Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Anticalcification Treatment of Glutaraldehyde-fixed Bovine Pericardium with Amino Acids (The Effect of Ethanol, Glutamic Acid and Homocysteic Acid Treatment)

글루타르알데하이드로 고정한 소 심낭의 아미노산을 이용한 항석회화 처리(에탄올, 글루타믹 산, 호모시스테익 산 처리의 효과)

  • Lee, Cheul (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital) ;
  • Kim, Yong-Jin (Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul National University Hospital Clinical Research Institute, Xenotransplantation Research Center) ;
  • Lee, Chang-Ha (Department of Thoracic and Cardiovascular Surgery, Sejong General Hospital) ;
  • Kim, Soo-Hwan (Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul National University Hospital Clinical Research Institute, Xenotransplantation Research Center) ;
  • Choi, Seung-Hwa (Department of Thoracic and Cardiovascular Surgery, Seoul National University College of Medicine, Seoul National University Hospital Clinical Research Institute, Xenotransplantation Research Center)
  • 이철 (세종병원 흉부외과) ;
  • 김용진 (서울대학교 의과대학 흉부외과학교실, 서울대학교병원 임상의학연구소, 바이오 이종장기개발사업단) ;
  • 이창하 (세종병원 흉부외과) ;
  • 김수환 (서울대학교 의과대학 흉부외과학교실, 서울대학교병원 임상의학연구소, 바이오 이종장기개발사업단) ;
  • 최승화 (서울대학교 의과대학 흉부외과학교실, 서울대학교병원 임상의학연구소, 바이오 이종장기개발사업단)
  • Published : 2009.08.05
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Abstract

Background: Glutaraldehyde-fixed heterografts are prone to calcification after long-term implantation in human, and this is one of the limiting factors for the longevity of the heterografts used in cardiovascular surgery. The aim of the study was to evaluate the anticalcification effect of an ethanol and amino acids treatment on glutaraldehyde-fixed bovine pericardium. Material and Method: Bovine pericardial tissues were divided into 5 groups. Group 1 consisted of tissues fixed with glutaraldehyde, group 2 consisted of commercially available bovine pericardial valve tissues (Carpentier-Edwards PERIMOUNT), group 3 consisted of glutaraldehyde-fixed tissues treated with ethanol, group 4 consisted of glutaraldehyde-fixed tissues treated with ethanol and L-glutamic acid, and group 5 consisted of glutaraldehyde-fixed tissues treated with ethanol and homocysteic acid. The tissue microstructure was examined by light and electron microscopy. Tissue samples of each group were implanted into rat subcutaneous tissue for 3 $\sim$ 4 months and the calcium contents were measured after harvest. Result: The collagen fibers appeared to be well preserved in all the groups. The calcium contents of groups 2, 3, 4 and 5 (13.46$\pm$11.74, 0.33$\pm$0.02, 0.39$\pm$0.08 and 0.42$\pm$0.06 $\mu$g/mg, respectively) were all significantly lower than that of group 1 (149.97$\pm$28.25 $\mu$g/mg) (p<0.05). The calcium contents of groups 3, 4 and 5 were all significantly lower than that of group 2 (p<0.05). Conclusion: Treatment with ethanol alone or in combination with amino acids (L-glutamic acid or homocysteic acid) strongly prevented the calcification of glutaraldehyde-fixed bovine pericardium.

배경: Glutaraldehyde로 고정한 이종 조직을 인체 내에 장기간 이식 시 발생하는 기능부전의 주된 병변은 석회화이며, 이는 심혈관 수술에 사용되는 이종 조직 이식편(heterograft)의 내구성을 감소시키는 중요한 요인들 중 하나이다. 이 연구에서는 glutaraldehyde로 고정한 소 심낭에 ethanol 및 아미노산을 이용한 항석회화 처리를 하여 그 효과를 알아보고자 하였다. 대상 및 방법 : 소 심낭 조직을 5개의 군으로 나누어 실험하였다. 1군은 glutaraldehyde 고정만 시행하였고, 2군은 상용화된 소 심낭 판막 조직(Carpentier-Edwards PERIMOUNT)을 사용하였으며, 3군은 glutaraldehyde 고정 후 ethanol 처리, 4군은 glutaraldehyde 고정 후 ethanol 및 L-glutamic acid 처리, 5군은 glutaraldehyde 고정 후 ethanol 및 homocysteic acid처리를 하였다. 처리한 조직들의 미세구조를 광학 및 전자현미경으로 검사하였다. 각 군당 8$\sim$10개씩의 심낭 조직들을 쥐의 피하 조직에 3$\sim$4개월간 이식한 후 수거하여 각각의 칼슘 함량을 측정하였다. 결과: Glutaraldehyde 고정만 한 조직 및 다양한 항석회화 처리를 한 조직들 모두 조직 내 콜라겐 섬유들의 구조가 잘 유지되고 있었다. 2, 3, 4, 5군의 칼슘 함량(각각 13.46$\pm$11.74, 0.33$\pm$0.02, 0.3910.08, 0.42$\pm$0.06$\mu$g/mg)은 1군의 칼슘 함량(149.97$\pm$28.25$\mu$g/mg)과 비교하여 모두 유의하게 낮았다(p<0.05). 3, 4, 5군의 칼슘 함량은 2군의 칼슘 함량과 비교하여 모두 유의하게 낮았다(p<0.05). 결론: 쥐 피하 이식 모델을 이용한 단기간 생체내 이식실험 결과, glutaraldehyde로 고정한 소 심낭에 ethanol을 단독으로 처리하거나 ethanol과 아미노산(L-glutamic acid 혹은 homocysteic acid)을 함께 처리한 경우 모두 항석회화 처리를 하지 않은 소 심낭 조직과 비교하여 우수한 항석회화 효과를 나타냈다.

Keywords

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