Lin H, Ignatescu M, Wilson J E, Roberts C R, Horley K J, Winters G L, Costanzo M R, McManus B M
Department of Pathology, University of British Columbia, Vancouver, Canada.
J Heart Lung Transplant. 1996 Dec;15(12):1223-32.
Transplant arteriopathy (TA) is characterized by vessel wall thickening with prominent glycosaminoglycan and lipid deposits. In this light, we have recently demonstrated the distribution of proteoglycans in allograft coronary arteries. The aim of this study is to examine the distribution of apolipoproteins within allograft coronary arteries and to investigate their localization in relation to proteoglycans.
Particular transverse sections of left and right epicardial coronary arteries from 46 human cardiac allografts, 11 normal hearts, and 11 hearts with native atherosclerosis were stained immunohistochemically for apolipoprotein B, apolipoprotein (a) (apo[a]), apolipoprotein E (apoE), biglycan, decorin, and versican by use of an automated immunostainer.
Apo(a) and apoE immunopositivity in TA was much more intense than that in native atherosclerosis, whereas the reverse was true for apoB. Prominent apoE deposits were evident circumferentially in endothelia and extracellularly in superficial intima of mildly diseased TA, as well as in deeper intima of severely diseased TA. Apo(a) had a staining pattern very similar to apoE except for a patchy deposition also seen in TA media. The intimal areas staining prominently with apoE or apo(a) in TA arteries corresponded very closely to the areas with proteoglycan deposits, especially versican.
The distinctive patterns of apolipoprotein accumulation in TA and native atherosclefosis appear to reflect different pathogenetic processes in the two conditions. The colocalization of proteoglycans and apolipoproteins in TA intima supports the hypothesis that interactions between proteoglycans and apolipoproteins influence lipid retention and overload in allograft coronary arteries.
移植血管病（TA）的特征是血管壁增厚，伴有显著的糖胺聚糖和脂质沉积。鉴于此，我们最近已证明蛋白聚糖在同种异体移植冠状动脉中的分布。本研究的目的是检查载脂蛋白在同种异体移植冠状动脉内的分布，并研究它们相对于蛋白聚糖的定位。
使用自动免疫染色仪，对46例人类心脏同种异体移植、11例正常心脏以及11例患有原发性动脉粥样硬化的心脏的左右心外膜冠状动脉的特定横切片进行免疫组织化学染色，检测载脂蛋白B、载脂蛋白（a）[apo（a）]、载脂蛋白E（apoE）、双糖链蛋白聚糖、核心蛋白聚糖和多功能蛋白聚糖。
TA中apo（a）和apoE的免疫阳性比原发性动脉粥样硬化中的要强得多，而apoB的情况则相反。在轻度病变的TA的内皮中，明显可见沿圆周分布的显著apoE沉积，在浅表内膜的细胞外也有沉积，在重度病变的TA的更深层内膜中也有沉积。apo（a）的染色模式与apoE非常相似，只是在TA中膜也可见斑片状沉积。TA动脉中apoE或apo（a）显著染色的内膜区域与蛋白聚糖沉积的区域非常紧密地对应，尤其是多功能蛋白聚糖。
TA和原发性动脉粥样硬化中载脂蛋白积累的独特模式似乎反映了这两种情况下不同的发病机制。TA内膜中蛋白聚糖和载脂蛋白的共定位支持了以下假设，即蛋白聚糖和载脂蛋白之间的相互作用影响同种异体移植冠状动脉中的脂质潴留和过载。
