异基因造血干细胞移植后FOXP3动态监测的临床意义  

The clinical significance of dynamic changes of FOXP3 in patients with allogeneic hematopoietic stem cell transplantation

作　　者：毛星宁[1] 夏凌辉[2] 方峻[2] 陈红霞[2] 谢薇[2] 

机构地区：[1]武汉市第一医院 [2]华中科技大学同济医学院附属协和医院血液病研究所,武汉430022

出　　处：《临床内科杂志》2008年第9期594-596,共3页Journal of Clinical Internal Medicine

摘　　要：目的探讨FOXP3mRNA水平的动态变化在异基因造血干细胞移植（allo—HSCT）中的临床意义。方法allo—HSCT患者27例，12例采用短程甲氨蝶呤联合环孢素A（MTX＋CsA）预防移植物抗宿主病（GVHD），15例加用抗CD。强化GVHD预防；发生急性移植物抗宿主病（aGVHD）者11例。采用实时荧光定量PCR反应动态监测allo—HSCT患者移植预处理前、移植当天、移植后1、2、4周及aGVHD发生时外周血FOXP3mRNA水平，分析FOXP3mRNA水平的变化与aGVHD发生的相互关系。结果抗CD25对FOXP3mRNA水平无影响；Ⅰ～Ⅱ度和Ⅲ～Ⅳ度aGVHD组发生aGVHD时FOXP3mRNA水平均较发生前降低，差异具有统计学意义（P〈0．05）。结论FOXP3是CD4^＋CD^＋Treg细胞的特异性标志，对CD4^＋CD^＋Treg细胞的发育和功能发挥起重要作用，对aGVHD的发生具有保护作用，可作为临床监测aGVHD发生的重要指标之一。Objective To investigate the clinical significance of dynamic changes of FOXP3mRNA in patients with allogeneic hematopoietie stem cell transplantation（allo-HSCT）. Method Twenty seven patients received allo-HSCT. The graft-vesus-host disease（GVHD） was prevented by ciclosporin A and short-term MTX regimen in all patients. 15 of all the patients received CD25MAb at the day of transplantation and day 4 after transplantation. The levels of FOXP3mRNA in peripheral blood were detected by real-time quantitative PCR from 27 patients following allo-HSCT 0 d, 1,2,4 weeks and the time of aGVHD development,respectively. Result The results showed that anti-CD25 eouldn＇t influence the periphera/blood levels of FOXP3mRNA. The results also showed that FOXP3mRNA levels were significant lower after development of aGVHD than before in patients with grade 1 - 4 aGVHD compared with those in patients without aGVHD. Condnsion FOXP3 is identified as a key regulatory gene required for the development and functional activity of CD4^＋CD^＋ regulatory T cells. FOXP3 is important for the aGVHD prevention and can be a useful clinical surveillant index for the development of aGVHD.

关 键 词：造血干细胞移植 异基因 急性移植物抗宿主病 FOXP3 

分 类 号：R457.7[医药卫生—治疗学]