杀伤细胞免疫球蛋白样受体基因多态性对造血干细胞移植后巨细胞病毒感染的影响

  目的 探讨杀伤细胞免疫球蛋白样受体（KIR）基因的多态性对造血干细胞移植后巨细胞病毒（CMV）感染的影响。方法 选择2005年10月至2011年5月行造血干细胞移植供受体138对，移植前采用序列特异性引物聚合酶链反应（PCR-SSP）对供受体KIR基因分型，移植后2周起，每周采用荧光免疫组化法检测移植后患者外周血CMVpp65抗原，分析在CMV阳性组和CMV阴性组，供受体抑制性和激活性KIR基因以及供受体KIR单体型频率的差异。结果 供受体KIR基因频率分布和供受体AA，AB，BB单体型频率分布差异无统计学意义。供体2DS2、2DS4*003-007基因在CMV阳性组频率明显低于CMV阴性组（8%比16%，P=0.0420；3%比13%，P=0.0050），受体KIR基因在CMV阳性组和阴性组频率的差异无统计学意义。供体BB单体型CMV感染率明显低于AA单体型（36.84%比64.38%，P=0.0299），受体各单体型间CMV感染率差异无统计学意义。多因素分析发现2DS4*003-007，BB单体型与CMV感染有关。结论 供体KIR 基因多态性与造血干细胞移植后CMV感染相关。   

The association of killer cell immunoglobulin like receptor gene polymorphism with cytomegalovirus infection after hematopoietic stem cell transplantation

Objective To explore the influence of the killer cell immunoglobulin like receptor (KIR) gene polymorphism on cytomegalovirus (CMV) infection and pathogenesis after hematopoietic stem cell transplantation (HSCT).Methods The KIR genotype was determined by sequence-specific primer polymerase chain reaction (PCR-SSP) in 138 pairs of donors and recipients before HSCT during October, 2005 and May, 2011. Posttransplant monitoring for CMVpp65 antigen was performed by indirect immune histochemically assays since week 2 after transplantation. The differences between CMV positive group and negative group, inhibitive and active KIR of donors and recipients, and KIR haplotype frequency of donors and recipients were analyzed.Results There were no significant differences in frequency of KIR gene and haplotype AA, AB, BB between the donors and recipients. The frequencies of 2DS2 and 2DS4*003-007 of donors in CMV positive group were obviously lower than those in CMV negative group with significant differences(8% vs 16%，P=0.0420；3% vs 13%，P=0.0050). There was no significant difference in KIR gene between CMV positive group and CMV negative group. The CMV infection rates of haplotype AA, BB, AB donors were 64.38%, 36.84% and 50.00%, while CMV infection rates of haplotype AA, BB, AB recipients were 53.73%, 46.15% and 51.72%, respectively. The CMV infection rate was higher in the patients received KIR haplotype AA donor than in those received KIR haplotype BB donor (36.84% vs 64.38%，P=0.0299). 2DS4*003-007 and haplotype BB of donor were found associated with CMV infection in multifactor analysis.Conclusion KIR genotypes of donors are associated with CMV infection after HSCT.