移植。通过酶联免疫吸附测定法，在移植后1、2、4、6、8和12周（所有患者）以及6、9和12个月（仅SB和SB/L患者）测定了sICAM-1和sE-选择素的血浆水平。将这些水平与可溶性白细胞介素-2受体（sIL-2R；淋巴细胞活化的标志物）和可溶性HLA I类分子（据报道在肝移植相关并发症中会升高）的水平进行了比较。在移植后的前12周内，稳定的孤立SB移植物患者的sICAM-1平均血浆水平升高了2.4倍，sE-选择素升高了1.8倍，sIL-2R升高了10.6倍，sHLA I类分子升高了1.3倍。除了sHLA I类分子外，每种蛋白质的水平在移植后1年内随后都有所下降。然而，与稳定移植物相比，在SB排斥反应期间观察到sICAM-1、sIL-2R和sE-选择素水平进一步升高。在稳定的SB移植物功能期间（移植后长达12周）或排斥反应期间，接受孤立SB移植的患者中所有分子的平均水平均高于接受肝脏移植或联合（SB/L）移植的患者。数据表明，SB移植后黏附分子的产生/释放增加，并且提示与孤立SB移植相比，肝脏和SB/L移植中免疫激活的总体水平降低。
