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背景用于异体神经移植中的免疫抑制剂—环胞素A价格昂贵;而相关文献报道,中药雷公藤制剂具有免疫抑制作用。目的探讨同种异体神经移植雷公藤多甙替代环孢素A(cyclosporinA,CSA)进行免疫抑制可行性。设计随机分组双盲设计。地点和对象实验在武汉大学人民医院完成,对象为健康雄性SD大鼠48只,Wistar大鼠18只,SPF级,体质量180～210g,购自武汉大学医学动物实验中心。干预方法取Wistar大鼠坐骨神经为供体,于SD大鼠上制备坐骨神经移植模型,随机分为4组,即自体移植组,行自体神经原位移植;CSA组,异体神经移植应用CSA5mg/(kg·d)5周;雷公藤组,异体神经移植应用雷公藤多甙5mg/(kg·d)5周;对照组,单纯异体神经移植而无免疫抑制剂。主要观察指标移植术后12周移植段神经形态学观察,神经运动诱发电位潜伏期、神经运动诱发电位峰值、神经传导速度和振幅积分,腓肠肌称重及再生轴突计数。结果12周时,自体移植、CSA、雷公藤组的潜伏期峰值、诱发电位、传导速度、振幅积分、肌肉湿质量、肌肉湿质量恢复度、轴突数目各项检测指标明显优于对照组(q=3.95～8.32,P<0.01),再生神经形态与功能恢复良好。结论同种异体神经移植时,雷公藤多甙可以替代CSA发挥有效的免疫抑制作用。
BACKGROUND Cyclosporin A, an immunosuppressive agent used in allograft transplantation, is expensive. The related literature reports that T. wilfordii preparations have immunosuppressive effects. Objective To investigate the feasibility of immunosuppression of allograft tripterygium wilfordii instead of cyclosporin A (CSA). Design randomized double blind design. The place and object experiments were completed at the People’s Hospital of Wuhan University. The subjects were 48 male healthy SD rats, 18 Wistar rats, SPF grade, and a body weight of 180-210 g. They were purchased from the Medical Animal Experimental Center of Wuhan University. Interventions Wistar rat sciatic nerves were used as donors. Sciatic nerve transplantation models were prepared on SD rats. They were randomly divided into 4 groups: autograft group and autologous nerve orthotopic transplantation; CSA group; allogeneic nerve transplantation was applied CSA 5mg/(kg). d) 5 weeks; Tripterygium wilfordii group, allogeneic nerve transplantation using Tripterygium wilfordii 5mg / (kg · d) 5 weeks; control group, allogenic nerve transplantation without immunosuppressive agents. MAIN OUTCOME MEASURES Nerve morphology, neuromotor evoked potential latency, neural motor evoked potential peak, nerve conduction velocity and amplitude integral, gastrocnemius muscle weight and regenerating axon count were observed at 12 weeks after transplantation. Results At 12 weeks, the detection indexes of autograft, CSA, triptolide peak, evoked potential, conduction velocity, amplitude integral, muscle wet mass, muscle wet mass recovery, and number of axons were significantly better than those of the control group (q). =3.95 to 8.32, P<0.01). The regenerative nerve morphology and function recovered well. Conclusion Allograft tripterygium can substitute for CSA to play an effective immunosuppressive effect.