【摘要】 目的 :检测角膜移植排斥反应房水中肿瘤坏死因子 α(tumornecrosisfactoralpha ,TNF α)含量及其与角膜移植免收稿日期 :2 0 0 2 -11-19;修回日期 :2 0 0 3 -0 1-2 2作者简介 :李贵仁 (1943 -) ,男 ,山东潍坊人 ,主任医师 ,研究方向 :角膜病。通信作者 :李贵仁 (E -mail:li-yan2 0 0 2 0 0 1@163 .com)疫排斥反应的关系。方法 :将健康新西兰白兔 4 4只随机分为 4组。A组 :正常对照组 8只 ;B组 :自体穿透性角膜移植组 12只 ;C组 :异种异体穿透性角膜移植后用CsA治疗组 12只 ;D组 :异种异体穿透性角膜移植组 12只。供体为新鲜鸡角膜。分别于术后第 3、第 7、第 14、第 2 1、第 2 8天采取兔耳缘动脉血和房水 ,应用酶联免疫吸附 (ELISA)双抗体夹心法检测房水及外周血中TNF α的含量 ,并对房水细胞行免疫组化染色观察。结果 :正常血清和房水中均可检测到少量的TNF α ,它们的浓度分别为 (6 9.98± 17.4 0 )pg/ml和 (31.2 5±17.13)pg/ml。术后早期D组房水及外周血中TNF α含量即升高 ,至排斥反应前达最高水平 ,在观察期 (2 8d)内维持高水平。血、房水TNF α含量变化呈密切正相关 (r =0 .94 ,P <0 .0 1)。排斥反应发生时 ,D组房水涂片、瑞氏染色可见较多淋巴细胞和巨噬细胞 ,而相同时间的A、B组房水均未发现?更多还原

【Abstract】 Objective:To determine the content of tumor necrosis factor alpha in aqueous humor after penetrating keratoplasty and study the relation between TNF α and corneal graft rejection.Methods:Forty four healthy new zealand rabbits were randomly divided into four groups:normal group,autograft group,heterograft group with CsA treatment and heterograft group without treatment. The chicken to rabbit models of penetrating keratoplasty were used for the heterograft groups. The levels of TNF α in serum and aqueous humor were dynamically determined by enzyme linked immunosobent assay(ELISA) on 3,7,14,21 and 28 days after surgery. An immunohistochemical technique was performed on aqueous humor cells after surgery.Results:In the heterograft groups,the TNF α positive cells had spread into the aqueous humor when rejection occurred. At the same time,we could only find a few TNF α positive cells in the CsA treatment group,and there were no positive cells in the aqueous humor of the autograft and normal groups. There were no inflammatory cells in the aqueous humor of the normal and autograft groups either,but a few lymphocytes were noticed in that of the CsA treatment group and there were even more lymphocytes and macrophagocytes in the heterograft group. The mean TNF α levels in aqueous humor and serum in the control animals that did not undergo surgery were(31.25±17.13)pg/ml?(69.98±17.40)pg/ml. Levels increased in the early stages postoperatively in all surgical groups. Subsequently,levels decreased in the autograft group and gradually reached a normal level,while high levels were sustained in the CsA treatment group. Levels for the heterograft group continued to increase and were higher when compared to those of the CsA treatment group(P<0.01). Correlation analysis showed the change in TNF α had a positive correlation between the aqueous humor and serum(r=0.94,P<0.01).Conclusion:Tumor necrosis factor alpha(TNF α) in serum and aqueous humor plays a critical role in initiating and maintaining corneal graft rejection. Monitoring the content of TNF α postoperatively can indicate the degree of local immune reaction and predict the occurrence of graft rejection.更多还原