异基因外周造血干细胞移植后CD4^＋ CD25^＋调节性T细胞与GVHD关系的研究

目的:研究异基因外周血干细胞移植(Allo-PBSCT)后CD4 CD25 调节性T细胞(CD4 CD25 Tregs)与急、慢性移植物抗宿主病(a/cGVHD)的关系。方法:采用流式细胞术动态监测50例血液病恶性肿瘤患者Allo-PBSCT过程中,在移植前、植入时、植入后 30d、 60d、 120d、 360d外周血CD4 CD25 Tregs在CD4 T细胞中的百分含量。结果:Allo-PBSCT过程中,CD4 CD25 Tregs的百分含量在植入时降到最低,然后逐渐回升, 180d最高, 360d回落到移植前水平。发生aGVHD患者外周血的CD4 CD25 Tregs百分含量与无aGVHD患者无显著性差异,发生cGVHD患者CD4 CD25 Tregs百分含量较无cGVHD患者显著性增加。结论:Allo-PBSCT术后发生aGVHD时,受者调控CD4 CD25 Tregs数量的功能尚未恢复正常,发生cGVHD时,CD4 CD25 Tregs的数量可以反馈性地增加,但由于多种原因,CD4 CD25 Tregs难以抑制cGVHD的发生。

Relationship Between CD4 + CD25+ Regulatory T cells and Graft Versus Host Disease After Allogeneic Peripheral Blood Stem Cell Transplantation

Objective:To investigate the relationship between CD4 CD25 regulatory T cells (CD4 CD25 Tregs) and acute/chronic graft versus host disease (a/cGVHD) after allogeneic peripheral blood stem cell transplantation(Allo-PBSCT).Methods: The percentage of CD4 CD25 Tregs of peripherial blood in CD4 T cells in fifty patients with hematological malignancies were detected by flow cytometry in the course of Allo-PBSCT on pretransplantation,during transplantation, day 30, day 60, day 90, day 180, day 360 respectively in order to observe the dynamic changes. Results: The percentage of CD4 CD25 Tregs declined to minimum on transplantation day in the course of Allo-PBSCT,then increased gradually,with maximum on day 180 and restored to the pretransplantation level on day 360. There was no significant differnce in the percentage of CD4 CD25 Tregs in the peripheral blood between patients with aGVHD and those without aGVHD. The percentage of CD4 CD25 Tregs in the peripheral blood of patients with cGVHD increased significantly compared with those without cGVHD.Conclusion: In recipients with aGVHD the regulatory of the numbers of CD4 CD25 Tregs do not restore completely after Allo-PBSCT. The numbers of CD4 CD25 Tregs increase because of the feedback reaction to cGVHD,but they can not inhibit the onset of cGVHD for many reasons.