IL-21、IL-4在急性移植物抗宿主病中的临床研究

目的探讨IL-21和IL-4等细胞因子在异基因造血干细胞移植(allo-HSCT)后急性移植物抗宿主病(Acute Graft-Versus-Host,aGVHD)发病机制中的变化规律。方法 20例白血病患者通过异基因造血干细胞移植治疗,统计aGVHD的发生率,采集20例患者移植前后的外周血,双夹心酶联免疫吸附法(ELISA)检测外周血中IL-21、IL-4的浓度。结果 (1)allo-HSCT后20例患者全部获得重建造血功能,中性粒细胞恢复到0.5×109/L及血小板恢复到20×109/L的中位时间分别为移植后13.5 d及18 d;(2)发生急性移植物抗宿主病的患者,IL-21浓度较移植前明显升高,IL-21浓度在aGVHD阳性组明显高于aGVHD阴性组(P<0.01)。但IL-4的浓度较移植前明显减低,而且IL-4的浓度在aGVHD阳性组明显低于aGVHD阴性组(P<0.01)。结论 (1)IL-21在急性移植物抗宿主病的发病中起重要的正向调节作用,而IL-4则起负向调节作用;(2)检测allo-HSCT后患者血清的IL-21、IL-4水平,有助于预测急性移植物抗宿主病的发生。

Effect of IL-21,IL-4 on Acute Graft-Versus-Host Disease

Objective To study the effect of IL-21、IL-4 on acute graft-versus-host disease（aGVHD） after allogeneic hemopoietic stem cell transplantation（allo-HSCT）.Methods The aGVHD was observed in 20 patients with allo-HSCT.The peripheral blood of 20 patients was collected before and after transplantion,the concentration of IL-21、IL-4 was detected by enzyme-linked immunosorbentassay（ELISA）.Results The haematogenesis of 20 patients recovered after the allogeneic hemopoietic stem cell transplantation.The median-time that neutrophilic granulocyte recovered to 0.5×109/L was 13.5 days,the median-time that platelet recovered to 20×109/L was 18 days.The concentration of IL-21 in patients with aGVHD significantly increased more than that in patients without aGVHD（P0.01）,while that of IL-4 decreased significantly.Conclusion IL-21 has the up-regulated function in Agvhd,and IL-4 has down-regulated function.It might be valuable to detect the concentration of IL-21 after transplantation for predicting aGVHD.