Armstrong A T, Strauch A R, Kardan A, Starling R C
Department of Internal Medicine, Ohio State University College of Medicine, Columbus, USA.
J Heart Lung Transplant. 1996 Aug;15(8):818-26.
Heart transplant vascular sclerosis has been characterized in epicardial coronaries of human transplanted hearts. The purpose of this study was to analyze coronary arterioles (< 100 microns in diameter) within endomyocardial biopsy specimens from heart transplant recipients for the presence of disease.
The morphologic compartments of trichrome-stained vessels were quantified by means of computer imaging to measure the percentage of stenosis of 164 arterioles from 30 transplant recipients over time. The arterioles were divided into three groups based on their biopsy date after transplantation: early (0 to 6 months), middle (6 to 18 months), and late (18 to 36 months). The percentage of stenosis of arterioles from a control group of nondiseased hearts was compared with the grafts. Also, arterioles from heart transplant recipients were immunohistochemically labeled with an antibody, PC10, specific for proliferating cell nuclear antigen. The arterioles were immunocytochemically labeled with an antibody specific for vascular smooth muscle alpha-actin and the fluorescent signal was analyzed.
The percentage of stenosis was not significantly different among the early, middle, late, and control groups. Vessels from the early, middle, and late groups did not show binding of the PCNA antibody. The antibody signal intensity and amount of alpha-actin within each vessel was significantly higher in the late groups as compared with the early and middle groups.
The coronary microvasculature of human transplanted hearts does not exhibit intimal thickening or cellular proliferation within 3 years after transplantation. However, as shown by an increase of smooth muscle alpha-actin over time, vascular remodeling may occur in response to cytokines released as a result of injury.
心脏移植血管硬化已在人类移植心脏的心外膜冠状动脉中得到描述。本研究的目的是分析心脏移植受者心内膜心肌活检标本中的冠状动脉小动脉（直径<100微米）是否存在病变。
通过计算机成像对三色染色血管的形态学区域进行定量，以测量30名移植受者的164条小动脉随时间的狭窄百分比。根据移植后的活检日期，将小动脉分为三组：早期（0至6个月）、中期（6至18个月）和晚期（18至36个月）。将未患病心脏对照组的小动脉狭窄百分比与移植心脏进行比较。此外，用一种针对增殖细胞核抗原的抗体PC10对心脏移植受者的小动脉进行免疫组织化学标记。用一种针对血管平滑肌α-肌动蛋白的抗体对小动脉进行免疫细胞化学标记，并分析荧光信号。
早期、中期、晚期和对照组之间的狭窄百分比无显著差异。早期、中期和晚期组的血管未显示PCNA抗体结合。与早期和中期组相比，晚期组中每条血管内α-肌动蛋白的抗体信号强度和含量显著更高。
人类移植心脏的冠状动脉微血管在移植后3年内未表现出内膜增厚或细胞增殖。然而，随着时间的推移，平滑肌α-肌动蛋白增加表明，可能会因损伤释放的细胞因子而发生血管重塑。
