The Effect Of Airflow In Re-epithelization In Preventing Obliterative Airway Disease Associated With Posttransplantation

Objective To explore the effect of airflow in re-epithelization of tracheal allografts with recipient-drived mucous membrane in prevention of obliterative airway disease after airway transplantation.Method Obtaining C57BL/6 mouse's tracheal as donor, BALB/c mouse's tracheal as recipient.The increase airflow group:the two donor tracheal were sliver in the membrane and to sew a large trachea.The decrease group:the two donor tracheal were attached in parallel ,7 line were knotted in each ends to block up one of the donor,the other tracheal as a ventilate tracheal.control group:allografts were orthotopically transplanted into major histocompatibility mismatched BALB/c mouse (recipient) .Allografts were removed on 28 day after transplantation for histology, computerized morphometry, immunohistochemical detection of the phenotype of epithelium and ELISA detection the level of the IL-10,TGF-β,TNF-a. Scanning electron microscopy observe the density of the cilia. transmission electron microscopy observe the ultramicro structure of the cell.Results increasing airflow group allografts exhibited integrated mucous membrane and ciliated cuboida,with rare fibrous tissue and lymphocyte. Decreasing airflow group exhibited lower ciliated cuboida than increasing airflow group with abundant fibrous tissue and lymphocyte. The ciliary coverage of increasing airflow group allogrofts was much more than that of Decreasing airflow group and control group allografts. (p=0.000,0.008),but similar the normal tracheal(p=0.083). Decreasing airflow group allografts the fibrous tissue and fibroblasts of the lamina propria was much more than that of the increasing airflow group (p=0.000). Immunohistochemical analysis demonstrated that all of the tracheal allografts epithelium expressed recipient phenotype. The IL-10 and TNF of increasing airflow group is signifiance compared to the decreasing airflow group.Scanning electron microscopy of increasing airflow group allogrofts and control group demonstrating a dense population of normal cilia with interspersed mucus cells;and Scanning electron microscopy of decreasing airflow group allogrofts demonstrating a sparse population of blunted cilia with interspersed mucus cells; transimission electron microscopy of increasing airflow group allogrofts and control group demonstrating a normal and integrated cilia cells and cell structure;But decreasing airflow group allogrofts demonstrating many vacuole and apoptosis.Conclusion The airflow accelerate Orthotopic tracheal allografts re-epithelization with recipient-drived mucosa which prevents the development of OAD .