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排斥反应对犬肠道移植物电生理功能的影响:与组织病理学及钠钾ATP酶活性的相关性

Effect of rejection on electrophysiologic function of canine intestinal grafts: correlation with histopathology and Na-K-ATPase activity.

作者信息

Takeyoshi I, Zhang S, Kokudo Y, Nakamura K, Ikoma A, Zhu Y, Starzl T E, Todo S

机构信息

Pittsburgh Transplantation Institute, University of Pittsburgh, Pennsylvania, USA.

出版信息

J Invest Surg. 1995 Jul-Aug;8(4):223-34. doi: 10.3109/08941939509031596.

Abstract

To investigate whether electrophysiologic changes can detect the early onset and progress of intestinal rejection, changes in in vitro electrophysiologic function, intestinal histopathology, and Na-K-ATPase activity were studied in dogs. Adult mongrel dogs of both sexes, weighing 18-24 kg, were used for auto and allo small bowel transplantation. The entire small bowels, except for short segments at the proximal and distal ends, were switched between a pair of dogs (allograft). Animals receiving intestinal autotransplantation were used as controls. Allograft recipients were sacrificed 3, 4, 5, 7, or 9 days after transplantation, and autograft recipients were sacrificed 3, 7, or 14 days after transplantation. Immunosuppression was not used. Electrophysiologic measurements were done with an Ussing chamber. Histological analysis was performed blindly using whole thickness sections. Na-K-ATPase activity in the mucosal tissue, which is said to regulate the potential difference, was also measured. Potential difference, resistance, and Na-K-ATPase activity of the allograft intestine decreased with time and were significantly lower 7 and 9 days after transplantation compared to host intestine, normal intestine, and graft intestine of controls (autograft). Potential difference, resistance, and Na-K-ATPase activity of the native intestinal tissue and the autografts did not decrease with time. Detection of histologically mild rejection of the intestine, which is important for appropriate immunosuppressive treatment in clinical cases, could not be achieved based on electrophysiology or Na-K-ATPase activity. Deterioration of electrophysiologic function during rejection correlated with the histological rejection process and Na-K-ATPase activity; however, electrophysiology may not be a reliable tool for monitoring grafts, since it cannot detect early intestinal rejection.

摘要

为研究电生理变化能否检测肠道排斥反应的早期发生及进展情况,对犬的体外电生理功能、肠道组织病理学及钠钾ATP酶活性变化进行了研究。选用体重18 - 24 kg的成年杂种犬进行自体和异体小肠移植。除近端和远端的短节段外,将整个小肠在一对犬之间进行交换(同种异体移植)。接受肠道自体移植的动物用作对照。同种异体移植受体在移植后3、4、5、7或9天处死,自体移植受体在移植后3、7或14天处死。未使用免疫抑制剂。用电极腔进行电生理测量。使用全层切片进行盲法组织学分析。还测量了黏膜组织中据认为可调节电位差的钠钾ATP酶活性。同种异体移植肠的电位差、电阻和钠钾ATP酶活性随时间降低,与宿主肠、正常肠及对照(自体移植)的移植肠相比,移植后7天和9天显著降低。天然肠组织和自体移植肠的电位差、电阻和钠钾ATP酶活性未随时间降低。基于电生理学或钠钾ATP酶活性无法检测到组织学上轻度的肠道排斥反应,而这对临床病例中适当的免疫抑制治疗很重要。排斥反应期间电生理功能的恶化与组织学排斥过程及钠钾ATP酶活性相关;然而,电生理学可能不是监测移植物的可靠工具,因为它无法检测早期肠道排斥反应。

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