中国汉族人群中KIR分布规律及其在HLA相合亲缘造血干细胞移植中的作用  

Distribution of immunoglobulinlike receptor gene in Han population in China and the impact thereof on the HLA-identical sibling hematopoietic stem cell transplantation

作　　者：窦立萍[1] 达万明[1] 赵丹丹[1] 王畅[2] 卢学春[1] 康慧媛[1] 闫蓓[1] 汪菲菲[1] 朱海燕[1] 李红华[1] 高春记[1] 于力[1] 

机构地区：[1]解放军总医院血液科,北京100853 [2]吉林大学第一医院肿瘤中心

出　　处：《中华医学杂志》2007年第44期3111-3114,共4页National Medical Journal of China

摘　　要：目的探讨杀伤细胞免疫球蛋白样受体(KIR)在中国汉族人群中的分布规律及其对人类白细胞抗原(HLA)相合亲缘移植预后的影响。方法采用 PCR 序列特异性引物(SSP)分型技术检测 HLA 及 KIR 基因型。检测了150例汉族人群中 KIR 的基因型分布、74例异基因造血干细胞移植供受者对 KIR 及 HLA 基因型,并对45例接受 HLA 相合亲缘移植、非去除 T 细胞异基因造血干细胞移植(allo-HSCT)的恶性血液病患者病例资料进行回顾性分析。结果 KIR2DL1的基因分布频率为100%,KIR2DL2为20%,KIR2DL3为100%,KIR3DL1为95%。96%的供者携带与 allo-HSCT 关系密切的3组 KIR 受体。45例 HLA 相合亲缘供者中,36例患者 KIR 不合,占总人数的80%,其中35例患者 KIR2DL1不合,1例 KIR2DL2/2DL3不合,31例 KIR3DL1不合。HLA 相合亲缘供者移植患者中KIR2DL1不合组的急性移植物抗宿主细胞病(aGVHD)发生率(31%)明显低于 KIR 相合组(70%),差异有统计学意义(P=0.029)。急性髓性白血病中 KIR 及 KIR2DL1不合组的 aGVHD 发生率(18%)明显低于 KIR 相合组(75%),差异有统计学意义(P=0.03),淋巴系统疾病中差异无统计学意义。结论绝大多数中国北方汉族人群携带与 allo-HSCT 关系密切的3组 KIR 受体,HLA 相合亲缘供者 HSCT 后供受者间 KIR 不合组 aGVHD 发生率明显下降。Objective To investigate the distribution of killer immunoglobulinlike receptor （KIR） gene in the Han population in north China and the impact of donor KIR and patient HLA genotypes on the outcome of HLA-identical sibling hematopoietic stem cell transplantation patients with hematological malignancy. Methods Polymerase chain reaction with sequence-specific primers （PCR-SSP） was used to detect the KIR distribution of 150 healthy people and the KIR genotype of donor and HLA genotype of allogeneic stem cell transplantation recipients of 74 donor-recipient pairs, and a retrospective study was carried out to analyze the outcomes of 45 patients with various hematological malignancies who received non T-cell-depleted transplant from HLA-identical sibling donors, all the subjects being of Han nationality in north China. Results The gene frequencies of KIR2DL1, KIR2DL2, KIR2DL3, and KIR3DL1 were 100%, 20%, 100%, and 95% respectively. 96% of the allogeneic donors carried one of the 3 class Ⅰ ligands of inhibitory KIR. 36 of the 45 （80%） donor-recipient HLA-identical sibling transplant pairs lacked recipient HLA ligand for donor KIR, among which 35 lacked recipient HLA ligand for donor KIR2DL1, 1 pair lacked that for KIR2DL2/2DL3 ,and 31 pairs lacked that for KIR3DL1. Cumulative incidence analysis of graft versus host disease （GVHD） in the patients undergoing HLA-identical sibli.ng hematopoietic stem cell transplantation demonstrated that the incidence of severe acute GVHD （aGVHD） in the patients lacking HLA ligand for donor-inhibitory KIR2DL1 was 31% , significantly lower than that of the patients with HLA ligand for donor-inhibitory KIR2DL1 （70% , P = 0. 029） , and the incidence of severe aGVHD in the acute myeloid leukemia patients lacking HLA ligand for donor-inhibitory KIR and KIR2DL1 was 18%, significantly lower than that of the KIR compatible patients （75%, P = 0.03）. Conclusion Almost all Chinese of Han nationality in north China carry having one of the 3 known class I ligands of inhibi

关 键 词：杀伤细胞 天然 受体 聚合免疫球蛋白 造血干细胞移植 组织相容性抗原 

分 类 号：R392[医药卫生—免疫学]