外周血干细细移植后GVHD的动态监控可溶性人类白细胞抗原-I及临床意义  

Dynamic monitoring of graft-versus-host disease after allogeneic peripheral blood stem cell transplantation by soluble HLA-I antigen detection

作　　者：夏荣[1,2] 邱慧颖[1] 章卫平[1] 曹琼[3] 兰炯采[3] 温宏升[1] 王健民[1] 

机构地区：[1]第二军医大学长海医院血液科 [2]南方医科大学南方医院输血科,广东广州510515 [3]南方医科大学南方医院输血科

出　　处：《第一军医大学学报》2005年第6期687-690,695,共5页Journal of First Military Medical University

基　　金：南方医科大学南方医院院长基金~~

摘　　要：目的研究动态监测可溶性人类白细胞抗原-I(sHIA-I)血清浓度对预测异基因外周血干细胞移植(allo—PBSCT)后移植物抗宿主病(GVHD)的意义。方法采用酶联免疫吸附试验fELISA)双抗夹心法，以W6／32单克隆抗体包被酶标板．加被检血清．再加抗B2m辣根过氧化物酶及底物显色。测定63名中国汉族正常献血员sHLA—I含量，并对24例异基因外周血干细胞移植患者移植前及移植后不同时间段血清sHLA-I含量进行连续检测。结果6例未发生GVHD和4例仅发生Ⅰ度GVHD移植受者sHLA-I水平在移植前后无明显变化(P>0．05)；而发生Ⅱ-Ⅳ度GVHD的14例移植患者在发生GVHD前3～7d．sHIA-I浓度就有统计学意义的升高(P<0．05)．在GVHD期升高程度更明显，具有显著性差异(P<0．005)。经免疫抑制剂冲击治疗至稳定期又降至基础水平。结论动态监控allo-PBSCT患者血清中sHLA—I含量对预测外周血干细胞移植后GVHD及治疗效果和预后有重要意义。Objective To assess the value of dynamic monitoring of soluble human lymphocytic antigen-I (sHLA-I) in the prediction of graft-versus-host disease (GVHD) after allogeneic peripheral blood stem cell transplantation (PBSCT). Method Sandwich enzyme-linked immunosorbent assay (ELISA) was used to quantitatively detect serum sHLA-I. The serum samples for testing were added into W6 32 monoclonal antibody-coated microtiter plate and incubated with anti-β2m HRP followed by color development with the addition of the substrate. Serum sHLA-I level was measured in 63 healthy blood donors of Shanghai and in 24 PBSCT recipients before and and at different time points after the operation. Result No changes in sHLA-I levels occurred in allogeneic PBSCT recipients without GVHD or with only gradeⅠGVHD, but sHLA-I reached high levels in patients suffering GVHDⅡ-Ⅳ(P<0.05), which was effectively lowered by the application of immunosuppressants. Conclusion Measurements of sHLA-I levels can be valuable for monitoring GVHD after PBSCT.

关 键 词：造血干细胞移植 移植物抗宿主病 人类白细胞抗原 动态监控 

分 类 号：R457.7[医药卫生—治疗学]