肝移植对肝硬化大鼠胃肠道粘膜免疫功能的影响及意义

THE EFFECT OF LIVER TRANSPLANTATION ON GASTROINTEROLOGICAL MUCOSAL IMMUNITY IN HEPATOCIRRHOSIS RATS

目的探讨肝移植前后,肝硬化大鼠胃肠道粘膜免疫改变的情况,为临床施以肝移植术后观察胃肠道粘膜免疫的变化和胃肠道功能的恢复提供理论依据。方法制备CCl4中毒性肝硬化大鼠模型,采用“二袖套法”进行肝移植,应用放免分析法和四甲基偶氮唑盐微量酶反应比色法(Mononuclear cell cytotoxicity assay,MTT),分别检测肝移植前后肝硬化大鼠胃、十二指肠、空肠以及回盲部组织中分泌型免疫球蛋白(Secretoryimmunoglobulin,SIgA)以及上皮肉淋巴细胞(Intraepitheli-al lymphocyte,IEL)和固有粘膜层淋巴细胞(Luminia propria lymyphocytes,LPL)变化的情况。同时,对手术应激对上述观察指标的影响也进行了对比观察。结果手术应激对胃肠道粘膜的SIgA水平以及胃肠道粘膜IEL和LPL增殖活力有一定程度的影响,但是这种影响在短期内即可恢复。肝移植前,肝硬化大鼠的胃、十二指肠、空肠以及回盲部组织中的SIgA,IEL,LPL均较正常大鼠胃肠道粘膜组织中为低;肝移植后,随着肝移植实施的时间的变化,胃肠道粘膜免疫功能逐渐接近正常,尤其以十二指肠变化最早和最为显著。结论肝硬化可导致胃肠道免疫功能明显下降,尤其以十二指肠为明显。随着肝移植手术的实施,胃肠道粘中膜免疫功能可以得到明显的改善,仍然以十二指肠的变化最为显著。

Objective To observe the change of gastroenterology mucosal immunity before and after transplantation of liver. Methods Hepatocirrhosis model was established in rats by subcutaneous injections of 40% carbon tetrarch loride. Liver transplantation model was made with two-cuff technique. By using radioimmunoassay and mononuelear cell cytotoxicity assay method,the changes of secretoryimmunoglobulin,intraepithelial lymphocyte and luminia propria lymyphoeytes in tissue of gastric, duodenum, upside of small intestine and ileum appendices were observed. In the mean time, the effect of operation stress on secretoryimmunoglobulin, intraepithelial lymphocyte and luminia propria lymyphocytes were compared. Results Operation could affect the level of SIgA, proliferation of IEL and LPL in gastroenterology mucosal, but it recovered shortly after operation. Before operation,the SIgA, IEl, LPL in tissue of gastric, duodenum, upside of small intestine and ileum-appendices. But on hepatocirrhosis rats the SIgA, IEL, LPL is lower than the normal rats. After operation, the mucosal immunal function gradually increased and similar to the normal level, especially on the duodenum. Conclusion Hepatoeirrhosis may decrease the immunal function of tissue in gastric,duodenum, upside of small intestine and ileum-appendices, especially in the duodenum. After the liver transplantation,the gastroenterology mucosal immunity function may come to the mormal level in tissue of gastric, duodenum, upside of small intestine and ileum appendices, especially in the duodenum.