猴颈上交感神经节脑内移植治疗实验性帕金森病的病理学研究

A pathological study on the autotransplantation of monkey′s cervical sympathetic ganglion into brain for the treatment of Parkinson′s disease

目的为交感神经节移植脑内能否长期存活寻找组织病理学证据，并为帕金森病的外科治疗寻找一种较理想的移植方法。方法用９只恒河猴以１甲基４苯基１，２，３，６四氢吡啶（ＭＰＴＰ）诱发帕金森病，自体颈上交感神经节移植至脑内尾状核（以相同方法移植肌腱做对照）并观察２年，所有标本采用连续冰冻切片，除ＨＥ染色观察外，并用乙醛酸诱发多巴胺荧光，免疫组织化学染色用抗嗜铬颗粒蛋白Ａ、神经丝蛋白、突触素、神经元特异性烯醇化酶（ＮＳＥ）、胶质纤维酸性蛋白（ＧＦＡＰ）等抗体标记观察。结果移植２年后除动物行为症状明显好转外，脑尾状核部位仍可见存活的神经节细胞，移植的神经节组织与脑组织间有神经轴树突联系，多巴胺荧光阳性，神经丝蛋白、突触素及嗜铬颗粒蛋白Ａ阳性表达。结论神经节的自体脑内移植细胞可存活达２年，交感神经节作为移植物治疗帕金森病优于其它组织，连续冰冻切片与诱发荧光、免疫组织化学染色相结合是观察神经节脑内移植的较好方法。

Objective In order to find out evidences in explicating whether the transplanted ganglion cells can be kept surviving longer in the brain and to find out an ideal transplantation way for the surgical treatment of Parkinson′s disease. Methods Cervical sympathetic ganglions autotransplantation into the caudate nuclei of the brain in 9 rhesus monkeys known to have the symptoms and signs of the Parkinson′s disease beforehand induced by using 1 methy1 4 phen 1, 2, 3, 6 tetrahydropynidne (MPTP) and in addition, muscle tendon tissue was also grafted for comparison. The experimental animals were followed up for 2 years. All the specimens taken were processed and prepared in continuous frozen sections for H & E, glyoxlyic acid induced dopamine fluorescence and immunochemistry stainings including anti chromogranin A, synaptophysin, neurofilament, NSE, GFAP as markers. Results Two years after the autotransplantation operation, there were still surviving ganglion cells left in the caudate nuclei. The grafted ganglion cells were connected by the neurodendrites with the brain tissue which showed dopamine fluorescence positive and also had expression of chromogranin A, synaptophysin and neurofilaments. Conclusions The grafted cells survived in the brain over 2 years. It′s considered that the sympathetic ganglion is the first choice in comparing with other tissues as the graft for the surgical treatment of Parkinson′s disease. Continuous frozen sections accompanying with inducing fluorescence and immunohistochemistry staining are seemed reliable as the parameters in checking the result after neural transplantation.