RESUMEN
HydroCoil (MicroVention, Aliso Viejo, CA, USA) is a self-expanding detachable coil developed to improve the endovascular occlusion of intracranial aneurysms. The hydrogel polymer covering the microcoil expands to several times its original diameter to enhance thrombosis of the intended vessel. We made use of this new technology to occlude a mesenteric artery pseudoaneurysm that failed superselective embolization with standard microcoils.
Asunto(s)
Aneurisma Falso/etiología , Aneurisma Falso/terapia , Materiales Biocompatibles Revestidos/uso terapéutico , Embolización Terapéutica/instrumentación , Hemorragia/terapia , Hidrogel de Polietilenoglicol-Dimetacrilato/uso terapéutico , Arteria Mesentérica Superior/cirugía , Terapia Recuperativa , Adulto , Aneurisma Falso/diagnóstico por imagen , Catéteres de Permanencia/efectos adversos , Hemorragia/diagnóstico por imagen , Humanos , Masculino , Arteria Mesentérica Superior/diagnóstico por imagen , Arteria Mesentérica Superior/patología , Oclusión Vascular Mesentérica/diagnóstico por imagen , Oclusión Vascular Mesentérica/etiología , Oclusión Vascular Mesentérica/terapia , Tomografía Computarizada por Rayos XRESUMEN
The extent of interaction between human T-lymphocytes and xenogeneic antigen-presenting cells (APCs) is species-dependent. A successful interaction requires high-affinity receptor-ligand pairing across species and recognition of antigens presented by foreign major histocompatibility complex (MHC). A deficient human T-lymphocyte response to xenogeneic cells is likely the result of a defect in these interactions. However, the requirements for a T-cell response to superantigen (SAg) may differ from those of other T-cell responses. Using irradiated murine splenocytes, which are believed to be incapable of eliciting human T-cell responses, and porcine aortic endothelial cells (PAECs) as the APC populations, we studied the human T-lymphocyte response to antigens presented by these cells. Direct proliferation of human T-lymphocytes to SAg presented by murine APCs was demonstrated; it was blocked by anti-human LFA-1 and anti-murine MHC class II but not by anti-human MHC class II. PAECs also presented SAg to human T-cells, generating a proliferative response greater than the primary response to porcine xenoantigen. Culture of human T-cells with murine splenocytes or PAECs and SAg Staphylococcus enterotoxin A (SEA) for 7 days primed human T-cells to proliferate in a secondary culture in response to autologous APCs. This autologous secondary response was human MHC class II-dependent and was inhibited by anti-human LFA-1, anti-human CD2, and anti-human CD98. Surprisingly, both of these responses were also blocked by anti-SEA, suggesting that despite vigorous washing, a small amount of functionally important SAg was carried over from primary to secondary culture, probably bound to the surface of T-cells. Xenogeneic APCs, even those that fail to stimulate human T-cells directly, can serve as APCs for primary human T-cell responses. After such interactions T-cells can develop secondary responses in autologous interactions based on retention of minute amounts of SAg. Such interactions may have important implications for xenotransplantation.