非清髓造血干细胞移植后致敏供者淋巴细胞输注对嵌合状态及GVHD影响的实验研究

本研究目的是探讨经受者皮肤致敏后的异基因供者淋巴细胞输注(DLI)是否能在促进形成完全供者嵌合(CC)的同时减轻移植物抗宿主病(GVHD)。以C57BL/6小鼠(H-2b,B6)为受者,于第0天接受60Coγ线全身照射(TBI),总剂量为5.5Gy,照射当天移植经粒细胞集落刺激因子(G-CSF)动员后的BALB/c小鼠(H-2d,BA)外周血干细胞(2×107个),移植后第2天腹腔注射环磷酰胺200mg/kg,并分别于移植后第28天输注致敏/未致敏的供者淋巴细胞2×106。结果显示,致敏后DLI的受鼠(黑色)无1例出现GVHD,60天时转变为完全供者嵌合,表型明显呈现为供鼠(白色)特征,CD4+/CD8+T淋巴细胞比值在DLI后早期下降,半月后有所升高,但仍低于正常水平;未致敏的DLI受鼠出现不同程度的GVHD,嵌合率稍有上升,仍表现为混合嵌合体(MC),CD4+/CD8+比值在DLI后早期升高,后期降至正常水平。结论:经受者皮肤致敏后的DLI在诱导CC的同时降低GVHD发病率,CD4+/CD8+比值与GVHD发病率间具有良好的相关性。

Effects of Sensitized Donor Lymphocyte Infusion on the Chimerism and Graft-versus-Host Disease after Nonmyeloablative Allogeneic Stem Cell Transplantation

To explore whether the complete donor chimerism could be achieved and graft-versus-host disease could be alleviated by donor lymphocyte infusion which was sensitized by the skin of the recipient, female C57BL/6 mice (H-2(b), B6) as recipients received total body irradiation (TBI) of 5.5 Gy ((60)Co gamma-ray) on day 0 followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT). The allo-grafts consisted of 2 x 10(7) peripheral hematopoietic stem cells from mobilized male BALB/c (H-2(d)) donor mice with the granulocyte colony-stimulating factor (G-CSF). Day 2 after allo-HSCT, the recipient mice were given 200 mg/kg cyclophosphamide intraperitoneally. Afterwards these recipient mice were infused 2 x 10(6) sensitized or unsensitized-donor lymphocytes at the 28 days after transplantation. The results showed that the mice receiving sensitized-donor lymphocyte infusion did not suffer from GVHD and the phenotypic character of the recipient mice (black color) converted to that of the donor mice (white color), and to become full-donor chimerism. It was found that the ratio of CD4(+)/CD8(+) T lymphocytes of them decreased at the earlier period and increased after half month, but which were also lower than that of the normal value. While various grades of acute GVHD was observed in that of the control group and the mixed-chimeras were maintained, though it increased a little, and the ratio of CD4(+)/CD8(+) T lymphocytes increased at first, then decreased to the normal level half month later. It is concluded that sensitized DLI converted mixed to complete donor chimerism without GVHD, and the rate of CD4(+)/CD8(+) has close relation to the incidence of GVHD.