Stevenson S, Li X Q, Davy D T, Klein L, Goldberg V M
Department of Orthopaedics, Case Western Reserve University, Cleveland, Ohio 44106, USA.
J Bone Joint Surg Am. 1997 Jan;79(1):1-16.
Our goal in this study was to evaluate the effects of and the interaction between the hypothesized principal determinants of the incorporation of grafts: antigenicity and treatment of the graft. We implanted fresh and frozen cortical bone grafts that were matched for both major and non-major histocompatibility complex antigens (syngeneic grafts), matched for major but not for non-major histocompatibility complex antigens (minor mismatch), and mismatched for both major and non-major histocompatibility complex antigens (major mismatch). We used a rat model with an eight-millimeter segmental defect in the femur. The construct was stabilized with a plastic plate, threaded Kirschner wires, and cerclage wires. We evaluated the grafts at one, two, and four months after implantation. We measured the immune response; assessed the incorporation of the graft with use of histological examination, biomechanical testing, and quantitative isotopic kinetics; and statistically analyzed the effects of and the interactions among three independent variables: time, the degree of matching for major histocompatibility complex antigens, and the treatment of the graft (whether it was fresh or frozen). These three independent variables had profound effects on the pattern, rate, and quality of the incorporation of the graft. Two-way and three-way interactions among these variables were also noted. Serial changes in every dependent variable were observed with time. Systemic antibody specific for donor antigens was measurable only in the serum of animals that had a major mismatch, but freezing markedly attenuated the systemic antibody response. Revascularization was profoundly affected by histocompatibility-antigen matching; the syngeneic grafts were revascularized more quickly and to a greater degree than the grafts with either a minor or a major mismatch. Freezing significantly (p < 0.001) reduced the revascularization of the syngeneic grafts but had no discernible effect on the grafts with a minor mismatch.
本研究的目的是评估移植物植入的假定主要决定因素（抗原性和移植物处理）的作用及其相互作用。我们植入了主要和非主要组织相容性复合体抗原均匹配的新鲜和冷冻皮质骨移植物（同基因移植物）、主要组织相容性复合体抗原匹配但非主要组织相容性复合体抗原不匹配的移植物（轻微错配），以及主要和非主要组织相容性复合体抗原均不匹配的移植物（严重错配）。我们使用了一个在股骨中造成8毫米节段性缺损的大鼠模型。用塑料板、螺纹克氏针和环扎钢丝固定该结构。我们在植入后1个月、2个月和4个月对移植物进行评估。我们测量了免疫反应；通过组织学检查、生物力学测试和定量同位素动力学评估移植物的整合情况；并对三个独立变量（时间、主要组织相容性复合体抗原的匹配程度和移植物处理方式（新鲜或冷冻））的作用及其相互作用进行了统计分析。这三个独立变量对移植物整合的模式、速度和质量有深远影响。还注意到这些变量之间的双向和三向相互作用。随着时间的推移，观察到每个因变量的系列变化。仅在严重错配动物的血清中可检测到针对供体抗原的全身性抗体，但冷冻显著减弱了全身性抗体反应。组织相容性抗原匹配对血管再生有深远影响；同基因移植物比轻微或严重错配的移植物血管再生更快且程度更大。冷冻显著（p<0.001）降低了同基因移植物的血管再生，但对轻微错配的移植物没有明显影响。
