tailieunhanh - Advanced therapy in thoracic surgery - part 7

Việc sử dụng liệu pháp gen trong môi trường cấy ghép là thuận lợi bởi vì điều trị ức chế miễn dịch có khả năng có thể cho phép transfection lặp đi lặp lại với cùng một vector virus mà không cần phát triển , 103 chiến lược Nhiều đã được sử dụng thực nghiệm bị chuyển phổi nhà tài trợ với sự thành công biến | 330 Advanced Therapy in Thoracic Surgery tice the allograft is gently reinflated before reperfusion and ventilated with an FiO2 of PEEP of 5 cm H2O and a pressure-control ventilation limiting the peak airway pressures to 25 cm 101 Gene Therapy The utilization of gene therapy in the transplantation setting is advantageous because immunosuppressive therapy may potentially allow repeated transfection with the same viral vector without developing 103 Multiple strategies have been used experimentally to transfect donor lungs with variable success. Genes have been administered to the donor before lung retrieval on the back table during the cold ischemic time and to the recipient after reperfusion. They have been delivered intravascularly intramuscularly and transtracheally as naked deoxyribonucleic acid DNA or with the help of a vector either viral or nonviral such as cationic We have demonstrated that transfection of the donor lung is possible through the transtracheal route using a second-generation adenoviral vector without contaminating other organs such as the heart liver or Since the transfection rate is significantly decreased at cold temperatures this mode of administration is useful in that it allows for efficient transfection before retrieving and cooling the lungs. We have shown that the transtracheal administration of the gene coding for the antiinflammatory cytokine human interleukin-10 to the donor 12 and 24 hours prior to lung retrieval reduces ischemia-reperfusion injury and improves lung function in a rat single lung transplant A high dose of steroids given before the administration of the adenoviral vector can reduce the inflammation induced by the adenoviral vector and allow the transfection time to be reduced to 6 hours before retrieving the lungs. We are currently performing similar experiments in a large animal study. Once similar results can be reproduced human lung protection .