Molossi S, Clausell N, Rabinovitch M
Division of Cardiovascular Research, Hospital For Sick Children, Toronto, Ontario, Canada.
Circulation. 1993 Nov;88(5 Pt 2):II248-56.
Graft coronary arteriopathy has become the major complication observed in the late follow-up of cardiac transplant patients. We investigated this process experimentally in piglets after a heterotopic cardiac transplant and observed early changes in donor coronary arteries compatible with an immune-inflammatory process, ie, there is increased expression of interleukin-1 beta (IL-1 beta), fibronectin, and activated lymphocytes associated with intimal thickening.
In this study, we cultured porcine coronary artery endothelial cells from host and donor hearts and found similarities in morphology and uptake of acetylated low-density lipoprotein (LDL). As well, host and donor cells showed similar patterns of growth, protein, and glycosaminoglycan synthesis. Endothelial cell fibronectin synthesis was determined after radiolabeling with [35S]-methionine in serum-free medium, gelatin-sepharose extraction of the culture medium and resolution on 5% SDS-PAGE. Donor coronary artery endothelial cell fibronectin synthesis was up to fivefold higher than that of host but was not associated with comparable increased levels of fibronectin mRNA. IL-1 beta appeared to mediate this enhanced fibronectin production, since the IL-1 receptor antagonist caused a 50% decrease in this feature, a change not observed in host cells. Furthermore, donor endothelial cells produced twice the amount of IL-1 beta compared with host cells as judged by immunoprecipitation.
Increased donor coronary artery endothelial cell fibronectin appears to be regulated at least partly by an autocrine mechanism involving IL-1 beta, and fibronectin may mediate lymphocyte trafficking and smooth muscle cell migration related to graft arteriopathy.
移植冠状动脉病变已成为心脏移植患者晚期随访中观察到的主要并发症。我们在异位心脏移植后的仔猪中对这一过程进行了实验研究,观察到供体冠状动脉的早期变化与免疫炎症过程相符,即白细胞介素-1β(IL-1β)、纤连蛋白和活化淋巴细胞的表达增加,并伴有内膜增厚。
在本研究中,我们培养了来自宿主和供体心脏的猪冠状动脉内皮细胞,发现它们在形态和乙酰化低密度脂蛋白(LDL)摄取方面具有相似性。此外,宿主和供体细胞在生长、蛋白质和糖胺聚糖合成方面表现出相似的模式。在无血清培养基中用[35S]-甲硫氨酸进行放射性标记后,通过明胶-琼脂糖提取培养基并在5%十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)上进行分离,测定内皮细胞纤连蛋白的合成。供体冠状动脉内皮细胞的纤连蛋白合成比宿主细胞高出五倍,但与纤连蛋白mRNA水平的相应增加无关。IL-1β似乎介导了这种纤连蛋白产生的增强,因为IL-1受体拮抗剂使这一特征降低了50%,而宿主细胞未观察到这种变化。此外,通过免疫沉淀判断,供体内皮细胞产生的IL-1β量是宿主细胞的两倍。
供体冠状动脉内皮细胞纤连蛋白的增加似乎至少部分受涉及IL-1β的自分泌机制调节,纤连蛋白可能介导与移植血管病变相关的淋巴细胞转运和平滑肌细胞迁移。