移植肾慢性排斥反应与血小板衍化生长因子及胰岛素样生长因子表达的关系

Relationship between expression of PDGF-A and IGF-1 and transplanting arteriosclerosis in chronic rejection

目的 :探讨慢性排斥反应移植体动脉硬化与血小板衍化生长因子 A(PDGF A)链、胰岛素样生长因子 1(IGF 1)表达的关系。 方法 :采用免疫组化S P法研究 2 2 2只大鼠的移植动脉 ,用RIA法及S P法研究 2 0例慢性排斥反应移植肾组织及动脉中PDGF A、IGF 1的表达。 结果 :实验组 :术后 3天 ,PDGF A、IGF 1在大鼠移植动脉壁各层出现阳性表达 ;术后 7天 ,PDGF A在动脉壁各层表达为最高峰 ,IGF 1术后 2 1天达最高峰 ;术后 2 1天 ,内膜明显增生 ,面积比为 (2 6 4± 3 12 ) %。临床组 :移植肾动脉PDGF A表达主要集中在内膜 ,其次为外膜 ,中层较少 ,IGF 1在肾动脉血管壁全层中均呈阳性表达 ;而在肾组织中PDGF A与IGF 1的表达均主要集中在远曲小管、远直小管上皮细胞及肾小球毛细血管上皮细胞。 结论 :移植体动脉硬化过程中 ,细胞增生、内膜增厚、血管及肾组织纤维化与PDGF A、IGF 1表达关系密切。慢性排斥反应的移植肾动脉及肾组织中PDGF A、IGF 1呈高表达 ,且与术后早期排斥反应的发生频率及程度等因素密切相关。

Objective:To investigate the relationship between the expressions of PDGF A,IGF 1 and the transplanting arteriosclerosis of chronic rejection. Methodology:222 rats and 20 patients with chronic rejection were enrolled in this study.The expressions of PDGF A and IGF 1 on the allograft artery and renal tissue were detected by immunohistochemistry S P method or RIA method. Results:In the experimental group,the expressions of PDGF A and IGF 1 on transplanting artery showed positive at 3 days,PDGF A present a peak at 7 days post operation,a peak of IGF 1 at 21 days,and the intimal membrane thickened and the area ratio (26 4%±3 12%) showed a peak at 60 days post operation.In the clinical group,the expression of PDGF A was mainly found in the intimal membrane of transplanting renal artery,the next was in the exomembrane,where as the media showed a few.The expression of PDGF A was mainly found in the renal distal tubule and epithelial cells of distal straight tubule and glomerulus capillary,but IGF 1 in transplanting artery equal expressed. Conclussion:In the development of allograft arteriosclerosis,there was a close relationship between the over expression of PDGF A,IGF 1 and the cell proliferation,the thickened intimal membrane and the renal fibrosis.