雷公藤内酯及CsA联合抗大鼠异种角膜移植排斥.docVIP

雷公藤内酯及CsA联合抗大鼠异种角膜移植排斥 　【摘要】 目的 我们用大鼠异种穿透性角膜移植的动物模型，来研究雷公藤内酯与CsA联合抗移植排斥的效果。方法 我们用豚鼠角膜对Wistar大鼠实施异种穿透性角膜移植术，分别用雷公藤内酯按100μg/kg体重; CsA注射液按15mg/kg体重；雷公藤内酯和CsA注射液联合用药（100μg/kg+10mg/kg）组抗移植排斥反应。根据Holland等建立的临床观察评分法和免疫组化观察疗效。结果 (1)临床观察结果表明，CsA和雷公藤内酯联合用药抗排斥作用优于单独给药（P＜0.01）。(2)观察外周血T细胞亚群的变化发现CD8+细胞的百分数变化联合用药组明显低于CsA或雷公藤单独给药组，CsA组和联合用药组的IL-2R+细胞百分数变化明显低于雷公藤内酯，它们的差别均有统计学意义（P＜0.05）。(3)角膜移植后15天联合用药组植片中淋巴细胞浸润最轻。结论 雷公藤内酯和CsA具有协同抗移植排斥作用。 【关键词】 雷公藤内酯；环孢素A；移植排斥；角膜移植 Combination therapy of triptolide and cyclosporine A resist xenocorneal transplant rejection 【Abstract】 Objective A xencorneal penetrating keratoplasty model was established in Wistar rat and investigated the effect of anti-rejection by combination therapy under CsA and triptolide. Methods After the corneal of Guinea-pig was transplanted into the eye of Wistar rat， we injected 100μg/kg body weight of triptolide， 15mg/kg body weight of CsA and 100μg/kg + 10mg/kg of triptolide and CsA for anti-rejection. The observations on the effect of different anti-rejection agents base the method of Holland and immunochemistry. Results (1)Clinical observation had shown more long-term survival in xenocorneal recipients with combination therapy than triptolide or CsA separating therapy. (2)The changes of percent of CD8+ cell in combination therapy group was less than other therapy groups and percent of IL-2R+ cell in combination therapy group and CsA group was less than triptolide group(P＜0.05).(3)15 days after keratoplasty， there were a few lymphocytes infiltrating the graft cornea in combination therapy group and excel other therapy groups.Conclusion Tiptolide and CsA have a synergetic effect on preventing and treating transplant rejection. 【Key words】 triptolide；CsA；transplant rejection；keratoplasty 历史上，因移植角膜的特惠性生存使眼部被视为具有免疫赦免性的器官之一。最近的研究表明，角膜具有和机体其它器官相似的免疫成分和免疫体系，角膜的免疫赦免是相对的。角膜移植术后，排斥反应的发生率仍为10%～65%，因此和其它组织、器官移植一样，角膜移植排斥是角膜移植术后继发移植失败的最常见的原因，而且有着与前者相似的排斥机制［1］。即：(1)创伤修复和炎症期；(2)移植抗原致敏期；(3)激活免疫活性细胞；(4)移植物（植片）受损期。我们应用大鼠异种穿透性角膜移植的动物模