同种异基因造血干细胞移植受者血清白介素18水平与急性移植物抗宿主病的关系  

Correlation between Serum Levels of IL-18 and Acute Graft Versus Host Disease in Patients after Allogeneic Hematopoietic Stem Cell Transplantation

作　　者：柳金[1] 张献共[2] 陆道培[1] 

机构地区：[1]北京大学人民医院血液病研究所 [2]北京大学深圳医院血液科,深圳518036

出　　处：《中国实验血液学杂志》2007年第3期553-557,共5页Journal of Experimental Hematology

基　　金：深圳市科技局2004科技三项经费重点资助项目(编号2004081330000008)

摘　　要：本研究探讨同种异基因造血干细胞移植(allo-HSCT)受者血清白介素18(IL-18)与急性移植物抗宿主病(aGVHD)的关系,查明血清IL-18在aGVHD发病中的作用,为临床早期预测aGVHD提供可靠指标。采用双夹心酶联免疫吸附法(ELISA)检测62例allo-HSCT患者移植前及移植后aGVHD发生前后血清IL-18表达水平。62例患者被分为5组:A组为无aGVHD移植前组(28例),指移植后没有发生aGVHD的患者在移植前收集的标本;B组为有aGVHD移植前组(34例),指移植后发生aGVHD的患者在移植前收集的标本;C组为aGVHD症状前组(34例),指临床出现I-II级aGVHD症状前3-4天的标本;然后根据I-II级aGVHD患者治疗后,有无进展至III-IV级回顾性地将aGVHD前组患者分为疗效好组(18例)和疗效差组(16例);D组为I-II级aGVHD组;E组为III-IV级aGVHD组(16例)。结果表明:34例患者发生I-II级aGVHD,其中16例aGVHD进展至III-IV级;发生aGVHD患者的血清IL-18表达水平显著高于未发生aGVHD患者,血清IL-18表达水平上升发生在aGVHD临床症状出现前3天左右;血清IL-18表达水平与aGVHD的严重程度呈正相关,与HLA配型、预处理方案及感染无关;aGVHD早期血清IL-18表达水平与预后相关;血清IL-18高表达者aGVHD容易进展至III-IV级。结论:血清IL-18与aGVHD的发病相关联,检测血清IL-18水平有助于aGVHD早期诊断,血清IL-18表达水平可作为评估aGVHD病情、判断预后的指标。This study was aimed to investigate the correlation between the serum levels of IL-18 and acute graft versus host disease （aGVHD） in patients received allogeneic hematopoietic stem cell transplantation （ allo-HSCT）, and to explore the role of serum IL-18 levels in the pathogenesis of aGVHD so as to provide a reliable and early indicator for the diagnosis of aGVHD. 62 patients received allo-HSCT were enrolled in this study. Before and after transplantation, as well as at onset of aGVHD, the serum levels of IL-18 were analyzed by ELISA. 62 patients were divided into 5 groups： group A without aGVHD （28 cases） referred to the patients who had no aGVHD after transplantation and whose specimen were collected before transplantation; group B with aGVHD before transplantation （34 cases） referred to the patients who had aGVHD after transplantation and whose specimen were collected before transplantation; group C before the onset of aGVHD （34 cases） referred to patients with Ⅰ -Ⅱ grade a GVHD whose specimen were collected before 3 - 4 days, and according to whether the Ⅰ -Ⅱ grade aGVHD patients developed Ⅲ-Ⅳ grade or not after treatment, these patients were divided into two subgroups retrospectively, one subgroup had good curative effect （ 18 cases） and the other subgroup had not （16 cases） ; group D with Ⅰ -Ⅱ grade aGVHD; group E with Ⅲ-Ⅳ grade aGVHD （16 cases）. The results showed that 34 patients developed Ⅰ -Ⅱ grade aGVHD, then out of them 16 patients （16/34） developed Ⅲ-Ⅳ grade aGVHD. The serum levels of IL-18 in these patients with aGVHD were higher than that in patients without aGVHD. About 3 days before onset of aGVHD, the serum levels of IL-18 started to increase. The serum levels of IL-18 were correlated with the severity of aGVHD, but no correlation was found with infection, conditioning regimens and disparity of HLA-typing. The serum levels of IL-18 in the early stage of aGVHD were correlated with prognosis. The aGVHD of patients with higher serum

关 键 词：同种异基因造血干细胞移植 白介素-18 急性移植物抗宿主病 早期预测 

分 类 号：R457.7[医药卫生—治疗学]