目的 探討細(xì)胞凋亡和相關(guān)因子Fas、 FasL、 bcl-2和bax在大鼠胰腺移植急性排斥反應(yīng)中的作用，評價(jià)十二指腸黏膜活檢在胰腺移植中診斷排斥反應(yīng)的價(jià)值。
方法 選SD 和 Wistar大鼠行全胰十二指腸移植，實(shí)驗(yàn)分同基因胰腺移植組和異基因胰腺移植組。于移植術(shù)后第3、5及7 d分批處死受體，取移植胰腺和十二指腸標(biāo)本用HE染色和原位末端脫氧核糖核苷酸轉(zhuǎn)移酶標(biāo)記技術(shù)（TUNEL）檢測移植物。免疫組化法檢測移植后胰腺和十二指腸Fas、 FasL、bcl-2和bax的表達(dá)。
結(jié)果 異基因胰腺移植組胰腺和十二指腸病理評分相同者占61.1%（11/18）； 評分不同者占38.9%（7/18），其中胰腺評分較高者6例， 十二指腸黏膜評分較高者僅1例。 異基因胰腺移植組胰腺和十二指腸病理學(xué)評分和細(xì)胞凋亡指數(shù)均明顯高于同基因胰腺移植組(P＜0.05，P＜0.01)。胰腺和十二指腸細(xì)胞凋亡指數(shù)與急性排斥反應(yīng)的病理學(xué)評分成正相關(guān)(r=0.965，P＜0.01； r=0.942，P＜0.01)。隨著術(shù)后時(shí)間延長,排斥反應(yīng)分級上升,細(xì)胞凋亡增加, FasL表達(dá)升高，在異基因移植組bcl-2表達(dá)下降，而Fas和bax表達(dá)無明顯變化。
結(jié)論 細(xì)胞凋亡與移植胰腺急性排斥反應(yīng)的嚴(yán)重程度呈正相關(guān),細(xì)胞凋亡指數(shù)可作為判斷移植物損傷程度的指標(biāo)。FasL和bcl-2與胰腺移植急性排斥及組織損傷密切相關(guān)。十二指腸黏膜活檢有助于判斷有無胰腺急性排斥反應(yīng)發(fā)生。
引用本文： 李濤,羅軍,溫浩. 細(xì)胞凋亡在大鼠胰腺移植急性排斥反應(yīng)中的作用. 中國普外基礎(chǔ)與臨床雜志, 2007, 14(1): 59-62. doi: 復(fù)制
| 1. | Nakhleh RE, Sutherland DE, Tzardis P, et al. Correlation of rejection of the duodenum with rejection of the pancreas in a pig model of pancreaticoduodenal transplantation [J]. Transplantation， 1993; 56(6)∶1353. |
| 2. | Matsuno T, Sasaki H, Nakagawa K, et al. Fas antigen expression and apoptosis in kidney allografts [J]. Transplant Proc， 1997; 29(1-2)∶177. |
| 3. | Kabelitz D. Apoptosis, graft rejection, and transplantation tolerance [J]. Transplantation， 1998; 65(7)∶869. |
| 4. | Woodle ES, Kulkarni S. Programmed cell death [J]. Transplantation， 1998; 66(6)∶681. |
| 5. | Kagi D, Vignaux F, Ledermann B, et al. Fas and perforin pathways as major mechanisms of T cell-mediated cytotoxicity [J]. Science， 1994; 265(5171)∶528. |
| 6. | Asoh S, Ohta S. Bcl-2 completely blocks Fas-mediated apoptosis in mtDNA-depleted HeLa cells [J]. Biochem Biophys Res Commun， 1997; 237(3)∶659. |
| 7. | Gaber LW, Stratta RJ, Lo A, et al. Role of surveillance biopsies in monitoring recipients of pancreas alone transplants [J]. Transplant Proc， 2001; 33(1-2)∶1673. |
| 8. | Zibari GB, Aultman DF, Abreo KD, et al. Roux-en-Y venting jejunostomy in pancreatic transplantation: a novel approach to monitor rejection and prevent anastomotic leak [J]. Clin Transplant， 2000; 14(4 Pt 2)∶380. |
- 1. Nakhleh RE, Sutherland DE, Tzardis P, et al. Correlation of rejection of the duodenum with rejection of the pancreas in a pig model of pancreaticoduodenal transplantation [J]. Transplantation， 1993; 56(6)∶1353.
- 2. Matsuno T, Sasaki H, Nakagawa K, et al. Fas antigen expression and apoptosis in kidney allografts [J]. Transplant Proc， 1997; 29(1-2)∶177.
- 3. Kabelitz D. Apoptosis, graft rejection, and transplantation tolerance [J]. Transplantation， 1998; 65(7)∶869.
- 4. Woodle ES, Kulkarni S. Programmed cell death [J]. Transplantation， 1998; 66(6)∶681.
- 5. Kagi D, Vignaux F, Ledermann B, et al. Fas and perforin pathways as major mechanisms of T cell-mediated cytotoxicity [J]. Science， 1994; 265(5171)∶528.
- 6. Asoh S, Ohta S. Bcl-2 completely blocks Fas-mediated apoptosis in mtDNA-depleted HeLa cells [J]. Biochem Biophys Res Commun， 1997; 237(3)∶659.
- 7. Gaber LW, Stratta RJ, Lo A, et al. Role of surveillance biopsies in monitoring recipients of pancreas alone transplants [J]. Transplant Proc， 2001; 33(1-2)∶1673.
- 8. Zibari GB, Aultman DF, Abreo KD, et al. Roux-en-Y venting jejunostomy in pancreatic transplantation: a novel approach to monitor rejection and prevent anastomotic leak [J]. Clin Transplant， 2000; 14(4 Pt 2)∶380.