学术
摘 要:
目的探讨监测调节性T淋巴细胞（Treg）的动态变化在异基因造血干细胞移植（allo-HSCT）中的临床意义。方法选择45例allo-HSCT患者，其中31例采用短程甲氨蝶呤（MTX）联合环孢素A（CsA）预防移植物抗宿主病（GVHD），另14例加用霉酚酸酯（MMF）和达利珠单抗（抗CD25单克隆抗体）强化GVHD的预防。采用流式细胞术动态监测allo-HScT患者移植预处理前、移植后2、4、8、12周时及发生急性移植物抗宿主病（aGVHD）时外周血Treg的水平；分析Treg水平的变化与aGVHD发生的相互关系。结果45例患者中，发生Ⅱ～Ⅳ度aGVHD10例。移植后8和12周时，未使用达利珠单抗组中发生Ⅱ～Ⅳ度aGVHD较发生0～I度aGVHD的患者外周血Treg水平显著降低，差异有统计学意义（P〈0．05）；患者发生Ⅱ～Ⅳ度aGVHD后，外周血Treg水平较发生前显著降低，差异有统计学意义（P〈0．05）。使用达利珠单抗组的患者外周血Treg水平在各时间点均明显降低，各时点间比较，差异均无统计学意义。结论Treg的动态变化与aGVHD的关系密切，可作为临床监测aGVHD发生的重要指标之一；达利珠单抗的应用显著降低了外周血Treg的水平，其对aGVHD的预防作用有待今后深入研究。[著者文摘]
文章出处:
《中华器官移植杂志》-2007年28卷10期 -613-616页
栏目信息:
分 类 号:
The clinical significance of dynamic changes of CD4^ ＋ CD25^ ＋ regulatory T cells in patients subject to allogeneic hematopoietic stem cell transplantation
FANG Jun , XIA Ling-hui , YOU Yong , et al.（ Institute of Hematology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China）
Abstract:
Objective To investigate the clinical significance of dynamic changes of CD4^＋ CD25^＋ regulatory T cells （Treg） in patients subject to allogeneic hematopoietic stem cell transplantation （allo-HSCT）. Methods Forty-five patients received allo-HSCT. The graft-vesus-host disease （GVHD） was prevented by cyclosporine A and short-term MTX regimen in 31 patients. Fourteen of all the patients received Zenapox （CD25MAb） at the day of transplantation and day 4 after transplanation. The levels of Treg in peripheral blood were detected by flow cytometry from 45 patients at 2nd, 4th, 8th and 12th week after allo-HSCT and the time of aGVHD development, respectively. Results Anti-CD25 could suppress the peripheral blood levels of Treg significantly. The Treg levels were significantly higher in patients with grade 0-1 aGVHD than those with 2-4 aGVHD at 8th and 12th week after transplantation. Among patients with 2-4 aGVHD, Treg levels were significantly low- er after development of aGVHD than before. Conclusions Treg are important for the aGVHD prevention and can be a useful clinical surveillant index for the development of aGVHD. It can significantly decrease the levels of Treg in the peripheral blood with anti-CD25.[著者文摘]
Key words:
Hernatopoietic stem cell transplantation;Graft vs host disease;T-lymphocytes
基金资助:
湖北省卫生厅基金（20043-117）
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