Sharar S R, Mihelcic D D, Han K T, Harlan J M, Winn R K
Department of Anesthesiology, University of Washington School of Medicine, Seattle 98195.
J Immunol. 1994 Sep 1;153(5):2234-8.
mAb blockade of CD18-mediated neutrophil adherence has previously been shown to reduce tissue injury in the rabbit ear as a result of ischemia followed by reperfusion. Similar injury reduction has been demonstrated whether treatment is given before ischemia or at the time of reperfusion. We examined the effects of delayed treatment with blocking CD18 mAb (60.3) after reperfusion of ischemic rabbit ears. The central neurovascular bundle of rabbit ears was isolated by microsurgery, the remainder of the ear devascularized, and all nerves cut to render the ear anesthetic. Arterial blood flow was occluded with a microvascular clamp for 6 h at an ambient temperature of 23 to 24 degrees C. The clamp was then removed and the ear allowed to reperfuse. Rabbits were divided into five treatment groups: 1) i.v. saline at reperfusion, 2) i.v. mAb 60.3 (2 mg/kg) at reperfusion, 3) i.v. mAb 60.3 1 h after reperfusion, 4) i.v. mAb 60.3 4 h after reperfusion, and 5) i.v. mAb 60.3 12 h after reperfusion. Ear edema (measured by volume displacement) was determined daily for 7 days. Edema in the immediate, 1 h, and 4 h mAb-treated groups was significantly less than in saline-treated controls, although less pronounced in the 4-h treatment group. Tissue necrosis measured at 7 days was significantly reduced in the same three mAb-treated groups compared with controls. However, edema and tissue necrosis in the 12 h mAb-treated group were similar to controls. We conclude that mAb blockade of CD18 at 1 h after reperfusion is as effective as immediate treatment in reducing ischemia reperfusion injury in the rabbit ear. Delaying treatment for 4 h is also effective but less so, whereas delaying treatment for 12 h results in no beneficial effects.
先前已表明,单克隆抗体阻断CD18介导的中性粒细胞黏附可减少兔耳因缺血再灌注所致的组织损伤。无论在缺血前还是再灌注时进行治疗,均已证实有类似的损伤减轻效果。我们研究了在缺血兔耳再灌注后延迟给予阻断CD18单克隆抗体(60.3)的效果。通过显微手术分离兔耳的中央神经血管束,使耳的其余部分缺血,切断所有神经以使耳失去感觉。在23至24摄氏度的环境温度下,用微血管夹阻断动脉血流6小时。然后移除夹子,让耳进行再灌注。将兔子分为五个治疗组:1)再灌注时静脉注射生理盐水;2)再灌注时静脉注射单克隆抗体60.3(2毫克/千克);3)再灌注后1小时静脉注射单克隆抗体60.3;4)再灌注后4小时静脉注射单克隆抗体60.3;5)再灌注后12小时静脉注射单克隆抗体60.3。连续7天每天测定耳水肿(通过体积置换法测量)。即时、1小时和4小时单克隆抗体治疗组的水肿明显少于生理盐水治疗对照组,尽管4小时治疗组的水肿不太明显。与对照组相比,相同的三个单克隆抗体治疗组在7天时测得的组织坏死明显减少。然而,12小时单克隆抗体治疗组的水肿和组织坏死与对照组相似。我们得出结论,再灌注后1小时用单克隆抗体阻断CD18在减轻兔耳缺血再灌注损伤方面与即时治疗同样有效。延迟4小时治疗也有效,但效果稍差,而延迟12小时治疗则没有有益效果。