Terakura M, Murase N, Demetris A J, Ye Q, Thomson A W, Starzl T E
Department of Surgery, Thomas E. Starzl Transplantation Institute, University of Pittsburgh Medical Center, Pennsylvania 15213, USA.
Transplantation. 1998 Aug 15;66(3):350-7. doi: 10.1097/00007890-199808150-00012.
The role of leukocyte migration and chimerism in organ allograft acceptance has been obscured by the lack of information about the late localization of the donor cells.
Male Lewis rat-->female Brown Norway abdominal heart transplantation was performed under tacrolimus immunosuppression (days 0-13, 20, and 27) with or without donor bone marrow and (in bone marrow subgroups) a 1-week postoperative course of a possibly chimerism-enhancing drug. Using rat sex-determining region-Y-specific oligonucleotide primers, we determined the donor DNA concentration by polymerase chain reaction in serial venous blood samples for 100 days and in tissue specimens when animals were killed.
Chimerism was detected out to 56 days in 89% of the blood samples but in none of the samples at 100 days. However, donor DNA was detected when animals were killed in 95% of the native hearts, 80% of the skin biopsy specimens, and 23% of the spleens. The presence and quantity of early and late chimerism were strongly correlated the administration of adjunct bone marrow and with a reduction in the vasculopathy and inflammation index in the cardiac allografts. Marginally significant further increases in chimerism and/or reductions in chronic heart rejection beyond those achieved with adjunct bone marrow alone were associated with additional treatment with the growth factors Flt-3 ligand, granulocyte colony-stimulating factor, and a recombinant molecular variant of interleukin-6 (interleukin-6 mutein) but not with hepatocyte growth factor or lisofylline.
The previously suspected shift of early chimerism in the blood and lymphoid organs to dominance in host nonlymphoid tissues is consistent with the dual mechanisms of clonal exhaustion and immune indifference, governed by antigen migration and localization, that have been postulated elsewhere to account for organ allograft acceptance.
由于缺乏关于供体细胞晚期定位的信息,白细胞迁移和嵌合体在器官移植接受中的作用一直不明确。
在他克莫司免疫抑制(第0 - 13天、20天和27天)下进行雄性Lewis大鼠至雌性Brown Norway大鼠的腹部心脏移植,分为有或无供体骨髓组,并且(在骨髓亚组中)术后1周给予一种可能增强嵌合体的药物。使用大鼠性别决定区Y特异性寡核苷酸引物,通过聚合酶链反应测定连续静脉血样本100天以及动物处死时组织标本中的供体DNA浓度。
89%的血样在56天内检测到嵌合体,但100天时所有样本均未检测到。然而,动物处死时,95%的原位心脏、80%的皮肤活检标本和23%的脾脏中检测到供体DNA。早期和晚期嵌合体的存在及数量与辅助骨髓的给予以及心脏同种异体移植中血管病变和炎症指数的降低密切相关。除单独使用辅助骨髓所达到的效果外,嵌合体的进一步显著增加和/或慢性心脏排斥反应的进一步降低与生长因子Flt - 3配体、粒细胞集落刺激因子和白细胞介素 - 6的重组分子变体(白细胞介素 - 6突变体)的额外治疗有关,而与肝细胞生长因子或利索茶碱无关。
先前怀疑的血液和淋巴器官中早期嵌合体向宿主非淋巴组织优势的转变,与克隆耗竭和免疫无反应的双重机制一致,这两种机制由抗原迁移和定位所调控,在其他地方已被假定用于解释器官移植的接受。