间α胰蛋白酶抑制剂水平反映肾移植慢性排斥反应★

摘要

背景：目前，肾移植病理学检查仍为移植肾慢性排斥反应的“金标准”，但肾移植程序性活检在中国尚难以普及，且存在一定的风险；由于诸多原因，使患者慢性排斥反应早期因未及时发现而错失治疗时机。目的：观察肾移植慢性排斥反应大鼠血浆中间α胰蛋白酶抑制剂的水平。　　方法：实验以正常雄性Wistar大鼠为供体，正常雄性SD大鼠为受体进行肾移植。移植后分为慢性排斥反应组和正常肾移植组。慢性排斥反应组受体于移植前3 d起，每日给予腹腔注射环孢素A微乳化剂2 mg/kg，正常肾移植组则每日给予环孢素A微乳化剂腹腔注射5 mg/kg。　　结果与结论：移植后4，6，8，10，12周，Western blot检测结果显示，与移植前1周相比，正常肾移植组和慢性排斥反应组间α胰蛋白酶抑制剂蛋白表达量明显降低(P<0.01)。移植后第4，6周，慢性排斥反应组间α胰蛋白酶抑制剂蛋白表达高于正常肾移植组(P<0.01)，而在8，10，12周低于正常肾移植组(P<0.01)。慢性排斥反应组血浆间α胰蛋白酶抑制剂呈时间依赖性下降(P<0.01)。结果证实，大鼠肾移植后出现慢性排斥反应时，血浆α胰蛋白酶抑制剂水平显著下调。间α胰蛋白酶抑制剂水平变化与肾移植慢性排斥反应关系密切，可为肾移植后慢性排异反应的预测提供参考依据。%BACKGROUND:Currently, the pathological examination of renal transplantation is stil the“gold standard”for chronic renal al ograft rejection. But the procedural biopsy for renal transplantation is stil difficult to spread in China, and there exists a certain risk. Due to various reasons, the patients with chronic rejection miss the timing of treatment as timely detection fails. OBJECTIVE:To detect the inter-alpha-trypsin inhibitor level in the serum of rats with chronic renal al ograft rejection. METHODS:Normal male Wistar rats were used as donors and normal male Sprague Dawley rats were used as recipients to perform renal transplantation. After transplantation, the rats were divided into chronic rejection group and normal renal transplantation group. Recipents in the chronic rejection group were intraperitoneal y injected with cyclosporine A microemulsion 2 mg/kg once a day from 3 days before transplantation, and those in the normal renal transplantation group were intraperitoneal y injected with cyclosporine A microemulsion 2 mg/kg daily. RESULTS AND CONCLUSION:Western blot results showed that the inter-alpha-trypsin inhibitor levels in two groups at 4, 6, 8, 10 and 12 weeks after transplantation were significantly decreased when compared with those at 1 week before transplantation (P<0.01). At 4 and 6 weeks after transplantation, the inter-alpha-trypsin inhibitor level in the chronic rejection group was higher than that in the normal renal transplantation group (P<0.01), but lower than that in the normal renal transplantation group at 8, 10 and 12 weeks after transplantation. The inter-alpha-trypsin inhibitor level in the chronic rejection group was decreased in a time-dependent manner (P<0.01). The results show that the inter-alpha-trypsin inhibitor level is significantly decreased when chronic rejection appears after renal transplantation. The change of inter-alpha-trypsin inhibitor level is closely related with the chronic renal al ograft rejection, which can provide basis for the prediction of chronic rejection after renal transplantation.