摘要:
BACKGROUND: Hepatocyte transplantation has achieved some success in animal experiments for the treatment of metabolic diseases and acute liver failure. However, the clinical efficacy of hepatocyte transplantation is unsatisfactory. The difference between the experimental results and the clinical efficacy may be related to the hepatocyte transplantation approach. OBJECTIVE: To evaluate the therapeutic effects of hepatocyte transplantation by the intubation via the intubation of the splenic artery and intrasplenic injection in rats with acute hepatic failure, providing more optimal transplantation approaches and methods. METHODS: Hepatocytes were isolated and cultured by the modified Seglen's method (two-step). Acute hepatic failure was induced by D-gal in Sprague-Dawley rats (provided by the Experimental Animal Center of Chongqing Medical University in China). After 24 hours, an intubation tube was inserted into the splenic artery in 65 rats with acute hepatic failure, which was successful in 60 rats. Then these 60 rat models were randomly divided into three groups (n=20 per group). Intrasplenic injection group received about 2×107 hepatocytes through intrasplenic injection and 0.4 mL of Hank's solution through the splenic artery. Splenic artery group received 0.4 mL of Hank's solution through intrasplenic injection and 2×107 hepatocytes through the splenic artery. Model group received 0.4 mL of Hank's solution through intrasplenic injection and 0.4 mL of Hank's solution through the splenic artery. Survival rate and liver function of the rats was observed within 14 days after transplantation. The distribution of CFDA-SE-labeled hepatocytes transplanted via the splenic artery was observed under fluorescence microscope at 7 days after transplantation, and meanwhile, the distribution and proliferation of transplanted hepatocytes in the spleen were observed using hematoxylin-eosin staining. Synthesis of albumin in the spleen was observed by immunofluorescence staining. RESULTS AND CONCLUSION: (1) 80%-90% hepatocytes survived after isolation. (2) At 14 days after transplantation, the survival rates of rats in the three groups were significantly different: intrasplenic injection group> splenic artery group> model group. (3) The liver function of rats was significantly improved in the intrasplenic injection group and the splenic artery group, especially in the former group. (4) CFDA-SE-labeled hepatocytes (green fluorescence) were scattered in the rat spleen and liver at 7 days after transplantation via the splenic artery. (5) At 14 days after transplantation, immunofluorescent staining of albumin demonstrated some positive cells in the rat spleen in the intrasplenic injection group and splenic artery group. (6) At 7 days after transplantation, transplanted hepatocytes were concentrated and colonized in the red pulp of the spleen. In conclusion, hepatocyte transplantation through catheterization of the splenic artery via carotid route can improve the survival of rats with acute hepatic failure and ameliorate the hepatic function, but intrasplenic injection is significantly superior to the injection via the splenic artery.%背景:肝细胞移植在治疗代谢性疾病和急性肝衰竭的动物实验中取得了一定成功, 然而肝细胞移植的临床疗效却并没有动物实验理想.造成实验模型与临床疗效的差异可能与肝细胞移植途径有一定关系.目的:探讨经颈动脉途径脾动脉插管注射与脾脏直接注射两种方法行肝细胞移植治疗急性肝衰竭大鼠的疗效, 得出更加优化的移植方法.方法:在Seglen改良两步法的基础上稍加改进分离培养肝细胞.采用D-氨基半乳糖诱导大鼠 (重庆医科大学实验动物中心提供) 急性肝衰竭24h后, 65只大鼠经颈动脉途径脾动脉插管, 60只插管成功后随机分为3组:脾脏直接注射组 (n=20) 大鼠经脾脏直接注射约2×107个肝细胞、脾动脉注射0.4m Lhank's液;脾动脉注射组 (n=20) 大鼠经脾脏直接注射0.4 mL Hank's液、脾动脉注射2×107个肝细胞;模型对照组 (n=20) 经脾脏直接注射0.4 mL Hank's液、脾动脉注射0.4 mL Hank's液.移植后14 d内观察各组大鼠的生存率及肝功能变化;移植后7d, 荧光显微镜观察经脾动脉移植肝细胞的体内分布情况, 苏木精-伊红染色观察移植肝细胞在脾内的分布和增殖情况;移植后14 d, 免疫荧光染色观察白蛋白合成情况.结果与结论: (1) 大鼠肝细胞分离存活率达80%-90%; (2) 3组大鼠生存率的比较差异有显著性意义, 脾脏直接注射组14 d存活率显著高于脾动脉注射组, 脾动脉注射组14 d存活率高于模型对照组; (3) 脾脏直接注射组、脾动脉注射组大鼠肝功能均明显改善, 尤其以脾脏直接注射组最为显著; (4) CFDA-SE荧光标记的肝细胞经脾动脉移植7 d后, 受体大鼠脾脏和肝脏可以看到散在绿色荧光分布; (5) 移植14 d后, 脾脏直接注射组、脾动脉注射组脾脏内有肝细胞白蛋白绿色荧光信号; (6) 移植7d后, 脾脏直接注射组、脾动脉注射组肝细胞在脾脏红髓中簇集在一起并定植下来; (7) 结果表明, 经大鼠颈动脉途径脾动脉插管移植肝细胞能提高急性肝衰竭大鼠的存活率和改善其肝功能;脾脏直接注射法优于脾动脉途径注射法.