角膜移植排斥反应中ICAM-1含量的变化

Change of ICAM-1 content in the rejection of corneal transplantation

目的:探讨细胞间粘附分子-1(intercellular adhesion mole-cule-1,ICAM-1)在血液和房水中的含量变化与角膜移植排斥反应的关系。方法:缝线法诱发兔角膜新生血管化(corneal neovascular-ization,CNV)后,制作穿透性角膜移植(penetrating kerato-plasty,PKP)模型4组,A组:正常对照组;B组:自体穿透性角膜移植组;C组:同种异体穿透性角膜移植组;D组:新生血管化穿透性角膜移植组。术后记录植片存活时间和移植排斥指数(rejection index,RI);ELISA法检测房水及外周血中可溶性ICAM-1(sICAM-1)的含量,免疫组化法观察ICAM-1的表达。结果:B、C组在观察期内未见排斥反应发生。D组发生排斥反应,角膜植片平均存活12.4±1.3d,术后房水及外周血中sICAM-1含量即升高,至排斥反应前达最高水平分别为53.9±19.3ng/L,378.8±30.6ng/L,在排斥反应发生时,免疫组化染色发现角膜组织中ICAM-1呈强阳性表达。结论:血液和房水中的ICAM-1含量可以是角膜移植免疫排斥反应发生的指标,术后监测ICAM-1浓度变化对排斥反应的发生有一定预测和早期诊断作用。

AIM： To investigate the relationship between the change of ICAM-1 content and corneal transplantation immunologic rejection. METHODS： Suture was used to induce corneal neovascularization（CNV） in New Zealand white rabbits. Then penetrating keratoplasty （ PKP ） model was established in 4 groups. They were as follows： A. normal group,B：autograft group, C： allograft group, D：CNV PKP group. Graft mean survival time and rejection index were recorded after the surgery. The levels of sICAM-1 in aqueous humor and serum were dynamically determined by enzyme-linked immunosorbent assay （ELISA）. An immunohistochemical technique was employed on cornea to observe expression and distribution of ICAM-1. RESULTS： During the observation period, no graft rejection occurred in group B and C. In group D corneal graft mean survival time was 12.4 ± 1.3 days. Levels of sICAM-1 in aqueous humor and serum for the graft rejection group （ group D ） increased postoperatively, continued to increase and peak values were 53.9 ± 19.3ng/L, 378.8 ± 30. 6ng/L. When graft rejection took place, ICAM-1 was positively expressed in corneal tissues, found by immunohistochemical staining. CONCLUSION： The content of ICAM-1 in aqueous humor and serum could be regarded as a norm of immunological rejection in the corneal transplantation. Monitoring the change of ICAM-1 content after operation may be of value for the prediction and early diagnosis of acute rejection.