rhG-CSF动员对健康供者外周血淋巴细胞亚群和免疫功能的影响

目的探讨重组人粒细胞集落刺激因子(rhG-CSF)动员对健康供者外周血淋巴细胞亚群和免疫功能状态的影响。方法 2017年1月-2018年3月在广州军区广州总医院血液科进行外周血造血干细胞动员及采集的健康供者57例,使用rhG-CSF 5~10μg/(kg·d)连续5 d皮下注射进行外周血造血干细胞动员,于动员第0、3、5天采集供者外周血,使用流式细胞术检测淋巴细胞亚群,使用全自动生化仪检测免疫功能五项。结果动员第0、3、5天供者外周血中,总淋巴细胞百分比下降,动员第5天下降尤为明显(P<0.05)。总T细胞(CD3^+)、辅助/诱导T淋巴细胞(CD3^+CD4^+)、总B淋巴细胞(CD19^+)亚群比例在动员第3天上升,第5天降低,但差异无统计学意义(均P>0.05)。抑制/细胞毒T淋巴细胞(CD3^+CD8^+)、NK细胞(CD3^-CD56^+)细胞亚群在动员后呈下降趋势,但差异无统计学意义(均P>0.05)。CD4^+/CD8^+比值有上升趋势,但差异无统计学意义(P>0.05)。动员第0、3、5天供者外周血中免疫球蛋白(IgA、IgG、IgM)和补体(C3、C4)水平无明显变化(均P>0.05)。结论 rhG-CSF动员不影响健康供者外周血淋巴细胞亚群和免疫功能,能安全应用于造血干细胞动员。

Effect of rhG-CSF mobilization therapy on circulating lymphocyte subsets and immune function in normal stem cell donors

Objective To investigate the effects of recombinant human granulocyte colony-stimulating factor (rhG-CSF) mobilization therapy on lymphocyte subsets and immune function in peripheral blood of the normal stem cell donors. Methods Hematopoietic stem cell mobilization and collection were performed on 57 normal stem cell donors in the Department of Hematology, General Hospital of Guangzhou Military Command from January 2017 to March 2018. RhG-CSF (5-10 μg·kg-1·d-1) was administered subcutaneously for 5 days to mobilize hematopoietic stem cells (HSCs). Peripheral blood from donors was collected on the 0th, 3rd, and 5th day after the mobilization therapy. Then lymphocyte subsets were detected by using flow cytometry. Immunoglobulins and complements were detected by using automatic biochemical analyzer. Results In the peripheral blood of donors on day 0, 3, and 5 after mobilization therapy, the percentage of total lymphocytes decreased, and the decrease was particularly significant on the 5th day of mobilization (P<0.05). The proportion of total T cells (CD3+), T helper cells (CD3+CD4+), and B lymphocytes (CD19+) increased on the 3rd day of mobilization and decreased on the 5th day, but the difference was not statistically significant (P>0.05). The subpopulations of cytotoxic T lymphocytes (CD3+CD8+) and NK cells (CD3-CD56+) showed a downward trend after mobilization, but the difference was not statistically significant (P>0.05). The CD4+/CD8+ ratio showed an upward trend, but without statistically significance (P>0.05). There were no significant changes in the levels of immunoglobulins (IgA, IgG, IgM) and complements (C3, C4) in the peripheral blood of the donors on days 0, 3 and 5 of mobilization (P>0.05). Conclusion The rhG-CSF mobilization therapy does not affect lymphocyte subsets and immune function in the peripheral blood of normal stem cell donors, which can be safely applied to hematopoietic stem cell mobilization.