肠康复治疗用于小肠移植的免疫安全性研究

Evaluation of immune safety of application of enteral rehabilitative therapy in small bowel transplantation

目的 :观察肠康复治疗对大鼠小肠移植急性排斥反应的影响 ,评价其应用的安全性。方法 :48只异基因异位小肠移植受体大鼠 (SD→Wistar)根据肠康复治疗及环孢素A应用与否随机分为 4组 ,观察至术后 14天各时相点移植小肠病理改变、固有层淋巴细胞IL 2受体表达、血浆IL 2水平以及受体大鼠脾淋巴细胞转化试验和IL 2分泌能力。结果 :肠康复治疗能够增强小肠移植受体大鼠的细胞免疫功能 ,加重急性排斥反应。应用环孢素A(10mg·kg-1·d-1)能阻断这种免疫增强作用 ,在这种情况下 ,肠康复治疗不能诱发或加重急性排斥反应。结论 :肠康复治疗能够加重小肠移植的排斥反应 ,但在应用环孢素A的情况下 ,免疫增强作用受抑制 ,不会诱发或加重急性排斥反应。

Objective: To evaluate the safety of application of enteral rehabilitative therapy in small bowel transplantation.Methods: Forty-eight recipients of rat allogeneic heterotopic small bowel transplantation(SD→Wistar)were divided into 4 groups randomly according to the application or not of enteral rehabilitative therapy or cyclosporine A.The pathological changes of graft,IL-2 receptor expression of lamina propria lymphocyte,serum IL-2 concentration,transformation test of spleen lymphocyte and its IL-2 secretion capacity were determined and compared.Results: The enteral rehabilitative therapy may promote the immune function of recipient so to augment the acute rejection of small bowel transplantation.But such effects can be block by the common used immunosuppressant-cyclosporine A.Under the immunosuppression of CsA(10mg·kg -1 ·d -1 ,IM),application of enteral rehabilitative therapy can not induce or promote acute rejection of small bowel transplantation.Conclusion: Enteral rehabilitative therapy can augment the acute rejection of small bowel transplantation,but cyclosporine A can block its immunoenhancement effects.So under effective immunosuppression,application of enteral rehabilitative therapy is safe in small bowel transplantation.