非血缘关系HLA全相合造血干细胞移植中供者-受者NK细胞KIR的研究

目的研究自然杀伤细胞免疫球蛋白样受体（KIR）的生物学功能及供者抑制性KIR和受者HLA遗传背景在无关供者全相合造血干细胞移植（HSCT）中的作用。方法采用序列特异性引物聚合酶链反应（SSP—PCR）和序列特异性寡核苷酸探针聚合酶链反应（SSOP—PCR）的方法，对中国造血干细胞捐献者资料库中提供的51对HLA全相合供、受者进行KIR及HLA分型，患者中急性淋巴细胞白血病ALL18例，慢性粒细胞白血病（CML）15例，急性髓系白血病（AML）10例及其他患者8例。结果51对供者一受者均存在2DL1、2DL2／L3、2DIA、3DL2和3DL3，基因频率均为1，96．7％的个体表达KIR3DL1。供-受者中21．57％KIR完全相同；78．43％KIR不完全相同，而KIR不相同又分为受者KIR基因型包含供者KIR为25．49％，供者KIR基因型包含受者KIR为27．45％。74.62％的供者KIR2DL1无受者C2配体，5．91％的供者KIR2DL2／L3无受者C1配体，19．74％的供者KIR3DLl无受者Bw4配体，54．91％的供者KIR3DL2无受者A3、A11配体。结论KIR独特型和HLA-Ⅰ类抗原是独立遗传的。供者KIR2DL1和KIR3DL2是主要引起NK细胞异源活性的受体，供、受者的KIR／HLA不匹配可能在全相合的无关供者异基因HSCT中起着十分重要的作用。KIR受体-配体模型可以更好地提示HSCT的预后。

Study on the behavior of NK cell KIRs of donor/recipient pairs in HLA matched unrelated allo-HSCT

OBJECTIVE: To study the biological function of killer cell immunoglobulin-like receptor (KIR) and the role of donor inhibitory KIR and recipient genetic background in HLA matched unrelated hematopoietic stem cell transplantation (HSCT). METHODS: HLA genotype of 51 patients (ALL 18 cases, CML 15 cases, AML 10 cases and others 8 cases) and their respective matched unrelated donors from Database of China Marrow Registration was determined by polymerase chain reaction sequence oligonucleotide probes (PCR-SSOP) and sequence specific primers (PCR-SSP). The KIR genotype was determined by PCR-SSP. RESULTS: All the patients and the donors expressed KIR2DL1, KIR2DL2/L3, KIR2DL4, KIR3DL2 and KIR3DL3. 96.7% individuals expressed KIR3DL1. Among them, 21.57% of KIR was completely identical, while 78.43% was not. Of the non-identical KIRs, 25.49% were the recipient's KIR genotype containing the donor's ones, and 27.45% was the donor's containing the recipient's. 74.62% of donor's KIR2DL1 lacked recipient's C2 ligand, 5.91% of donor's KIR2DL2/L3 lacked recipient's C1 ligand, 19.74% of donor's KIR3DL1 lacked recipient's Bw4 ligand and 54.91% of donor's KIR3DL2 lacked recipient's A3, Al11ligand. CONCLUSION: KIR genotype and HLA class I antigen are inherited independently. KIR2DLI and KIR3DL2 of donors may cause alloreactivity of NK cell. The mismatch of KIR/HLA in donor-recipient plays a very important role in matched unrelated allo-HSCT. The outcome of HSCT can be better predicted by the model of the presence of KIRs on the donor' sNK cells and the absence of corresponding KIR ligand in the recipient's HLA.