Stevenson S, Shaffer J W, Goldberg V M
Department of Orthopaedics, Case Western Reserve University, School of Medicine, Cleveland, OH, USA.
Clin Orthop Relat Res. 1996 May(326):86-95. doi: 10.1097/00003086-199605000-00011.
The cytotoxic donor specific antibody response after vascularized and nonvascularized bone allograft implantation was assessed in rats and dogs. Nonvascularized segmental femoral grafts were studied in rats; nonvascularized fresh and cryopreserved massive osteochondral allografts were studied in dogs; and vascularized and nonvascularized fibular allografts were studied in dogs. The major histocompatibility complex antigens of all animals were defined. All grafts were stabilized by internal fixation and the antibody response was measured in a 51chromium release microcytotoxicity assay using donor lymphocytes as target cells. In all cases, donor specific antibody responses were elicited by major histocompatibility complex mismatched grafts. The response was directed primarily at Class I specificities although there was likely and antiClass II response as well. Among fully mismatched grafts, antidonor antibody was detectable earlier in animals receiving vascularized grafts (1 week after surgery) than in animals receiving nonvascularized grafts (3 weeks after surgery). Massive grafts elicited a sustained response whereas relatively smaller grafts, such as the fibula did not. The antidonor antigen antibody response was transient and less frequent in animals receiving frozen grafts. The clinical implications of these data are unclear. Although some improvement of clinical outcome has been observed with grafts matched for major histocompatibility complex antigens, the potential benefits of tissue antigen matching or modulation of the host immune response remain unresolved.
在大鼠和犬类动物中评估了血管化和非血管化骨移植植入后的细胞毒性供体特异性抗体反应。在大鼠中研究了非血管化节段性股骨移植；在犬类动物中研究了非血管化新鲜和冷冻保存的大块骨软骨移植；在犬类动物中研究了血管化和非血管化腓骨移植。确定了所有动物的主要组织相容性复合体抗原。所有移植均通过内固定进行固定，并使用供体淋巴细胞作为靶细胞，通过51铬释放微量细胞毒性试验测量抗体反应。在所有情况下，主要组织相容性复合体不匹配的移植均引发了供体特异性抗体反应。该反应主要针对I类特异性，尽管可能也存在抗II类反应。在完全不匹配的移植中，接受血管化移植的动物（术后1周）比接受非血管化移植的动物（术后3周）更早检测到抗供体抗体。大块移植引发持续反应，而相对较小的移植，如腓骨则不会。在接受冷冻移植的动物中，抗供体抗原抗体反应是短暂的且频率较低。这些数据的临床意义尚不清楚。尽管观察到主要组织相容性复合体抗原匹配的移植在临床结果上有一些改善，但组织抗原匹配或调节宿主免疫反应的潜在益处仍未得到解决。
