异种肌腱移植免疫反应的处理方法

摘要

背景:异体肌腱移植是目前修复肌腱缺损的理想方法.其中异种肌腱供源丰富,但移植后的排斥反应为其使用受到限制的主要原因.目的:对异种肌腱的抗原性和移植后的免疫反应及降低异种肌腱排斥反应的方法的研究进展进行综述.方法:第一作者应用计算机检索PubMed 数据库和CNKI 数据库中1995-01/2010-12 在标题和摘要中以"肌腱,异体移植,免疫"或"tendons,transplantation Immunity,"为检索词进行检索.选择文章内容与肌腱移植免疫反应相关,同一领域文献则选择近期发表或发表在权威杂志文章.初检得到196 篇文献,根据纳入标准选择30 篇文章进行综述.结果与结论:目前对异种移植物抗原的研究包括半乳糖-a-1,3-半乳糖抗原(Gal)和非Gal 抗原,以对Gal 抗原基因研究的较多.Gal 抗原由存在于哺乳动物细胞表面的Gal-a-1,3-Gal 抗原引起,是引起超级排斥反应的主要因素.异种肌腱移植后早期以细胞免疫为主,晚期仅有体液免疫参与;动物实验表明经不同物理和化学方法处理后的异种肌腱有潜在应用价值.肌腱移植不同于器官移植,肌腱移植属于非功能性移植,异体肌腱只为受区提供一个生长支架,移植后的生物学特点主要体现在生物力学上,因此,探讨出新的消除免疫原性同时保留移植物生物力学特性的方法是异种肌腱移植获得突破的关键.%BACKGROUND: Tendon defects or damaged when clinically repairing needed transplant tendons. Heterogeneous tendon is an ideal method to repair the tendon defects. Heterogeneous tendon source is sufficient, but post-transplantation rejection limits the use of heterogeneous tendons.OBJECTIVE: To review the antigens of heterogeneous tendons and post-transplantation immune response as well as reduction of xenograft rejection.METHODS: Using "tendons, transplantation, immunity" in Chinese and English as the key words, the first author conducted a computer search of Pubmed database (http://www/ncbi.nlm.nih.gov/PubMed) and CNKI database (www.cnki.net/index.htm)through screening the titles and abstracts. Articles recently published or published in the authority magazines were preferred in the same field. Totally 30 documents were included.RESULTS AND CONCLUSION: At present, the study for heterogeneous graft antigens involves Gal-a-1 , 3-Gal antigen (Gal) and non-Gal antigen, especially Gal antigen gene. Gal antigen is a main factor of super rejection (HAR). Cellular immunity mainly exists at early stage after heterogeneous tendon transplantation, and only humoral immunity exists at late stage. Animal experiments have shown that heterogeneous tendons after different physical and chemical treatments have potential application value. Unlike other organ transplantation, tendon transplantation is a non-functional transplantation, which only provides a growth support for the recipient. The biological research after transplantation mainly focuses on bio-mechanical characteristics. Therefore,the elimination of the immunogenicity and reservation of graft biomechanical properties is the key to heterogeneous tendon graft.