Changes of Serum IgM, IgG in Pig's Xenograft Perfusion and Immunofluorescence Changes of the Deposition of IgM, IgG in the Xenograft in Dogs

잡종견에서 돼지 신장과 폐를 이용한 혈액관류에서 수술 전.후 혈액의 IgM, IgG와 이식 장기의 IgM, IgG 침착 정도 변화

  • Lee, Doo-Yun (Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Institute of Chest Disease, Yonsei University College of Medicine) ;
  • Paik, Hyo-Chae (Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Institute of Chest Disease, Yonsei University College of Medicine) ;
  • Jeon, Se-Eun (Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Institute of Chest Disease, Yonsei University College of Medicine) ;
  • Kim, Eun-Young (Department of Thoracic and Cardiovascular Surgery, Yongdong Severance Hospital, Institute of Chest Disease, Yonsei University College of Medicine) ;
  • Nam, Jin-Young (Department of Diagnostic Pathology, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Hong, Soon-Won (Department of Diagnostic Pathology, Yongdong Severance Hospital, Yonsei University College of Medicine) ;
  • Hwang, Jung-Joo (Department of Thoracic and Cardiovascular Surgery, Eulji University Hospital, Eulji University) ;
  • Wada, Hiromi (Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, Kyoto University) ;
  • Bando, Toru (Department of Thoracic and Cardiovascular Surgery, Graduate School of Medicine, Kyoto University)
  • 이두연 (연세대학교 의과대학 폐질환연구소 영동세브란스병원 흉부외과학교실) ;
  • 백효채 (연세대학교 의과대학 폐질환연구소 영동세브란스병원 흉부외과학교실) ;
  • 전세은 (연세대학교 의과대학 폐질환연구소 영동세브란스병원 흉부외과학교실) ;
  • 김은영 (연세대학교 의과대학 폐질환연구소 영동세브란스병원 흉부외과학교실) ;
  • 남진영 (연세대학교 의과대학 영동세브란스병원 진단병리학교실) ;
  • 홍순원 (연세대학교 의과대학 영동세브란스병원 진단병리학교실) ;
  • 황정주 (을지의과대학교 을지대학병원 흉부외과학교실) ;
  • 히로미 와다 (교토대학교 의학대학원 흉부외과학교실) ;
  • 토루 반도 (교토대학교 의학대학원 흉부외과학교실)
  • Published : 2007.07.05

Abstract

Background: Lung transplantation is the definitive therapy for end stage lung disorders. The success of allogenic lung transplantation has led to an increasing shortage of donor lungs from humans, including cadavers, and attention has now turned to transplantation of lungs from other species. However, there are many biological hurdles when using organs from other species because of hyperacute rejection after discordant xenotransplantation. Material and Method: Pigs (n=6, weighing $20{\sim}30kg$ each) for the donors and mongrel dogs (n=6, weighing $20{\sim}28kg$ each) for the recipients were used in this experiment. The left kidney of a pig was perfused to a mongrel dog for 30 minutes through the femoral artery and vein of the dog, and the right kidney was perfused for 30 minutes sequentially. Then, both lungs of the pig were perfused to the dog through the pulmonary artery and left atrium with using the same time intervals. The levels of IgM and IgG were measured from the blood and specimens of the kidney and lung. Result: The average levels of serum IgM gradually decreased after the perfusion, but the average levels of serum IgG did not charge from before to after perfusion. The immunohistochemical findings revealed decreased deposition of IgG and IgM after the perfusion. Conclusion: We conclude that the levels of the serum natural antibodies would be decreased with pre-transplantation xenograft perfusion in the recipient and the occurrence rate of hyperacute rejection after transplantation would be decreased.

배경: 폐 이식이 호흡부전증 환자의 유일한 치료방법으로 인정받고 있으나 이는 역설적으로 많은 호흡부전증 환자의 이식 대기 기간 증가와 공급 장기 부족 현상을 초래하였다. 이에 동물에서 장기를 적출하는 이종 장기이식 수술이 대두되게 되었다. 그러나 이들 이종 장기이식 후 나타나는 초급성 거부반응을 아직 해결하지 못했으며 본 실험은 기초연구로써 이들 초급성 거부반응을 일으키는 주요 인자인 면역글로불린의 이식 전, 후 변화를 관찰하였다. 대상 및 방법: $20{\sim}30kg$의 잡종견과 돼지 각 6마리를 이용하여 돼지의 좌측 신장을 잡종견의 좌측 대퇴동정맥에 연결하여 30분간 관류하였고 다시 우측 신장을 교체 연결 후 30분간 관류하였다. 다시 돼지의 좌측 폐를 잡종견의 폐동맥과 좌심방에 연결 후 30분간 관류하였고 우측 폐를 교체 연결한 후 30분간 관류하였다. 실험과 실험 사이에 혈액을 채취하여 혈청을 분류하였고 절제한 신장과 폐의 IgM과 IgG 침착 정도를 관찰하였다. 결과: 관류 시간이 길어짐에 따라 혈액의 IgM은 감소하였으나 IgG의 감소는 확실하지 않았다. 신장과 폐의 면역형광염색 소견에서 IgM, IgG의 염색반응이 크게 줄어드는 것을 확인할 수 있었다. 결론: 이와 같은 연구결과로 이종 장기이식 전에 신장 및 폐를 이용하여 수혜자의 혈액을 관류함으로써 공급자의 자연 항체를 흡수 제거하는 방법은 이종 이식 후 발생하는 초급성 거부반응을 줄일 수 있으리라 생각한다.

Keywords

References

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