造血干细胞移植受者外周血中单核细胞趋化蛋白2水平变化与急性移植物抗宿主病发生相关性探讨  

Correlation between serum level of monocyte chemoattractant protein-2 and acute graft-versus-host disease in patients after allogeneic hematopoietic stem cell transplantation

作　　者：许多荣[1] 杨茂华[1] 张祥忠[1] 彭爱华[1] 许辉茹[1] 邹外一[1] 黄珊[1] 李娟[1] 

机构地区：[1]中山大学附属第一医院血液科,广州510080

出　　处：《中华移植杂志（电子版）》2009年第4期285-288,共4页Chinese Journal of Transplantation(Electronic Edition)

基　　金：国家自然科学基金资助课题(30670997);教育部归国人员启动基金资助课题(2005546);广东省科技计划资助课题(B080703055);中山大学附属一院优秀青年人才支持计划资助课题(18700108)

摘　　要：目的探讨白血病患者异基因造血干细胞移植(allo-HSCT)术后外周血中单核细胞趋化蛋白2(MCP-2/CCL8)水平的变化与急性移植物抗宿主病(aGVHD)发生之间的关系。方法以10例白血病自体造血干细胞移植(auto-HSCT)患者作为对照,采用酶联免疫分析法检测31例行allo-HSCT白血病患者(观察组)干细胞回输前1d(-1d)、回输后7d(+7d)外周血中CCL8、TNF-α和IL-2的水平;同时,对观察组受者+7d后每7d动态监测上述指标,至+98d结束。结果对照组和观察组+7d时血浆中CCL8、TNF-α和IL-2的中位水平与-1d时比较,各指标均无明显改变(均P>0.05)。观察组中共11例发生了aGVHD。11例受者在诊断aGVHD时,IL-2水平与+7d时比较无明显变化(P>0.05),但CCL8和TNF-α水平较+7d时明显升高(均P<0.05);经抗aGVHD治疗获得完全缓解后,血浆中CCL8、TNF-α水平又降至+7d时水平(均P<0.05);aGVHD患者血浆CCL8水平首次升高至出现aGVHD临床症状的平均间隔时间为(7.0±1.6)d,而TNF-α水平变化的间隔时间则为(2.4±1.1)d,两者比较差异具有统计学意义(P<0.05)。结论CCL8可能参与了allo-HSCT受者aGVHD的发生,而且其血浆水平出现显著变化的时间要早于TNF-α。Objective To explore the relationship between the serum level of monocyte chemoattractant protein-2 (MCP-2/CCL8) and acute graft-versus-host disease (aGVHD) in leukemia patients after allogeneic hematopoietic stem cell transplantation(allo-HSCT).Methods The serum levels of CCL8,TNF-α,and IL-2 in 31 allo-HSCT patients were detected with enzyme-linked immunosorbent assay on the day before (-1 d) and the 7th day (+7 d) after stem cell infusion.Another 10 leukemia patients with autologous stem cell transplantation (auto-HSCT) served as controls.The serum levels of above cytokines were measured in allo-HSCT patients every 7 days after +7 d.Results The median serum levels of CCL8,TNF-α,and IL-2 were not significant different between-1 d and +7 d in both auto-and allo-HSCT groups (P>0.05).Eleven of the 31 patients experienced aGVHD after allo-HSCT,whose serum levels of CCL8 and TNF-α were significantly higher than those on +7 d when clinical symptoms of aGVHD appeared (P<0.05),but no changes to the serum level of IL-2 (P>0.05).When complete remission was achieved after anti-aGVHD treatment,the serum levels of CCL8 and TNF-α returned to baseline on +7 d (P<0.05),and the level of IL-2 remained stable (P<0.05).The average interval time from increasing of the levels of CCL8 and TNF-α to appearance of clinical manifestations of aGVHD were (7.0±1.6) days and (2.4±1.1) days,respectively,and significant difference was noted between them (P<0.05).Conclusion CCL8 may involve in the pathophysiology of aGVHD after allo-HSCT,and the change of its serum level occur earlier than that of TNF-α.

关 键 词：急性移植物抗宿主病 异基因造血干细胞移植 单核细胞趋化蛋白2 Α肿瘤坏死因子 白细胞介素2 

分 类 号：R457.1[医药卫生—治疗学]