小肠移植急性排斥反应期移植肠白细胞介素2受体和细胞间粘附分子1的表达

Intragraft expression of IL 2R and ICAM 1 during small intestinal allograft rejection episode

目的 探讨移植肠白细胞介素２ 受体（ Ｉ Ｌ２ Ｒ） 和细胞间粘附分子１（ Ｉ Ｃ Ａ Ｍ１） 的表达在小肠移植排斥反应中的意义及诊断价值。方法 选用近交系大鼠 Ｆ３４４／ Ｎ 和 Ｗｉｓｔａｒ／ Ａ 进行全小肠异位移植，实验分４ 组，第１ 组： Ｗｉｓｔａｒ；第２ 组： Ｗｉｓｔａｒ→ Ｗｉｓｔａｒ ；第３ 组： Ｆ３４４ → Ｗｉｓｔａｒ；第４ 组： Ｆ３４４ → Ｗｉｓｔａｒ＋环孢霉素 Ａ（６ ｍｇ·ｋｇ － １·ｄ － １） 。术后第３ 、５ 、７ 天取各组动物移植肠标本进行病理学检查，应用免疫组化技术（ Ｓ Ｐ 法） 检测移植肠 Ｉ Ｌ２ Ｒ 和 Ｉ Ｃ Ａ Ｍ１ 的表达。结果 病理学检查显示第３ 组大鼠在术后第３ 、５ 、７天分别符合轻、中、重度排斥，第２ 、４ 组无明显排斥征象。第３ 组 Ｉ Ｌ２ Ｒ 表达在术后均非常显著高于其他３ 个对照组；第３ 组 Ｉ Ｃ Ａ Ｍ１ 表达在术后第３ 、５ 天较相似，尤其在上皮细胞表现为强阳性，并显著高于第１ 组。但第２ 、４ 对照组 Ｉ Ｃ Ａ Ｍ１ 表达也较高，第３ 组仅在术后第３ 天 Ｉ Ｃ Ａ Ｍ１ 评分显著高于第２ 组。结论 Ｉ Ｌ２ Ｒ 和 Ｉ Ｃ Ａ Ｍ１ 阳性细胞在小肠移植排斥反应过程中发挥重要作用。

Objective\ To investigate intragraft expression of IL 2R and ICAM 1 during small intestinal allograft rejection episode.Methods\ Heterotopic small intestinal transplantation was performed on inbred rats F344/N (RT1 1) and inbred rats Wistar/A (RT1 A k, RT1 E d). All recipients were divided into four group:group Ⅰ, Wistar; group Ⅱ, Wistar→Wistar; group Ⅲ, F344→Wistar; group Ⅳ, F344→Wistar+Cyclosporine A (6 mg·kg -1 ·d -1 ). The grafts were harvested on the postoperative day (POD) 3,5,7. Streptavidin peroxidase (SP) immunohistochemistry technique was used to detect the intragraft expression of IL 2R and ICAM 1.Results\ The histology showed that mild acute rejection occurred on POD 3 in group Ⅲ, moderate acute rejection on POD 5, severe acute rejection on POD 7, while none of group Ⅱ had histologic evidence of acute rejection, and the histologic evidence of group Ⅳ indicated that Cyclosporine A could effectively control small intestinal acute allograft rejection. Immunohistochemistry showed intragraft IL 2R expression of allografts was significantly higher in group Ⅲ than the other three control groups. The intragraft ICAM 1 expression of allografts was similar on POD 3 and on POD 5, the epithelial cells of grafts were stained strongly positive, and their expression level was significanly higher than nonoperative control group. The level of ICAM 1 expression in group Ⅱ and group Ⅳ was also high, only on POD3 the level of ICAM 1 expression of allografts was significantly higher than isografts. Conclusion\ IL 2R and ICAM 1 positive cells play an important role in small intestinal allograft rejection. Anti rejection therapy or induction of immune tolerance could be achieved by applying monoclonal antibody of IL 2R and ICAM 1.\;