Ono N, Yokomise H, Muro K, Inui K, Hitomi S, Yodoi J, Wada H
Department of Thoracic Surgery, Chest Disease Research Institute, Kyoto, Japan.
J Thorac Cardiovasc Surg. 1995 Jul;110(1):15-21. doi: 10.1016/S0022-5223(05)80004-2.
Lung transplantation is now an accepted therapeutic option for patients with end-stage lung disease, and an early diagnosis of rejection is essential in the management of these patients. Adult T-cell leukemia-derived factor (ADF), known as a human homolog of thioredoxin, has been shown to be induced by a variety of stresses. In this study we examined ADF expression in lung tissues and bronchoalveolar lavage cells after canine lung transplantation to determine whether it could be induced by allogenic stimulations and could be used to diagnose early rejection. Allotransplantations were performed in adult mongrel dogs, and immunosuppression was performed from the day of operation to the fifth postoperative day. No immunosuppressant was given from the sixth to the tenth postoperative days. Animals were put to death on the tenth postoperative day. Bronchoalveolar lavage was performed on the fifth and tenth postoperative days, and the lavage cells and lung tissues were examined immunohistochemically with anti-ADF antibody. The grades of rejection were as follows: grade 1 in two animals, grade 2 in three animals, and grade 3 in two animals. The percentages of ADF high-producer cells in bronchoalveolar lavage cells on the fifth and tenth postoperative days were 4.29% +/- 2.65% and 26.6% +/- 3.99%, respectively (p < 0.01). The percentages of ADF high-producer cells in normal healthy dogs and in those with grade 1, grade 2, and grade 3 rejection were 3.00% +/- 1.64%, 20.5% +/- 9.00%, 25.5% +/- 6.06%, and 34.5% +/- 6.50%, respectively. The percentage in each rejection group was significantly higher than that in normal healthy dogs (p < 0.05). These results suggest that examination of bronchoalveolar lavage cells with ADF staining may be useful in the early diagnosis of rejection.
肺移植目前是终末期肺病患者可接受的治疗选择，而早期诊断排斥反应对于这些患者的管理至关重要。成人T细胞白血病衍生因子（ADF），即硫氧还蛋白的人类同源物，已被证明可由多种应激诱导产生。在本研究中，我们检测了犬肺移植后肺组织和支气管肺泡灌洗细胞中ADF的表达，以确定其是否可由同种异体刺激诱导产生，并能否用于早期排斥反应的诊断。在成年杂种犬中进行同种异体移植，并从手术当天至术后第5天进行免疫抑制。术后第6天至第10天未给予免疫抑制剂。动物在术后第10天处死。在术后第5天和第10天进行支气管肺泡灌洗，并用抗ADF抗体对灌洗细胞和肺组织进行免疫组织化学检查。排斥反应分级如下：2只动物为1级，3只动物为2级，2只动物为3级。术后第5天和第10天支气管肺泡灌洗细胞中ADF高产生细胞的百分比分别为4.29%±2.65%和26.6%±3.99%（p<0.01）。正常健康犬以及1级、2级和3级排斥反应犬中ADF高产生细胞的百分比分别为3.00%±1.64%、20.5%±9.00%、25.5%±6.06%和34.5%±6.50%。每个排斥反应组的百分比均显著高于正常健康犬（p<0.05）。这些结果表明，用ADF染色检查支气管肺泡灌洗细胞可能有助于早期诊断排斥反应。
