Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model

Background Tracheal transplantation seems to be the logical step in the process of reconstruction of the trachea following a long-segment resection, which is usually done to treat malignant disease or benign stenosis of the airway caused by a traumatic, congenital, inflammatory, or iatrogenic lesion...

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Main Authors: Dimpy Sharma, Subramania Iyer, Sobha Subramaniam, Janarthanan Ramu, Mohit Sharma, Ajit Nambiar, AKK Unni, Sivanarayanan S.
Format: Article
Language:English
Published: Thieme Medical and Scientific Publishers Pvt. Ltd. 2020-12-01
Series:Indian Journal of Plastic Surgery
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Online Access:http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721860
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author Dimpy Sharma
Subramania Iyer
Sobha Subramaniam
Janarthanan Ramu
Mohit Sharma
Ajit Nambiar
AKK Unni
Sivanarayanan S.
author_facet Dimpy Sharma
Subramania Iyer
Sobha Subramaniam
Janarthanan Ramu
Mohit Sharma
Ajit Nambiar
AKK Unni
Sivanarayanan S.
author_sort Dimpy Sharma
collection DOAJ
description Background Tracheal transplantation seems to be the logical step in the process of reconstruction of the trachea following a long-segment resection, which is usually done to treat malignant disease or benign stenosis of the airway caused by a traumatic, congenital, inflammatory, or iatrogenic lesion. Immunosuppression following transplant is essential but not ideal after oncoresection. Methods The tracheal allografts, harvested from Sprague Dawley rats, were implanted in the Wistar strain rat. The harvested tracheal grafts were divided into groups and subgroups, based on the layers of trachea, method of decellularization, and immunosuppression. The antigenicity of different layers of trachea and the effect of various decellularization methods were studied within three time frames, that is, day 3, 9, and 15. Result On structural analysis, the day 3 and day 15 samples showed no meaningful comparison could be made, due to extensive neutrophil infiltration in all three layers. The day 9 tracheal grafts showed loss of epithelium, with no signs of regeneration in most of the allografts. The subepithelial lymphoid infiltration was found to be severe in nonimmunosuppressed allografts. The group in which both inner and outer layers were removed showed moderate-to-severe infiltrate of lymphoid cells in all the allografts, but there was no cartilage loss, irrespective of the method of decellularization. The irradiated specimens retained the cartilage but showed extensive ischemic damage. Conclusion Rat trachea is a good model for tracheal transplant research but not adequately sturdy to sustain mechanical debridement. Irradiation and chemical decellularization eliminates the immune response but causes intense ischemic damage. Out of the three time frames, day 9 seemed to be the best to study the immune response. To substantiate the results obtained in this study, the immunohistochemical study of the allografts is needed to be performed among a larger group of animals.
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spelling doaj-art-eef39f91d3f546b2b4ad715994d030fc2025-08-20T02:22:25ZengThieme Medical and Scientific Publishers Pvt. Ltd.Indian Journal of Plastic Surgery0970-03581998-376X2020-12-01530335736210.1055/s-0040-1721860Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent ModelDimpy Sharma0Subramania Iyer1Sobha Subramaniam2Janarthanan Ramu3Mohit Sharma4Ajit Nambiar5AKK Unni6Sivanarayanan S.7Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Pulmonary Medicine, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Clinical Pathology, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Central Animal Research Facility, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaDepartment of Central Animal Research Facility, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, IndiaBackground Tracheal transplantation seems to be the logical step in the process of reconstruction of the trachea following a long-segment resection, which is usually done to treat malignant disease or benign stenosis of the airway caused by a traumatic, congenital, inflammatory, or iatrogenic lesion. Immunosuppression following transplant is essential but not ideal after oncoresection. Methods The tracheal allografts, harvested from Sprague Dawley rats, were implanted in the Wistar strain rat. The harvested tracheal grafts were divided into groups and subgroups, based on the layers of trachea, method of decellularization, and immunosuppression. The antigenicity of different layers of trachea and the effect of various decellularization methods were studied within three time frames, that is, day 3, 9, and 15. Result On structural analysis, the day 3 and day 15 samples showed no meaningful comparison could be made, due to extensive neutrophil infiltration in all three layers. The day 9 tracheal grafts showed loss of epithelium, with no signs of regeneration in most of the allografts. The subepithelial lymphoid infiltration was found to be severe in nonimmunosuppressed allografts. The group in which both inner and outer layers were removed showed moderate-to-severe infiltrate of lymphoid cells in all the allografts, but there was no cartilage loss, irrespective of the method of decellularization. The irradiated specimens retained the cartilage but showed extensive ischemic damage. Conclusion Rat trachea is a good model for tracheal transplant research but not adequately sturdy to sustain mechanical debridement. Irradiation and chemical decellularization eliminates the immune response but causes intense ischemic damage. Out of the three time frames, day 9 seemed to be the best to study the immune response. To substantiate the results obtained in this study, the immunohistochemical study of the allografts is needed to be performed among a larger group of animals.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721860decellularized tracheal allograftimmune-mediated rejectionrodent modeltracheal allograft antigenicitytracheal transplantation
spellingShingle Dimpy Sharma
Subramania Iyer
Sobha Subramaniam
Janarthanan Ramu
Mohit Sharma
Ajit Nambiar
AKK Unni
Sivanarayanan S.
Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model
Indian Journal of Plastic Surgery
decellularized tracheal allograft
immune-mediated rejection
rodent model
tracheal allograft antigenicity
tracheal transplantation
title Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model
title_full Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model
title_fullStr Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model
title_full_unstemmed Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model
title_short Evaluation of Antigenicity of Components of Tracheal Allotransplant and Effect of Immunosuppressant Regime in a Rodent Model
title_sort evaluation of antigenicity of components of tracheal allotransplant and effect of immunosuppressant regime in a rodent model
topic decellularized tracheal allograft
immune-mediated rejection
rodent model
tracheal allograft antigenicity
tracheal transplantation
url http://www.thieme-connect.de/DOI/DOI?10.1055/s-0040-1721860
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