可调控表达IL-2基因骨髓基质细胞促进异基因骨髓移植小鼠免疫功能重建

目的　探讨可调控表达IL 2基因的骨髓基质细胞系对异基因骨髓移植小鼠免疫功能重建的促进作用。方法　构建四环素诱导的表达小鼠IL 2基因的逆转录病毒载体 ,转染包装细胞PT6 7,感染骨髓基质细胞系QXMSC1(H 2 d) ,构建可诱导表达IL 2基因的工程化骨髓基质细胞系QXM SC1tet on IL 2。受体小鼠C5 7BL 6 (H 2 b)经γ射线致死剂量照射后 ,输入供体BALB c(H 2 d)骨髓细胞1× 10 7 只 (去除T细胞 ) ,同时输注骨髓基质细胞QXMSC1tet on IL 2 5× 10 5 只。灌服多西环素 (Dox)诱导IL 2表达。于骨髓移植 (BMT)后 30d、6 0d检测小鼠脾细胞对ConA的反应强度 ,空斑形成细胞(PFC)数和迟发型超敏反应 (DTH) ,脾细胞中T辅助细胞前体频数 (HTLp)及移植后小鼠脾脏T细胞亚群CD4 + CD8+ 的比值 ,评价BMT后免疫功能的恢复情况。结果　成功建立四环素诱导IL 2基因表达的基因工程化骨髓基质细胞系QXMSC1tet on IL 2。异基因BMT、联合输注QXMSC1tet on IL 2能显著提高BMT小鼠脾细胞对ConA的反应 ,增加脾脏淋巴细胞HTLp及PFC数目 ,并使DTH反应增强 ,改善小鼠脾脏T细胞亚群CD4 + CD8+ 的比值。结论　共输注可调控表达IL 2基因的骨髓基质细胞可促进异基因移植小鼠免疫功能重建。     

NK细胞在小鼠异基因骨髓移植中的作用

目的:研究自然杀伤(NK)细胞在异基因骨髓移植中对移植物抗宿主病(GVHD)、移植排斥、骨髓植入及造血重建的影响。方法:以近交系小鼠C57/6j(H-2^b)为供鼠、BALB/c(H-2^d)为受鼠,在移植物中增加供者的外周T细胞和/或NK细胞进行异基因骨髓移植,用流式细胞仪检测受鼠的CD₃₄^＋细胞计数和H-2K^b＋细胞表达水平,血细胞自动分析仪检测外周血白细胞计数,并结合临床表现和病理检查,比较不同移植组的存活率、GVHD、植入水平及造血重建等。结果:增加NK细胞组的小鼠存活率显著大于不增加NK细胞组,小鼠出现GVHD的数量少、程度轻,外周血白细胞及骨髓CD₃₄^＋细胞恢复快、H-2K^b＋细胞表达水平高。结论:NK细胞抑制小鼠异基因骨髓移植中的GVHD和移植排斥,促进骨髓植入及造血重建。     

小鼠同种异基因骨髓腔内骨髓移植促进早期造血功能重建

目的探讨同种异基因骨髓腔内骨髓移植(IBM-BMT)对小鼠早期造血功能重建的影响。方法将BALB/c小鼠骨髓单个核细胞(BMNCs)分别用胫骨骨髓腔内注射(IBMI)和尾静脉注射(IV)两种方法移植入经致死量60Coγ射线辐照后的60只C57BL/6小鼠。受鼠随机分为3组:骨髓腔内注射高和低剂量组(IBM1和IBM2组)、尾静脉注射组(IV组),每组20只。在骨髓移植后1、3、6和9d分别计数各组受鼠胫骨骨髓腔内有核细胞总数,并用流式细胞术检测供体植入水平(供体来源有核细胞总数、供体来源髓系细胞数)。结果于移植后6d,IBM1组和IBM2组注射侧胫骨骨髓腔内有核细胞总数、供体来源有核细胞总数、供体来源髓系细胞总数均明显高于IV组(P<0.05或P<0.01?。结论IBM-BMT较IV-BMT更能促进同种异基因骨髓移植后的早期造血功能重建。     

不同预处理方案对异基因骨髓移植物抗宿主病的影响

目的　建立大鼠异基因骨髓移植模型 ,应用不同的预处理方案 ,研究它们对移植物抗宿主病 (GVHD)严重程度的影响。方法　Wistar大鼠为供鼠 ,SD大鼠为受鼠 ,受鼠分 4组 ,分别予以不同的预处理方案 ,A、B组受鼠自移植前 4～ 1d ,腹腔注射氟达拉宾 (Fludarabine ,Flu) 1mg kg ,移植当天分别接受 2、6Gy的全身照射 ;C、D组受鼠在移植当天分别接受 2、6Gy的全身照射。制备供鼠骨髓细胞。照光 4h后 ,经尾静脉输注供鼠骨髓细胞 3.6× 10 7。观察各受鼠GVHD反应。结果　GVHD程度依次为 :Flu +2Gy组 <2Gy组 相似文献   

异基因骨髓移植中T细胞表达Ly49A与移植物抗宿主病发生相关

杀伤细胞抑制性受体 (ＫｉｌｌｅｒＩｎｈｉｂｉｔｏｒｙＲｅｃｅｐｔｏｒ,ＫＩＲ)是一种主要表达在ＮＫ、Ｔ细胞上的抑制性信号传递分子[1] 。鼠的ＫＩＲ分子被称为Ｌｙ4 9家族(Ｌｙ4 9Ａ Ｉ)。在细胞免疫识别阶段 ,Ｌｙ4 9分子特异地与不同的ＭＨＣＩ分子配体结合 ,传递抑制性信号 ,抑制杀伤细胞的早期活化。移植物抗宿主病(ＧＶＨＤ)主要是供者Ｔ细胞活化后对宿主细胞和组织的攻击所致。Ｌｙ4 9Ａ ＭＨＣＩ作为Ｔ细胞活化的抑制性信号传递分子 ,其在ＧＶＨＤ发生中的表达如何将有助于揭示ＫＩＲ分子参与控制ＧＶＨＤ的可能机制。本文采用…     

少量多次异基因骨髓移植的实验研究

目的：探讨少量多次异基因骨髓移植的ＧＶＨＤ反应。方法：采用不同少量异基因骨髓细胞的多次尾静脉注射。观察大小便，皮毛，体位及死亡率等ＧＶＨＤ反应一般表现。移植后不同天数进行体内混合淋巴细胞反应及嵌合体测定。外周血象及骨髓有核细胞按常规方法计数。半固体琼脂法进行骨髓ＣＦＵ－ＧＭ测定。肝、脾、小肠及皮肤病理学检查判断ＧＶＨＤ反应程度。外周血Ｌ６１５细胞及脾脏Ｌ６１５细胞比例判断ＧＶＬ作用。结果：一次性大剂量组ＧＭＨＤ反应表现明显，单纯多次异基因骨髓细胞移植的ＧＶＨＤ反应不明显，而少量多次骨髓移植组则ＧＶＨＤ反应强度界于两者之间，并且具有较好的造血恢复作用。在ＧＶＬ作用方面，一次性大剂量骨髓移植组产生较强的近期抗白血病作用，但多死于ＧＶＨＤ反应。少量多次骨髓移植１×１０６骨髓细胞及 １×１０６脾单个核细胞组抗白血病作用较强，３０ ｄ生存率达 ６０％，死亡原因主要为白血病。结论：少量多次骨髓移植可以减轻ＧＶＨＤ反应，保留部分ＧＶＬ作用。     

当归补血汤对骨髓移植小鼠免疫功能重建的影响

目的 研究当归补血汤(DBT)对骨髓移植小鼠免疫功能重建作用的影响.方法 BALB/c小鼠一次性接受全身137Csγ线致死量照射8.5Gy,照射后0-4h内经尾静脉输注同基因骨髓细胞107/只,同时给于不同剂量DBT,每日灌胃1次,连续15d.于骨髓移植后30、60d,检测以下指标:外周血红细胞(RBC)、白细胞(WBC)计数,骨髓有核细胞计数,胸腺、脾细胞总数和相应淋巴细胞亚类,以及反映免疫细胞功能的迟发型超敏反应(DTH)、空斑形成细胞数(PFC)等.结果 经一定剂量DBT治疗的骨髓移植小鼠,其外周血中RBC、WBC计数,骨髓有核细胞计数,脾细胞和胸腺细胞总数,胸腺内各类细胞[双阴性细胞(DN)、双阳性细胞(DP)、单阳性细胞(SP)]的百分比值,与单纯骨髓移植小鼠比较差异有统计学意义(P<0.05),并且淋巴细胞的功能也得到进一步增强.到移植后60d,其各项指标进一步恢复.结论 当归补血汤可以促进骨髓移植小鼠免疫功能的恢复.     

重组白细胞介素6促进骨髓移植小鼠的免疫功能重建

本文研究了重组白细胞介素6(rIL—6)对骨髓移植小鼠免疫功能重建的作用。结果表明,经致死量(950Rab)照射的 BA(?)b/c 小鼠在骨髓移植后第二天开始腹腔注射100μg/kg/天剂量的 rL—6,在骨髓移植后30天,其脾细胞对 conA 和 Lps 的增殖反应,对异型脾细胞(C_(57)BL/6)的混合淋巴细胞反应(MLR)和细胞杀伤活性(CTL)以及对绵羊红细胞(SRBC)的溶血空斑数(PFC)均较正常骨髓移植小鼠明显增强。骨髓移植后用 rIL—610天的小鼠,在移植后30天时,上述各项免疫功能已达到正常骨髓移植小鼠60天时的水平,说明 rIL—6能明显加速骨髓移植后免疫功能的重建过程.     

异基因造血干细胞移植后免疫功能重建

异基因造血干细胞移植(allo-HSCT)后患者的免疫功能受到严重损伤,移植后免疫功能低下主要表现在①免疫个体发生学过程再现的削弱;②缺乏长期稳定的供体免疫功能的转移;③移植物抗宿主病(GVHD)对免疫功能的影响;④胸腺功能的降低.临床实践证实,清髓性治疗后患者的免疫功能处于麻痹状态可以持续1年之久.     

MHC半相合骨髓移植后慢性GVHD小鼠模型的建立

目的建立MHC半相合异基因骨髓移植(allo-BMT)后慢性GVHD小鼠模型。方法以(Balb/c×C57BL/6)F1H-2d/b(CB6F1)雌性小鼠为受者,预处理条件为不同剂量的全身照射(TBI,60Co照射),输注MHC半相合Balb/cH-2d雄性小鼠骨髓细胞与不同数量脾细胞,观察移植后小鼠体质量变化,靶器官病理变化,血清抗ssDNA抗体、抗dsDNA抗体。结果在照射剂量为8Gy,输注骨髓细胞数量为8×106、脾细胞数量为4.5×107的小鼠至实验结束(移植后100d)全部存活,体质量减轻与对照组和其它实验组相比差异显著(P<0.05)。血清抗ssDNA抗体、抗dsDNA抗体较对照组和其它实验组显著升高(P<0.05)。该组皮肤、肝脏等病理改变明显。结论在照射剂量为8Gy,输注骨髓细胞数量为8×106、脾细胞数量为4.5×107的小鼠成功诱导出半相合allo-BMT慢性GVHD,为进一步研究慢性GVHD的发病机理、生物学特性、干预因素等打下了重要基础。     

慢病毒载体介导的鼠基因工程调节性T细胞对小鼠移植物抗宿主病的作用研究

目的 通过慢病毒载体介导的鼠叉状头螺旋转录因子(Foxp3)基因表达构建鼠基因工程调节性T细胞(Tr),探讨输注基因工程Tr细胞对小鼠异基因骨髓移植后移植物抗宿主病(GVHD)的影响.方法 利用慢病毒载体介导,将鼠Foxp3基因转导入BALB/c小鼠的CD4+CD25-T淋巴细胞,即为基因工程Tr细胞.建立小鼠异基因骨髓移植模型,在移植时联合输注基因工程Tr,通过受鼠移植后生存期、组织病理学改变、炎性细胞因子浓度等指标评价其防治GVHD的作用.并与单纯照射组、移植对照组、空载体对照组相比较.结果 单纯照射组、移植对照组、工程Tr组和空载体对照组小鼠存活时间分别为(8.8±0.6)d、(36.7±2.5)d、(51.6±4.0)d和(34.1±2.3)d,工程Tr组小鼠存活时间明显长于其他各组(P＜0.05).移植对照组及空载体对照组小鼠肝脏、皮肤和小肠病理切片均存在GVHD病理改变,工程Tr组长期存活小鼠的肝脏、皮肤和小肠常规病理切片结构基本正常,未见GVHD病理表现.移植后移植对照组、工程Tr组、空载体对照组受鼠血清IFN-γ、IL-2和TNF-α浓度在21～28 d时达高峰,工程Tr组在21 d时IFN-γ、IL-2和TNF-α浓度高峰较其他两组为低(P＜0.05).结论 小鼠异基因骨髓移植时联合输注基因工程Tr细胞可通过减少受鼠移植后炎性细胞因子的分泌有效减少GVHD的发生,减轻其严重程度.     

Immunohistological skin alterations in allogeneic bone marrow transplantation

Summary Skin biopsies of 26 patients with leukemia and seven patients with aplastic anemia were investigated before and at different stages after allogeneic bone marrow transplantation (BMT) to establish the immunological criteria which distinguish skin alterations during normal reconstitution from dermal lesions mediated by graft-versushost disease (GvHD). Of the 33 patients studied 27 presented with clinically diagnosed acute and/or chronic GvHD, one patient died of bone marrow rejection. Immunohistological analysis of the respective skin biopsies with selected monoclonal antibodies against human leukocyte antigens (HLA) and differentiation antigens of the lympho-hematopoietic cells revealed low dermal mononuclear cell counts with phenotypically normal constituents in five cases with uncomplicated reconstitution post-grafting. In contrast, increased dermal cellular infiltrates predominantly consisting of Lyt 3⁺, OKT 8⁺ T-lymphocytes, as well as of a large number of Ia-like (immune response associated = HLA-D) determinant⁺ monocytes/macrophages were observed in all patients with active acute/chronic GvH reactivity. As sign of activation simultaneous expression of HLA-D region products was also found on a subset of the invading OKT 8⁺ T-lymphocytes. Progression of GvHD was associated with additional surface staining of keratinocytes for Ia-like determinants. Loss of Ia-like determinant⁺, OKT 6⁺ dentritic epithelial cells in all leukemic patients, as well as in patients with aplastic anemia with or without GvHD suggested damage of Langerhans cells due to the previous radiotherapy and/or specific immunological destruction. In patients with fatal outcome of GvHD prolonged reduction of these dentritic epithelial cells seemed to be indicative of impaired immune reconstitution or bone marrow dysfunction. Thus immunopathological features of skin GvHR may enable early recognition and prognostic evaluation of this disease possibly allowing more effective therapy.Abbreviations GvHD graft-versus-host disease - GvHR graft-versus-host reactivity - SAA severe aplastic anemia - TBI total body irradiation - BMT bone marrow transplantation - HLA human leukocyte antigens - Ia-like antigens Immune-response-associated antigens - PBS phosphate buffered saline - FITC fluorescein isothiocyanate - TRITC tetramethylrhodamine isothiocyanate Supported by DFG Sonderforschungsbereich 120, Projekt A 2 and B 1Dedicated to Prof. Dr. Dr. h.c. H.E. Bock on the occasion of his 80^th birthday     

Histopathology of bone marrow reconstitution after allogeneic bone marrow transplantation

In order to study haematopoietic reconstitution in allogeneic bone marrow transplantation we investigated bone marrow histology in 61 biopsies of 37 patients, treated with HLA-compatible bone marrow grafts for leukaemia or severe aplastic anaemia. The biopsies were taken from the day of transplantation until 100 d after transplantation. Stromal changes, in particular oedema, fibrosis and granulomas, were found during the whole period of observation. These changes were more prominent in biopsies from leukaemia patients than from patients with aplastic anaemia. The cellularity in the biopsies increased until 28 d after bone marrow transplantation and was stable thereafter. Initially, only clusters of cells belonging to a single cell lineage were seen, suggesting that the first outgrowth of haematopoietic cells is by proliferation of committed precursor cells. Long-lasting abnormalities in localization of haematopoietic cells in the bone marrow space and of the myeloid: erythroid ratio were seen; dyserythropoiesis was common.     

Administration of granulocyte colony-stimulating factor to recipients followed by intra-bone marrow-bone marrow transplantation accelerates acceptance of allogeneic bone marrow cells in mice

We have recently established a novel method for bone marrow transplantation: intra-bone marrow–bone marrow transplantation (IBM–BMT), by which the rapid recovery of donor-derived hematopoiesis can be expected even when reduced radiation doses are used. In this paper, we examine, using mice, whether the combination of pretreatment of recipients with granulocyte-colony-stimulating factor (G-CSF) and IBM–BMT can induce a more rapid recovery of donor-derived hematopoiesis than IBM–BMT alone.

We first pretreated recipients with recombinant human (rh) G-CSF (250 μg/kg/day) for 5 consecutive days (days −6 to −2). On day −1, the recipients were irradiated, and IBM–BMT was carried out on day 0. On day 12, we performed colony-forming units of spleen (CFU-S) assays. The combination of G-CSF pretreatment and IBM–BMT augmented the CFU-S counts, the weight of spleens, and the numbers of donor-derived hematopoietic cells. We next analyzed the mechanisms underlying these effects of G-CSF and found that (i) G-CSF induces Th2 polarization, which can prevent graft rejection, and (ii) G-CSF augments natural suppressor activity, which suppresses graft rejection. The combination of G-CSF pretreatment and IBM–BMT can produce the rapid recovery of donor-derived hematopoiesis and suppress graft rejection. This method would lighten the burden on patients in allogeneic BMT.     

Cellular composition of the spleen after human allogeneic bone marrow transplantation

The cellular composition of the spleen has been assessed in 18 patients who died 15-326 days after receiving allogeneic marrow for leukaemia. The white pulp showed marked lymphocyte depletion with no germinal centres, very few B cells, and rare plasma cells. The marginal zone was unrecognizable but there were moderate numbers of T cells in the periarteriolar lymphatic sheaths (PALS), showing great variation in CD4/CD8 ratio. The percentage of CD4+ cells decreased with time post transplant. CD8+ cells were reduced in patients with graft-versus-host disease (GvHD) who also showed no increase in cells staining for activation markers. No T cells were detected expressing immature phenotypes and no differences were detected between patients who received marrow purged or unpurged of T cells. Macrophage numbers appeared normal. Extramedullary haemopoiesis (EMH) was predominantly in the red pulp greater than 30 days after transplantation but more commonly in the white pulp before then. Pyknotic cells were common in seven cases and appeared to be associated with EMH rather than GvHD. Chimaeric studies demonstrated small numbers of donor cells in the PALS at 26 days and larger numbers at 56 days.     

The pathology of bone marrow transplantation

Bone marrow transplantation (BMT) is increasingly being used to treat a variety of malignant and non-malignant diseases. As the toxicity of the conditioning regimen diminishes and the treatment of infection improves, graft-versus-host disease (GVHD) emerges as the main complication of allogeneic stem cell transplantation. Acute GVHD is difficult to eradicate and progression to chronic GVHD is associated with increased morbidity and mortality in long-term survivors of transplantation. GVHD primarily affects the skin, gastrointestinal tract and liver, and pathologists will be expected mainly to interpret biopsies taken from these organs. This review will therefore focus on the pathological features of GVHD with only a brief overview of other complications seen after BMT.     

Preincubation of donor bone marrow cells with a combination of murine monoclonal anti-T-cell antibodies without complement does not prevent graft-versus-host disease after allogeneic marrow transplantation

Protection of mice against graft-versus-host disease (GVHD) can be accomplished by incubating donor marrow with anti-T-cell antisera or with an anti-Thy-1 monoclonal antibody. Incubation of donor marrow with a single anti-T-cell monoclonal antibody, however, does not prevent GVHD in humans. Therefore, we carried out a clinical trial to determine the effect of treatment of donor marrow with a combination of eight anti-T-cell antibodies in the absence of complement. The nine patients were genotypically HLA identical with their donors and received methotrexate postgrafting. Prompt engraftment occurred in eight patients. Of six patients surviving at least 40 days with sustained engraftment, three had severe (grade III or IV) GVHD. Thus, there is no evidence that treatment of donor marrow with murine anti-T-cell monoclonal antibodies as described here can prevent GVHD.