移植气管组织中肿瘤坏死因子α的表达及临床意义

The expression and significance of the TNF-α in the tissue of transplanted trachea

目的建立兔同种异体气管移植的实验动物模型,探讨移植气管组织中肿瘤坏死因子α(TNF-α)基因表达与管腔狭窄相关性,并研究其表达与应用免疫抑制剂的相关性。方法20只雄性大白兔随机分为2组,每组10只,A组为对照组,常规行气管移植术;B组为保护组,气管移植术后给予免疫抑制剂环孢素A。术中均利用带蒂大网膜包绕气管移植体及上下吻合口。术后4周处死动物,行大体及组织学检查并测定移植气管的通畅度,利用RT-PCR技术检测移植气管组织中TNF-α的基因表达。结果A组移植体管腔严重狭窄,吻合口有水肿及坏死现象;B组移植体管腔轻度狭窄,吻合口生长良好。移植气管通畅度及TNF-α的mRNA的检测结果,两组差别具有显著性,移植物狭窄程度与TNF-α表达呈正相关,应用免疫抑制剂组,TNF-α表达明显下降。结论TNF-α在形成移植后管腔狭窄过程中起重要作用,免疫抑制剂有利于减少TNF-α的表达,为寻求解决移植气管管腔狭窄问题提供新的方法。

Objective To establish the experimental animal model of the rabbits＇ tracheal aLlotransplantation and to discuss the correlation between the gene expression of the TNF - α in the tissue of transplanted trachea and the constriction of the grafted trachea and to discuss the correlation between the expression and the using of the immunosuppresive agent. Methods 20 male rabbits were divided into two groups randomly and equally. There are 10 rabbits in each group. Group A is the contrast one： to operate the tracheal transplantation. Group B is the protection one ： to offer the ciclosporin A after the tracheal transplantation. Anastomotic sites were covered with omental pedicles. The rabbits were put to death 4 weeks after operation and examined by histology and physically to estimate the degree of smooth. To detect the gene expression of mRNA of TNF - αin the grafted tissue by RT- PCR. Results The tracheal constriction in group A is seriousl, there are phenomena of edema and necrosis at the stoma. In the group B, the tracheal constriction is gently, the stoma grow well. The degree of smooth and the expression of the TNF- α in the transplanted tissue shows that the difference of two groups is significant. The degree of the constriction of the graft and the expression of the TNF -αis positive correlated. In using ciclosporin A group, the expression of TNF -αdescended obviously. Conclusion TNF- α is very important in the procedure of the trachea constriction and using immunosuppressive agent can reduce this expression. This experiment can provide a new method to solve the problem of the constriction of the transplanted trachea.