EXPERIMENTAL STUDY FOR REDUCTION OF ISCHEMIA-REPERFUSION INJURY TO SKIN FLAP MODEL BY MONOCLONAL ANTIBODY TO ADHESION MOLECULE.

目的：缺血-再灌注（I-R）损伤仍然是长期缺血后自由组织移植和再植成功的一个问题。研究表明，白细胞和血管内皮细胞在缺血后的再灌注过程中释放多种炎症介质。选择素家族在炎症损伤部位介导活化白细胞和血管内皮的粘附，被认为在炎症反应的序列中起重要作用。选择素家族包括LECAM-1、ELAM-1和p -选择素，它们在活化的血管内皮中表达，并介导白细胞粘附血管内皮时的特殊白细胞滚动现象。本研究的目的是评估在大鼠皮肤皮瓣中，使用针对LECAM-1、ELAM-1和p -选择素的单克隆抗体（MAb）阻断白细胞内皮粘附以防止I-R损伤。方法：雄性SD大鼠225 ~ 250gr。皮瓣（45x30mm）…更多是由上腹部浅表A&V供应，包括股血管单侧分离。将股血管与腹壁血管交叉夹持，缺血9小时。治疗组动物在再灌注前15分钟静脉注射对LECAM-1、ELAM-1和p -选择素的单抗；对照组给予生理盐水治疗。通过追踪活区和非活区轮廓来评估皮瓣的生存能力。在接下来的7天收集数据。这些数据与皮瓣类似区域的组织学证据相证实。结果：示踪分析显示，治疗组皮瓣平均存活面积约80%，对照组约20% （p<0.05）。组织病理学上，治疗组未见明显炎症改变，对照组损伤明显。结论：在本研究中，我们得出结论，用单抗治疗皮肤组织的LECAM-1、ELAM-1和p -选择素对9小时热缺血后的I-R损伤有效。少

Aim : Ischemia-reperfusion (I-R) injury continues to be a problem for successful free tissue transfer and replantation after prolonged periods of ischemia. It has been shown that leukocytes and vascular endothelial cells release a variety of inflammatory mediators during reperfusion after ischemia. The selectin family, which mediates adhesion of activated leukocytes and vascular endothelium in inflammation at lesion sites, is considered to play an important role in the sequence of inflammatory reactions. The selectin family includes LECAM-1, ELAM-1, and P-selectin, which are expressed in activated vascular endothelium and mediates the special leukocyte rolling phenomenon seen when leukocytes adhere to vascular endothelium. The purpose of this study was to evaluate the blockage of leukocyte-endothelial adhesion by a monoclonal antibody (MAb) to LECAM-1, ELAM-1, and P-selectin in skin flaps to prevent I-R injury in rats.Methods : Male SD rats (225-250gr) were used. A skin flap (45x30mm) … More supplied by the superficial epigastric A＆V including the femoral vessels was isolated unilaterally. The femoral vessels were cross-clamped the epigastric vessels for 9 hours of ischemia. Animals in treated group received MAb to LECAM-1, ELAM-1, and P-selectin i.v. 15 minutes prior to reperfusion ; those in the control group received normal saline. Skin flap viability was assessed by tracing the outline of viable and nonviable areas. Data were collected for the following 7 days. These data were corroborated with histological evidence on comparable areas of the flap.Results : Tracing analysis revealed average flap survival area of about 80% in treated group and about 20% in control group (p<0.05). Histopathologically, few inflammatory changes could be observed in treated group, while marked damage was observed in control group.Conclusions : From this study, we concluded that treating skin flaps with Mab to LECAM-1, ELAM-1, and P-selectin were effective for I-R injury after 9 hours of warm ischemia. Less