雷公藤多甙对同种异体神经移植免疫抑制作用的实验研究(英文)

Experimental study of the immuno-suppressive effect of tripterygium on nerve allograft

背景用于异体神经移植中的免疫抑制剂—环胞素A价格昂贵;而相关文献报道,中药雷公藤制剂具有免疫抑制作用。目的探讨同种异体神经移植雷公藤多甙替代环孢素A(cyclosporinA,CSA)进行免疫抑制可行性。设计随机分组双盲设计。地点和对象实验在武汉大学人民医院完成,对象为健康雄性SD大鼠48只,Wistar大鼠18只,SPF级,体质量180～210g,购自武汉大学医学动物实验中心。干预方法取Wistar大鼠坐骨神经为供体,于SD大鼠上制备坐骨神经移植模型,随机分为4组,即自体移植组,行自体神经原位移植;CSA组,异体神经移植应用CSA5mg/(kg·d)5周;雷公藤组,异体神经移植应用雷公藤多甙5mg/(kg·d)5周;对照组,单纯异体神经移植而无免疫抑制剂。主要观察指标移植术后12周移植段神经形态学观察,神经运动诱发电位潜伏期、神经运动诱发电位峰值、神经传导速度和振幅积分,腓肠肌称重及再生轴突计数。结果12周时,自体移植、CSA、雷公藤组的潜伏期峰值、诱发电位、传导速度、振幅积分、肌肉湿质量、肌肉湿质量恢复度、轴突数目各项检测指标明显优于对照组(q=3.95～8.32,P<0.01),再生神经形态与功能恢复良好。结论同种异体神经移植时,雷公藤多甙可以替代CSA发挥有效的免疫抑制作用。

BACKGROUND: Cyclosprone A( CSA ), an immuno suppressive agent used in peripheral nerve allograft, is of high price. However, tripterygium, a traditional Chinese medicine, was previously reported to have the function of immuno suppression.OBJECTIVE: To verify the possibility of using tripterygium as a substitution of CSA in nerve allografts. DESIGN: Double blinded and randomized design.SETTING and PARTICIPANTS: Adult healthy male SD(48) and Wistar rats(18) of SPF grade, weighing 180-210 g,were provided by the Medical Animal experimental Center of Wuhan University.INTERVENTIONS: Forty eight SD rats as recipients of sciatic nerve allograft were randomly assigned into one of the following groups: Autograft Group; CSA Group, allograft with CSA 5mg/kg per day for 5 weeks; Tripterygium Group, allograft with tripterygium 5mg/kg per day for 5 weeks;and Control Group, allograft withnot immune treatment.Eighteen Wistar rats were the donors of the sciatic nerve allograft.MAIN OUTCOME MEASURES:Observation was done under light microscope and electron microscope examination 12 weeks post operatively. The number of axons in the middle segment of the allogeneic graft was counted,double sides of gastrocnemius muscle were weighed and electrophysiological parameters were also measured.RESULTS:At 12 weeks after transplantation, latent period peak of tripterygium Groups ,evoked potential nerve conduction velocity ,accumulated points of amplitude,the wet mass of muscle, the recovery degree of muscle's wet mass and the number of axis cylinder recovered of the autograft,CSA and tripterygium group were better than those of their control counterpart(q=3.95-8.32,P< 0.01).There were good regenerate nervus form and functional recovery. CONCLUSIONS:Tripterygium as an immuno suppressant has the similar effect to CSA on nerve allograft.