儿童异基因造血干细胞移植后早期调节性T细胞及iNKT细胞重建与aGVHD的关系

本研究旨在探讨儿童患者异基因造血干细胞移植后90d内调节性T细胞及iNKT细胞重建与急性移植物抗宿主病（aGVHD）的关系。对29例进行异基因造血干细胞移植的儿童患者分别于移植术后15d、30d、60d、90daGVHD发生时、糖皮质激素治疗后2周测定外周血淋巴细胞中CD4＋CD25＋CD127low Treg细胞、CD3＋TCRVα24＋iNKT细胞的比例。根据是否发生aGVHD将患者分为non-aGVHD组和aGVHD组，比较两组患者移植后90d内（15d、30d、60d、90d）外周血淋巴细胞中Treg细胞和iNKT细胞的比例有无差异；根据aGVHD患者对于糖皮质激素的治疗反应分为糖皮质激素治疗有效组和糖皮质激素治疗抵抗组，比较两组患者aGVHD发生时和糖皮质激素治疗后2周外周血淋巴细胞中Treg细胞、iNKT细胞的比例有无差异。结果显示：non—aGVHD组患者移植后15dTreg细胞比例显著高于aGVHD组患者（P=0．040）；non-aGVHD组患者与aGVHD组患者移植后90d内（15d、30d、60d、90d）外周血淋巴细胞中iNKT细胞比例无显著差异，但是non—aGVHD组患者15diNKT／T细胞的比值显著高于aGVHD组患者（P=0．025）。结论：对儿童异基因造血干细胞移植患者移植后早期联合监测Treg细胞和iNKT细胞的恢复情况，可能有助于aGVHD的早期发现和治疗。

Relation of Treg and iNKT Cell Reconstruction with aGVHD after Allogenetic Hematopoietic Stem Cell Transplantation in Chidren

This study was aimed to explore the relation of Treg and invariant natural killer T （iNKT） cell reconstruction with acute graft-versus-host disease （aGVHD） after allogeneic hematopoietic stem cell transplantation （allo-HSCT） in chidren. According to the occurence or absence of aGVHD, 29 pediatric patients who underwent allo- HSCT were firstly divided into two groups non-aGVHD and aGVHD group, then those patients with aGVHD were divided into steroid effective group and steroid resistent group according to their reaction to the steroid treatment. Flow cytometry was used to detect the frequency of Treg cells and iNKT cells in the peripheral blood of the recepients at different time after allo-HSCT （d 15, d 30, d 60, d 90, the time of aGVHD onset and two weeks after steroid treatment）. The result showed that the frequencies of Treg cells and the iNKT/T ratio on day 15 in non-aGVHD group were significantly higher than those in the aGVHD group （ P 〈 0.05 ）. It is concluded that a combined monitoring strategy of Treg and iNKT cell reconstruction early after allo-HSCT may facilitate the diagnosis and treatment of aGVHD in children.