Russell P S, Chase C M, Colvin R B
Transplantation Unit of the Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts, USA.
Am J Pathol. 1996 Jul;149(1):91-9.
Arteriopathy, sometimes termed accelerated atherosclerosis, often impairs transplants. We employed apolipoprotein-E-deficient, hypercholesterolemic mice to determine how the hyperlipidemic environment affected transplanted hearts. Strain 129 hearts transplanted to C57BL/6 normal or C57BL/6 apolipoprotein-E-deficient recipients were evaluated by immunochemical and histological techniques. Analyses were possible both of differences in the coronary lesions that developed in a normolipidemic as compared with a hyperlipidemic environment and of the coronary atherosclerotic process in transplanted hearts compared with native hearts in the same hyperlipidemic environment. Aortas and coronary arteries of transplanted aortas in both recipient groups developed florid intimal thickening by 4 to 10 weeks, with marked lipid deposition, foamy macrophages, and infiltration of smooth muscle alpha-actin-positive cells in apolipoprotein-E-deficient mice. Lipid was layered against the internal elastic lamina as in human transplants. VCAM-1 was increased in various sites in both groups. Allotransplants to apolipoprotein-E-deficient recipients had more severe aortic and coronary lesions with characteristic T cell infiltration than native hearts. In this sense, transplants suffered from accelerated atherosclerosis. The character of coronary vascular changes in transplanted hearts was distinctly affected by their lipid environment, but their severity, in terms of luminal encroachment, was not markedly different.
动脉病变,有时也称为加速性动脉粥样硬化,常常会损害移植器官。我们利用载脂蛋白E缺乏的高胆固醇血症小鼠来确定高脂血症环境如何影响移植心脏。将129品系的心脏移植到C57BL/6正常或C57BL/6载脂蛋白E缺乏的受体小鼠体内,并通过免疫化学和组织学技术进行评估。这样既可以分析在正常血脂环境与高脂血症环境中发生的冠状动脉病变差异,也可以分析与处于相同高脂血症环境中的正常心脏相比,移植心脏中的冠状动脉粥样硬化进程。在两个受体组中,移植主动脉的主动脉和冠状动脉在4至10周时均出现了明显的内膜增厚,伴有明显的脂质沉积、泡沫巨噬细胞以及载脂蛋白E缺乏小鼠中平滑肌α-肌动蛋白阳性细胞的浸润。脂质像在人类移植中那样在内弹力层处分层。两组中不同部位的血管细胞黏附分子-1(VCAM-1)均增加。与正常心脏相比,移植到载脂蛋白E缺乏受体小鼠体内的同种异体移植心脏具有更严重的主动脉和冠状动脉病变,并伴有特征性的T细胞浸润。从这个意义上说,移植器官会出现加速性动脉粥样硬化。移植心脏中冠状动脉血管变化的特征明显受其脂质环境的影响,但就管腔狭窄而言,其严重程度并无明显差异。