急性移植物抗宿主病病人Th细胞亚群变化及其临床意义  

Quantitative Change of Th Cell Subsets in Patients with Acute Graft-versus-Host Disease and Its Clinical Significance

作　　者：王书红[1] 达万明[1] 靳海杰[1] 靖彧[1] 苏荣[1] 阮秀霞[1] 

机构地区：[1]解放军总医院血液科,北京100853

出　　处：《中国实验血液学杂志》2007年第4期805-808,共4页Journal of Experimental Hematology

摘　　要：本研究探讨异基因造血干细胞移植(allo-HSCT)后急性移植物抗宿主病(aGVHD)时Th细胞亚群的数量变化及其临床意义。观察了23例allo-HSCT患者aGVHD的发病情况,aGVHD的诊断主要依据临床表现,对部分病例进行了皮肤活检,取得病理学依据。移植前后定期采集23例患者的外周血,采用流式细胞仪检测其Th细胞亚群Th1、Th2细胞比例的变化。结果表明:23例患者8例发生了aGVHD,其中3例Ⅰ度,2例Ⅱ度,3例Ⅲ度aGVHD,15例未发生aGVHD。流式细胞术检测显示,发生aGVHD患者的Th1细胞量明显高于未发生aGVHD患者(p<0.01),Ⅱ-Ⅲ度aGVHD患者Th1细胞的IFN-γ表达明显高于未发生aGVHD患者(p<0.01),而Th2细胞的IL-4表达明显低于未发生aGVHD患者,动态观察发现在aGVHD发生前和发生后未治疗的患者Th1细胞明显增高,治疗后明显下降,而未发生aGVHD的患者移植前后Th1细胞量变化不大。结论:发生aGVHD患者Th1细胞明显增多,且这种增多与aGVHD有关。因此,移植后早期动态监测Th细胞亚群Th1量的变化有助于aGVHD的诊治。This study was purposed to investigate the change of Th cell subsets in the patients with acute graft-versus host disease （aGVHD） and to explore its role in the pathogenesis of aGVI-ID after allogeneic hematopoietic stem cell transplantation（allo-HSCT）. 23 patients underwent allo-HSCT were selected for analysis, The aGVHD in patients was diagnosed according to clinical features, and was confirmed by skin biopsy in some patients. The peripheral blood from 23 patients was collected before and after allo-HSCT. The quantitative chenges of Thl and Th2 cells in peripheral blood samples were detected by using flow cytometry. The results showed that out of 23 patieats the aGVHD occured in 8 patients including 1 case of grade Ⅰ , 2 case of grade Ⅱ , 3 cases of grade Ⅲ ; no aGVHD occured in 15 patients. The flow cytometry analysis revealed that the amount of Thl cells in patients with aGVHD was much higher than that in patients without aGVHD （p 〈 0. 01 ）, the IFN-γ expression of Thl cells in patients with aGVHD of grad Ⅱ -Ⅲ significantly was higher than that in patients without aGVHD （p 〈0.01 ）, meanwhie the IL-4 expression of Th2 cells in patients with aGVHD of grade Ⅱ -Ⅲ was significantly lower than that in patients without aGVHD （p 〈 0.05 ）. Dynamical detection indicated that the Thl obviously increased before occurrence of aGVHD and before treatment of aGVHD, while the Thl cells obviously decreased after treatment of aGVHD. The Thl cells not changed significantly in patients without aGVHD before and after allo-HSCT. It is concluded that Thl cells obviously increase in patients with aGVHD, this increase is related to aGVHD pathogenesis. Detecting the changes of Th cell subsets in the early stage after allo-HSCT may be contributed to early diagnosis and therapy of aGVHD.

关 键 词：急性移植物抗宿主病 异基因造血干细胞移植 TH1细胞 TH2细胞 

分 类 号：R733[医药卫生—肿瘤] R457.7[医药卫生—临床医学]