联合应用IL-2基因疗法和IL-3基因疗法对骨髓移植后骨髓造血及免疫功能重建的影响

本文以大剂量化疗后骨髓功能严重损伤再给予同基因骨髓移植的小鼠为实验模型动态观察了联合应用成纤维细胞介导的IL-2基因和IL-3基因疗法对同基因骨髓移植后实验小鼠骨髓造血及免疫功能重建的影响，结果表明，联合应用基因治疗能显著加快骨髓CFU-E、CFU-CK恢复过程及骨髓ML、LAK活性，     

IL-2基因疗法对骨髓移植后免疫及造血重建的影响

本文以大剂量化疗后骨髓功能严重损伤做为实验模型．动态观察了成纤维细胞介导的IL-2基因疗法对同基因骨髓移植后免疫及造血功能重建的影响。结果表明，IL-2基因疗法能显著增强实验小鼠骨髓细胞的NK活性、LAK活性及ConA刺激的增殖反应，但对骨髓CFU-GM，CFU-MK、CFU-E集落形成无影响，提示成纤维细胞介导的IL-2基因疗法能加快和增强骨髓移植后的免疫功能重建过程，提高骨髓移植抗肿瘤作用，并可减少骨髓移植后感染等并发症。该结果为IL-2基因疗法应用于骨髓移植提供了一定的实验依据．     

单克隆抗体MGb2和LAK细胞的协同抗胃癌作用

本研究探讨了成纤维细胞介导的G-CSF基因疗法联合应用IL-2基因疗法及时对小鼠I期肾癌的治疗作用。经NIH3T3-IL-2基困疗法．NIH3T3-G-CSF基因疗法单独治疗后的荷瘤小鼠存话期明显延长，而经以上两者联合治疗后的荷癌小鼠存活期的延长更为明显，且有75％荷瘤小鼠长期存活。对经G-CSF基因疗法及IL-2基因疗法联合治疗后的荷瘤小鼠体内抗肿瘤免疫功能的检测表明，经治疗后第14天，荷瘤小鼠睥脏明显增大，睥脏淋巴细胞数量明显增多；肿瘤局部的常规病理检查可见数量较多的嗜酸性粒细胞浸润。荷瘤小鼠睥细胞NK活性、经诱导后的LAK话性及CTL，杀伤活性均明显升高，小鼠腹腔巨噬细胞杀伤活性在NIH3T3-IL-2基因疗法治疗组升高．而在NIH3T3-G-CSF基因疗法组未见明显升高。以上结果表明．联合应用成纤维细胞介导的G-CSF基因疗法与IL-2基因疗法可因对小鼠体内抗肿瘤免疫功能的联合增强作用而取得更佳的抗肿瘤效果。     

IL-3,IL-6和IL-4单独或联合G-CSF及GM-CSF对小鼠异基因骨髓移植后造血重建的影响

我们检测了IL-3，Il-6和IL-4单独和联合G-CSF和GM-CSF对小鼠异基因骨髓移植后造血重建的影响．IL-3 GM-CSF是增加移植后6d中性粒细胞绝对计数最有效的联合，显示显著的协同作用。当单独给予时，IL-6和G-CSF分别显著增加移植后6d血小板计数，而在联合给予中．只有IL-3 G-CSF显著增加移植后6d的血小板计数。IL-4对移植后7d中性粒细胞恢复有显著的抑制作用．对由IL-3和G-CSF加速的中性粒细胞恢复亦有显著的抑制作用。     

T细胞信号传递途径的改变与肿瘤免疫的关系

本室曾证明粒细胞.巨噬细胞集落刺激因子(GM-CSF)基因修饰的胎肝细胞脾内移植后,能选择性移入肝脏并在其中稳定表达外源基因,促进大剂量化疗后造血功能的恢复.本研究以大剂量化疗小鼠为实验模型,探讨了脾内移植CM-CSF基因修饰的胎肝细胞对化疗小鼠全身免疫功能恢复的影响.结果表明,脾内移植GM-CSF-FL组小鼠外周血CD4~ 细胞数及CD4~ /CD8~ 比值明显升高,脾细胞对ConA及LPS的增殖反应以及脾细胞NK活性显著增强,而骨髓细胞的NK活性及对丝裂原的增殖反应与对照组相比升高不明显,提示,脾内途径的GM-CSF基因疗法对大剂量化疗机体的免疫功能有显著促恢复作用,但对骨髓细胞免疫功能的恢复疗效不明显.     

白细胞介素3基因疗法和白细胞介素6基因疗法的联合造血调控作用

本文研究了成纤维细胞介导的IL-3基因疗法，IL-6基因疗法，以及两者联合后对造血系统的影响，结果出现：单用IL-3基因疗法的小鼠白细胞总数，中性粒细胞，骨髓CFU-GM，CFU-MK等显著上升，但血小板上升程度较弱，单用IL-6基因疗法的小鼠血小板，中性粒细胞，骨髓CFU-GM．CF-MK等显著上升，     

半相合骨髓移植的动物实验研究

目的：观察半相合骨髓移植对GVHD或GVL的影响。方法：以C57，BL-6小鼠急性放射病为模型，进行半相合小鼠骨髓移植，同时设异基因骨髓移植为对照，观察移植后小鼠存活率、造血重建、GVHD或GVL作用。结果：GVHD中，半相合骨髓移植组30天死亡率低于基因骨髓移植。半相合骨髓移植与异基因骨髓移植比较，外周血象或骨髓CFU-GM恢复快，以9天以后明显，脾结节数及嵌合体测定高于异基因组。体內混合淋巴细胞反应证实半相合骨髓移植较异基因骨髓移植GVHD小。在GVL中，异基因骨髓移植组主要死于GVHD。半相合骨髓移植组30天生存率仍为56.3％，表现出明显GVL作用。结论：半相合骨髓移植在减轻GVHD同时，产生明显的GVL作用。     

rBCG-IL-2对肿瘤生长抑制作用和免疫刺激作用的研究

 目的　将表达IL-2重组BCG用于动物实验,观察其对肿瘤生长和机体免疫功能的影响。方法　采用基因工程技术和电转化技术,构建重组卡介苗即rBCG-IL-2和rBCG,并用瘤株重组BCG接种荷瘤小鼠,几周后观察肿瘤生长情况和检测巨噬细胞的杀伤活性。结果　rBCG-IL-2能表达分泌IL-2,其表达量为9.87ng/ml±4.56ng/ml,rBCG-IL-2与rBCG抑制肿瘤生长的作用明显优于对照组,并能提高小鼠巨噬细胞杀瘤率。结论　rBCG-IL-2能有效抑制肿瘤生长,较早刺激机体的免疫功能,提高巨噬细胞的杀瘤活性。     

联合应用成纤维细胞介导的G-CSF基因疗法及IL-2基因疗法对肿瘤的治疗作用

本实验观察了成纤维细胞介导的G-CSF基因疗法对大剂量化疗后造血功能损伤小鼠的恢复作用。结果发现:接受G-CSF基因治疗的实验小鼠外周血白细胞尤其是中性粒细胞降低程度明显减弱,恢复速度明显加快;并可明显促进血小板的恢复,但作用较缓;其脾脏和骨髓CFU-GM、CFU-MK、CFU-S水平显著地高于对照组,表明成纤维细胞介导的G-CSF基因疗法可显著降低大剂量化疗后造血损伤程度,并明显加速受损的造血功能的恢复。     

IL-3基因修饰的骨髓基质细胞辅助大剂量化疗后造血功能恢复

为研究基因治疗在造血功能损伤后恢复中的应用,本课题以携带小鼠IL-3基因的复制缺陷型重组腺病毒载体转染骨髓基质细胞,对大剂量化疗后的小鼠进行脾内移植观察造血功能的恢复情况.结果表明,缺陷型腺病毒载体能有效地转染小鼠原代骨髓基质细胞,转染效率在80%以上(MOI=10);基因修饰的骨髓基质细胞体外分泌IL-3的水平可达110U/ml/10~6细胞/24小时;在大剂量环磷酰胺治疗后脾内移植IL-3基因修饰的基质细胞能有效地升高实验小鼠外周血白细胞总数;病理检测发现IL-3基因修饰的基质细胞治疗组小鼠脾脏和骨髓中细胞增生较其它组明显活跃;经IL-3基因修饰的基质细胞治疗组小鼠脾淋巴细胞对ConA反应明显增强.结果提示IL-3基因修饰的骨髓基质细胞体内移植对大剂量化疗后机体造血与免疫功能的恢复都有较好的促进作用.     

成纤维细胞介导的G-CSF基因疗法促进化疗后造血功能恢复的实验研究

利用RT-PCR方法克隆到包括有全部编码序列和部分5′、3′端非编码序列的人G-CSF cDNA,并通过核苷酸测序得到证实。将其定向克隆至逆转录病毒载体pLXSN,构建成人G-CSF的重组逆转录病毒表达载体pLGSN。体外经CRE和CRIP细胞的两次包装,病毒滴度达到了临床应用的水平(1.1×10~6CFU/ml)。hG-CSF逆转录病毒感染NIH3T3小鼠成纤维细胞后,分泌G-CSF达168U/ml,Southern分析表明hG-CSF基因已整合至NIH3T3-G-CSF细胞的基因组中,Northern和Western分析分别从mRNA和蛋白质水平证实了人G-CSF在NIH3T3-G-CSF细胞的表达。将NIH3T3-G-CSF细胞植入同系小鼠体内,能从血清中检测到持续表达的G-CSF活性。本研究为开展人G-CSF基因治疗奠定了基础。     

Induction of graft versus leukemia effect in bone marrow transplantation: dosage and time schedule dependency of interleukin 2 therapy

The present work is a continuation of our studies to improve the graft versus leukemia (GVL) effect in autologous bone marrow transplantation. We have recently shown that the GVL effect of bone marrow transplantation (BMT) with interleukin 2 (IL-2)-activated bone marrow (ABM) followed by IL-2 therapy immediately after BMT is superior to the GVL effect of BMT with fresh, syngeneic bone marrow, with or without IL-2 therapy, in mice with acute myeloid leukemia. The present studies show that institution of IL-2 treatment 1, 2, or 3 weeks after BMT with ABM resulted in shortening of survival and fall in cure rate as compared to IL-2 therapy instituted immediately after BMT with ABM. Increasing the dose of IL-2 did not improve results. However, reducing the frequency of IL-2 administration to once a day instead of twice a day affected the results adversely. Commencing IL-2 therapy 1, 2, or 3 weeks after BMT with fresh, syngeneic bone marrow did not improve the GVL effect as compared to IL-2 therapy started immediately after BMT with fresh, syngeneic bone marrow. Cryopreserved bone marrow was effectively activated with IL-2 and used successfully for BMT after thawing. The animals cured of leukemia by BMT with ABM and and IL-2 therapy were not resistant to leukemia and died when reinfused with leukemic cells. Our findings suggest that for optimum GVL effect, activation of bone marrow is necessary and IL-2 therapy should be started immediately after BMT with ABM.     

Immune reconstitution following allogeneic peripheral blood progenitor cell transplantation

Delayed immune reconstitution following allogeneic stem cell transplantation remains a major clinical problem, resulting in significant transplant-related mortality from infectious complications. The recovery of immunity after bone marrow transplantation (BMT) is a complex process dependent on a large number of pre- and post-transplant factors. It has been suggested that the use of peripheral blood instead of bone marrow as stem cell source may accelerate immune reconstitution after allogeneic transplantation. Some authors have recently reported a more rapid recovery of the number and function of T and B cells after allogeneic peripheral blood progenitor cell transplant (allo-PBPCT) in comparison with conventional BMT, results which would reflect the high number of lymphocytes infused to the patients. Such a rapid immune recovery could indeed contribute to the apparent therapeutic advantage of PBPCT when compared with BMT. However, there is limited knowledge on this issue and randomized trials are required to prove whether allo-PBPCT is indeed superior to BMT in terms of immune reconstitution post-transplant. A review of some quantitative and functional aspects of immune recovery after allo-PBPCT is presented in this article.     

自体骨髓移植联合MHC单倍体相合淋巴细胞治疗急性髓性白血病的临床疗效

目的:自体骨髓移植联合MHC单倍体相合淋巴细胞治疗急性髓性白血病的治疗效果和安全性。方法:以40例急性髓性白血病患者作为研究对象,随机分为两组各20例,研究组患者使用自体骨髓移植联合MHC单倍体相合淋巴细胞进行治疗,对照组单用自体骨髓移植进行治疗。结果:两组患者的造血系统都得到重建,重建时间以及并发症的发生均没有显著差异。而研究组患者复发率显著降低,且复发时间明显地长于对照组患者。研究组患者3年累积无病生存率明显地高于对照组患者,且差异具有统计学意义。结论:自体骨髓移植联合MHC单倍体相合淋巴细胞治疗能够有效控制急性髓性白血病病情,降低其复发,延长患者生存期。     

Use of recombinant human interleukin-2 in conjunction with bone marrow transplantation as a model for control of minimal residual disease in malignant hematological disorders: I. Treatment of murine leukemia in conjunction with allogeneic bone marrow transplantation and IL-2-activated cell-mediated immunotherapy.

Immunotherapy with recombinant human interleukin-2 (IL-2) and allogeneic spleen cells has led to significant antitumor effects in B-cell leukemia- (BCL1) bearing mice following transplantation with T-lymphocyte-depleted allogeneic bone marrow cells. Graft versus leukemia (GVL) effects were studied in a model mimicking minimal residual disease following bone marrow transplantation (BMT). Lethally irradiated (BALB/c x C57BL/6)F1 recipients were reconstituted with 20 x 10(6) T-lymphocyte-depleted C57BL/6 bone marrow cells mixed with 10(4) to 10(6) BCL1 cells followed by administration of sequential increments of allogeneic C57BL/6 spleen cells; 10(6) cells on Day +1, 10(7) cells on Day +5, and 5 x 10(7) cells on Day +9, with or without concomitant IL-2 treatment (intraperitoneal injections of 20,000 U twice daily for 3 days) together with each spleen cell administration. All mice receiving 10(4)-10(6) BCL1 cells developed marked splenomegaly by Day +21 and all adoptive recipients of 10(5) spleen cells obtained from these mice developed leukemia within 21-36 days. Treatment of mice which received 10(4) BCL1 cells by either three courses of low dose IL-2 or three increments of allogeneic spleen cells alone and certainly by a combination of both resulted in normalization of splenomegaly on Day +21, but only adoptive recipients of 10(5) spleen cells obtained from mice treated by both allogeneic spleen cells and IL-2 (10/10) or allogeneic spleen cells alone (8/10) were disease free (greater than 100 days). Mice inoculated with 10(5) BCL1 cells developed mild splenomegaly on Day +21 after IL2 treatment alone, but showed no clinical evidence of disease following administration of allogeneic spleen cells or both allogeneic spleen cells and IL-2. Following adoptive transfer of 10(5) spleen cells obtained from each treated group no leukemia (greater than 100 days) was evident in recipients of spleen cells obtained from mice treated with both allogeneic spleen cells and IL-2 (10/10) whereas a partial effect was observed in mice treated by allogeneic spleen cells only (4/10). Mice inoculated with a high dose of BCL1 cells (10(6] showed some delay in onset of splenomegaly, but no curative antileukemic effects could be observed even following a synergistic combination of IL-2 and allogeneic spleen cells. Our data suggest that immunocompetent allogeneic lymphocytes may play an important role against leukemic relapse and thus cell therapy may be used therapeutically to treat minimal residual disease after BMT even following initial reconstitution with T-cell-depleted bone marrow cells.(ABSTRACT TRUNCATED AT 400 WORDS)     

粒细胞集落刺激因子减轻混合骨髓移植后移植物抗宿主病的实验研究

Objective: How to reduce the incidence and severity of acute graft-versus-host disease (aGVHD) is a crucial step to improve the overall survival of allogeneic bone marrow transplantation (allo-BMT). The low incidence of severe aGVHD observed in allogeneic peripheral blood stem cell transplantation (allo-PBSCT), which may be related to modulating immune function of T lymphocytes by granulocyte colony-stimulating factor (G-CSF) primed donors. The study aimed to explore whether aGVHD could be alleviated by syngeneic bone marrow mixed with G-CSF-mobilized H-2 haploidentical marrow grafting. Methods: Female BALB/c mice and neonatal BALB/c mice were recipients and male (BALB/c × C57BL/6)F1(BCF1) mice were donor mice respectively. Donor mice were injected subcutaneously with G-CSF daily at 0.01 μg/g body weight or saline for 6 days, and splenocytes were harvested on day 6. Spleen index (SI) represented GVHD in neonatal mice after the intraperitoneal injection of mixed spleen cells. Lethally irradiated (60Co, 8.5 Gy) adult mice were transplanted with a mixture of syngeneic plus G-CSF-mobilized (control diluents) H-2 haploidentical marrow cells. Survival time and survival rate of the recipients were observed after mixed marrow transplantation (MBMT). GVHD was assessed by observing signs of weight loss, ruffled fur, diarrhea and histological change of skin, liver and small intestines. Enzyme-linked immunosorbent assay (ELISA) method was used to detect cytokines (IL-2, IL-4 and INF-γ). Fluorescence-activated cell sorting (FACS) analysis was used to detect T cells phenotype. Results: (1) The neonatal mice subject to injection of 2:1 and 1:1 mixed spleen cells and H-2 haploidentical spleen cells all suffered from aGVHD. The severity of aGVHD in recipient mice receiving G-CSF-mobilized splenocytes was dramatically reduced. (2) The aGVHD signs and histological change were observed in most mice of 2:1 and 1:1 MBMT groups. However, the survival time of G-CSF-mobilized MBMT was longer than in control groups and these mice had signs of moderate GVHD. (3) L3T4 cells and relative ratio in both subsets was significantly reduced in G-CSF-treated donor mice. The total number of Thy1.2 and lyt2 cells was increased after G-CSF pretreatment of donors, but no statistical difference. (4) The supernatants from a primary MLR were collected at 48 h for cytokine measurement. The results showed an increased production of IL-4 and a decreased production of IL-2 and INF-γ after stimulating with concanavalin A for 48 h. Conclusion: The GVHD could be reduced using syngeneic bone marrow mixed with H-2 haploidentical marrow cells. The severity of aGVHD in recipient mice receiving G-CSF-mobilized splenocytes or marrow cells could be further moderated, which is associated with increased IL-4 production and decreased IL-2 and INF-γ production.