【摘要】 目的:探讨肿瘤坏死因子-α(TNF-α)在角膜移植免疫排斥反应中的作用以及抗TNF-α单克隆抗体(TNF-α mAb)对排斥反应的抑制作用。方法:以近交系大鼠30只制作穿透性角膜移植模型(F344→Lou),随机等分入移植治疗组(每日结膜下注射0.5g/L抗TNF-α mAb 0.1mL)和移植模型组(结膜下注射等量生理盐水)。利用酶联免疫吸附实验(ELISA)技术分别检测术后3,7d及发生排斥反应时大鼠外周血清中TNF-α的水平,并观察移植角膜的组织病理学变化及植片存活情况。结果:角膜移植术后早期各组大鼠血清TNF-α浓度均有升高,与移植治疗组相比,移植模型组升高速度更快,水平更高(P<0.05);但当发生排斥反应时,二者已无显著性差异(P>0.05)。移植模型组大鼠植片存活时间为10.2±1.9d,而抗体治疗组平均13.8±2.2d,二者相比差异有显著性(P<0.01)。结论:TNF-α在角膜移植免疫排斥反应中发挥一定作用。动态检测外周血TNF-α浓度有助于预测、诊断排斥反应。应用抗TNF-αmAb治疗可部分延长植片存活时间。更多还原

【Abstract】 AIM: To investigate the role of tumor necrosis factor-alpha (TNF-α) in the allograft rejection of rat corneal transplantation and to evaluate the inhibition effect of anti-TNF-α monoclonal antibody (mAb) on it. ·METHODS: After received allogeneic grafts (F344→Lou rat), 30 inbred Lou rats were divided equally into two groups: the transplantation model group and the transplantation treatment group. While the treatment group were treated daily by subconjunctival injection of anti-TNF-α mAb (0.1mL, 0.5 g/L), the model group received the same volume injection of physiologic saline. Then, the serum levels of TNF-α were measured by using enzyme linked immunosorbent assay (ELISA) at 3 and 7 day, and the time when graft rejection occurred after corneal transplantation respectively. The corneal his-topathological changes and the allograft survival times were also observed. ·RESULTS: The serum levels of TNF-α in all rats elevated in the early stage after surgery, especially to the model group. Anti-TNF-α mAb decreased the levels and made them increase slowly (P<0.05). When the rejection occurred, the significant difference between the two groups didn’t exist any more (P>0.05). The treatment group had a significant delay in corneal allograft rejection with mean survival time of 13.8± 2.2 days vs 10.2±1.9 days for the model group (P<0.01). ·CONCLUSION: TNF-α may play an important role in the pathogenesis of corneal allograft rejection. Sequential determinations of serum TNF-α after operation may be of value in the prediction and diagnosis of acute rejection. Anti-TNF-α antibody treatment can prolong the allograft survival time to some extent.更多还原