Tabasco-Minguillán J, Cicalese L, Lee R G, Rakela J
Division of Transplantation Medicine, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Transplantation. 1995 Dec 27;60(12):1572-7. doi: 10.1097/00007890-199560120-00033.
During acute rejection (AR), the endothelial targeting seen in the mucosal vessels of the intestinal allograft (IA) could impair the blood supply and response to luminal stimuli. To study the effect of AR in the perfusion and reactivity of the IA mucosa, we measured the mucosal blood flow in the ileum (IL) of 2 groups of control rats (Lewis and ACI) and in the native and grafted IL of syngeneic (ACI to ACI) and allogeneic (donor ACI to recipient Lewis) rats. Using reflectance spectrophotometry and laser-Doppler flowmetry, parameters of mucosal oxygen saturation (ISO2), hemoglobin content (IHB), and blood flow (FLOW) were obtained at baseline and after saline and 50% dextrose (D50) stimulation. When compared to controls, the isograft IL had similar perfusion (ISO2, IHB, and FLOW). The allograft IL showed ischemia (similar ISO2, and lower ISO2 and FLOW). In the allografts, the ISO2 and FLOW were lower than in the isografts. In response to D50, the native IL of all groups showed an increased IHB and FLOW (hyperemia); the isografts showed an increase only in IHB (partial response); the allografts did not show any response at all. In summary, the mucosal perfusion in the rejecting allografts, but not in the isografts, showed ischemia. The response to D50 seen in the native ilea was only partial in the isografts and absent in the allografts. Because these changes occurred before the onset of mucosal ulcerations, we postulate that they could be used as early indicators of AR.
在急性排斥反应（AR）期间，肠道同种异体移植（IA）黏膜血管中出现的内皮靶向可能会损害血液供应以及对腔内刺激的反应。为了研究AR对IA黏膜灌注和反应性的影响，我们测量了2组对照大鼠（Lewis和ACI）回肠（IL）以及同基因（ACI到ACI）和异基因（供体ACI到受体Lewis）大鼠的天然和移植回肠中的黏膜血流。使用反射分光光度法和激光多普勒血流仪，在基线以及盐水和50%葡萄糖（D50）刺激后获取黏膜氧饱和度（ISO2）、血红蛋白含量（IHB）和血流（FLOW）参数。与对照组相比，同基因移植回肠具有相似的灌注（ISO2、IHB和FLOW）。同种异体移植回肠显示出缺血（ISO2相似，而IHB和FLOW较低）。在同种异体移植中，ISO2和FLOW低于同基因移植。对D50的反应方面，所有组的天然回肠均显示IHB和FLOW增加（充血）；同基因移植仅显示IHB增加（部分反应）；同种异体移植则完全没有任何反应。总之，正在发生排斥反应的同种异体移植的黏膜灌注显示出缺血，而同基因移植则没有。同基因移植中对D50的反应仅为部分反应，同种异体移植中则无反应。由于这些变化发生在黏膜溃疡出现之前，我们推测它们可作为AR的早期指标。
