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| 供者调控T细胞对异基因造血干细胞移植后造血与免疫重建、移植物抗宿主病发生及生存的影响 | |
| 引用本文： | 杨凯,范志平,刘启发,张钰. 供者调控T细胞对异基因造血干细胞移植后造血与免疫重建、移植物抗宿主病发生及生存的影响[J]. 南方医科大学学报, 2008, 28(4): 537-541 |
| 作者姓名： | 杨凯 范志平 刘启发 张钰 |
| 作者单位： | 南方医科大学南方医院血液科,广东,广州,510515;南方医科大学南方医院血液科,广东,广州,510515;南方医科大学南方医院血液科,广东,广州,510515;南方医科大学南方医院血液科,广东,广州,510515 |
| 摘 要： | 目的 研接受不同数量供者CD4 CD25 调控T细胞(TReg)移植对异基因造血干细胞移植(allo-HSCT)患者移植物抗宿主病(GVHD)的发生和造血与免疫重建的影响.方法 对30例接受allo-HSCT患者采用流式细胞仪测定移植物中的TReg值和移植后患者不同时间点外周血T淋巴细胞亚群及TReg.按移植供者TReg绝对数是否大于或等于10.0×10/kg为标准分为高TReg移植组和低TReg移植组,比较两组患者移植后造血与免疫重建、TReg重建、GVHD发生及无病生存率有无差异.结果 高TReg组的白细胞(WBC)和血小板(PLT)重建时间分别为 (8.62±2.29)d和 (12.69±5.74)d,低TReg组分别为 (8.88±2.71)d和 (15.18±6.71)d(P值分别为0.778和0.613),两组间WBC和PLT重建时间无显著性差异.高TReg组患者移植后 15 dCD4 CD3 ,CD45RO CD4 T细胞重建, 30dCD3 、CD4 CD3 T细胞重建明显快于低TReg组患者(P值分别为0.039、0.024、0.014、0.020).高TReg组患者移植后 15 dCD4 CD25 TReg重建, 180 d与低TReg组相比明显加快(P值分别为0.013、0.005).高TReg组和低TReg组患者急性GVHD发生率分别为61.54%(8/13)和94.12%(16/17),两组统计有显著性差异(P=0.027),移植的供者TReg数与急性GVHD的发生程度呈负相关(rs=0.393,P=0.032).高与低TReg组无病生存率分别为(60.40±16.10)%和(72.00±2.00)%,无显著性差异(P=0.818).结论 供者TReg能促进allo-HSCT后免疫重建及CD4 CD25 TReg重建,降低移植后急性GVHD的发生率. |
| 关 键 词： | 调控T细胞 异基因造血干细胞移植 造血与免疫重建 移植物抗宿主病 |
| 文章编号： | 1673-4254(2008)04-0537-05 |
| 修稿时间： | 2007-11-19 |
Effect of donor CD4~+CD25~+ regulatory T cells on hematopoietic and immune reconstitution,GVHD and disease-free survival after allogeneic hematopoietic stem cell transplantation |
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| YANG Kai,FAN Zhi-ping,LIU Qi-fa,ZHANG Yu. Effect of donor CD4~+CD25~+ regulatory T cells on hematopoietic and immune reconstitution,GVHD and disease-free survival after allogeneic hematopoietic stem cell transplantation[J]. Journal of Southern Medical University, 2008, 28(4): 537-541 | |
| Authors: | YANG Kai FAN Zhi-ping LIU Qi-fa ZHANG Yu |
| Affiliation: | Department of Hematology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China. yangkai356@yahoo.cn |
| Abstract: | OBJECTIVE: To observe the effect of donor CD4+;CD25+; regulatory T cells (TReg) on hematopoietic reconstitution, immune reconstitutuion and graft-versus-host disease (GVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT). METHODS: Thirty patients were divided into high TReg group (TReg> or =10.0 x 10(6) cells/kg, n=13) and low TReg group (TReg<10.0 x 10(6) cells/kg, n=17) according to the number of TReg in the grafts. Flow cytometry (FCM) was used to detect the TReg percentage in the grafts and recipients peripheral blood T lymphocyte subsets and TReg at different time points after allo-HSCT. The hematopoietic reconstitution, immune reconstitution, TReg reconstitution, incidence of GVHD and disease-free survival were compared between the two groups. RESULTS: The high and low TReg groups showed similar WBC reconstitution time (+8.62-/+2.29 vs +8.88-/+2.71 days, P=0.778) and platelet reconstitution time (+12.69-/+5.74 vs +15.18-/+6.71 days, P=0.613). In high TReg group, the reconstitutions of CD4+;CD3+; and CD45RO+;CD4+; T cells on day 15 and CD3+; and CD4+;CD3+; T cells on day 30 were significantly accelerated in comparison with those of the low TReg group (with P values of 0.039, 0.024, 0.014, 0.020, respectively). TReg reconstitution 15 and 180 days following the surgery was significantly faster in high TReg group than in low TReg group (P=0.013, 0.005, respectively). The incidence of acute GVHD in high TReg group (61.54%) was obviously lower than that in low TReg group (94.12%, P=0.027). A negative correlation was found between the number of infused donor TReg and the severity of acute GVHD (rs=-0.393, P=0.032). The one-year disease-free survival rates of the high and low TReg groups were (60.40-/+16.10)% and (72.00-/+12.00)%, respectively, showing no significant difference between the two groups (P=0.818). CONCLUSION: Donor TReg may promote immunological reconstitution and TReg reconstitution, and decrease the incidence of acute GVHD after allo-HSCT. |
| Keywords: | regulatory T cells allogeneic hematopoietic stem cell transplantation haematopoietic and immunological reconstitution graft-versus-host disease |
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