Tsang V T, Alton E W, Hodson M E, Yacoub M
Department of Cardiothoracic Surgery, Royal Brompton National Heart and Lung Hospital, London.
Thorax. 1993 Oct;48(10):1006-11. doi: 10.1136/thx.48.10.1006.
BACKGROUND--Bronchial epithelial function after heart-lung transplantation (HLT) for cystic fibrosis (CF) may be affected by the original disease as well as other factors such as prolonged organ ischaemic time, the interruption of bronchial arterial and lymphatic supply, infection, rejection, and cyclosporin. In vitro measurement of the bioelectric properties of the bronchial mucosal lining may be an effective means of characterising the mucosal function of the lung allografts in response to pharmacological agents. METHODS--Bronchial mucosal tissues from explanted native lungs of CF and non-CF patients at transplantation were used to assess the possible application of a mini-Ussing chamber. With this technique, the bioelectric responses of bronchial mucosal biopsies from six patients with CF, one patient with congenital heart disease, four with primary pulmonary hypertension, and one with emphysema, all after HLT, were studied. The bioelectric and pharmacological responses of biopsies of bronchial mucosa from patients after HLT were compared with biopsies from non-CF non-HLT subjects. RESULTS--The altered bioelectric properties of CF tissues could be detected by the mini-Ussing chamber technique. The basal bioelectric values and the responses to amiloride and isoprenaline in CF patients were not different from those in non-CF patients two years after HLT. No significant difference in the basal bioelectric properties and responses to amiloride and isoprenaline was found between HLT recipients and non-CF non-HLT subjects. CONCLUSIONS--The mini-Ussing chamber is an effective means of characterising the typical CF bioelectric defect which was not found in the transplanted lungs of CF patients up to two years after HLT. Furthermore, values were unaltered in comparison with non-transplanted lungs, suggesting that bronchial epithelial function is maintained after HLT.
背景——囊性纤维化(CF)患者进行心肺移植(HLT)后,支气管上皮功能可能受到原发病以及其他因素的影响,如器官缺血时间延长、支气管动脉和淋巴供应中断、感染、排斥反应和环孢素。体外测量支气管黏膜衬里的生物电特性可能是表征肺移植黏膜功能对药物反应的有效手段。
方法——使用移植时CF患者和非CF患者切除的天然肺的支气管黏膜组织,评估微型Ussing室的可能应用。采用该技术,研究了6例CF患者、1例先天性心脏病患者、4例原发性肺动脉高压患者和1例肺气肿患者在HLT术后支气管黏膜活检的生物电反应。将HLT术后患者支气管黏膜活检的生物电和药理反应与非CF非HLT受试者的活检结果进行比较。
结果——微型Ussing室技术可检测到CF组织生物电特性的改变。CF患者的基础生物电值以及对阿米洛利和异丙肾上腺素的反应与HLT术后两年的非CF患者无差异。HLT受者与非CF非HLT受试者之间在基础生物电特性以及对阿米洛利和异丙肾上腺素的反应方面未发现显著差异。
结论——微型Ussing室是表征典型CF生物电缺陷的有效手段,在CF患者HLT术后长达两年的移植肺中未发现该缺陷。此外,与未移植的肺相比,各项数值未改变,表明HLT术后支气管上皮功能得以维持。