异基因造血干细胞移植后合并慢性移植物抗宿主病患者T细胞免疫状态的研究  

The Research for the Status of Immune Reconstitution in Leukemia Patients with cGVHD After Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：符粤文[1] 吴德沛[1] 冯宇锋[1] 常伟荣[1] 朱子玲[1] 朱平[2] 

机构地区：[1]苏州大学附属第一医院血液科,江苏苏州215006 [2]北京大学第一医院血液实验室,北京100034

出　　处：《苏州大学学报（医学版）》2006年第5期774-776,779,共4页Suzhou University Journal of Medical Science

基　　金：卫生部科研基金资助项目(wjk2004);江苏省135重点人才基金资助项目(RC2002033);苏州大学附一院血液病学科135工程开放

摘　　要：目的 研究异基因造血干细胞移植后合并慢性移植物抗宿主病（cGVHD）时的T细胞免疫状态。方法 应用RT-PCR扩增14例白血病异基因造血干细胞移植后合并cGVHD患者及5名正常供者的外周血T细胞受体（TCR）BV24个家族的基因序列，并通过基因扫描的方法判断TCRBV家族的克隆表达情况、CDR3克隆性质，并计算BV家族的利用率。结果 在移植后6～19个月，所有患者TCRBV家族的利用仍处于不均一状态，检测到部分BV家族缺失，部分家族出现寡克隆、单克隆T细胞增殖。在24个BV家族的表达为6／24～15／24，并且均出现1～5个单克隆家族表达。单克隆及双克隆表达分布在不同的BV家族，未发现共用的BV家族。结论 异基因造血干细胞移植后合并cGVHD患者的T细胞免疫存在缺陷。在不同的TCRBV家族出现与cGVHD相关的克隆增殖的T细胞克隆。Objective To explore the status of immune reconstitution in leukemia patients with cGVHD after allogeneic hematopoietic stem cell transplantation （Allo-HSCT）. Methods The peripheral blood from 14 patients with cGVHD after Allo-HSCT was obtained, 24 subfamily genes of TCR BV was used to amplify. The control included five normal donors. The PCR products were further analyzed by genescaning to evaluate the clonality of BV subfamily and characteristics of CDR3 and calculate usage rate in TCR BV subfamily. Results 6 month to 19 months after Allo-HSCT, The usage of TCRBV subfamily was still skew. It can be detected that some BV subfamilies were missing, others expanded in monoclonal or oligoclonal. Among 24 BV subfamilies , there were only 6- 15 expressed and 1- 5 of them were monoclonal expressed. The monoclonal or oligoclonal clones existed in different 24 BV subfamilies, none of clones appeared to share the same BV subfamilies. Conclusion In 1.5 years after Allo-HSCT, The status of T cell immune reconstitution is still deficient for leukemia patients with cGVHD, In different BV subfamilies, it exists that monoclonal or oligoclonal clones associate with cGVHD.

关 键 词：造血干细胞移植 CGVHD TCR BV CDR3 

分 类 号：R392.4[医药卫生—免疫学]