急性白血病患者非血缘脐血干细胞移植后NK细胞及其表面受体的早期重建  

Reconstitution of NK Cells and Their Receptors in Patients with Acute Leukemia Following Unrelated Cord Blood Stem Cell Transplantation

作　　者：程杰[1] 孙自敏[1] 刘会兰[1] 耿良权[1] 王兴兵[1] 

机构地区：[1]安徽医科大学省立医院血液科,安徽合肥230001

出　　处：《中国实验血液学杂志》2009年第2期426-430,共5页Journal of Experimental Hematology

基　　金：安徽省十五科技攻关项目(编号01013032);安徽省自然科学基金(编号050430712)

摘　　要：本研究探讨非血缘脐血移植(unrelated cord blood stem cell transplantation,UCBT)后早期NK细胞及其表面受体重建的特点和规律及其对临床的重要性。对11例接受UCBT的急性白血病患者使用流式细胞术分别检测UCBT后受者早期(植活后90天内)NK细胞及其表面受体的重建以及T细胞和B细胞的免疫重建情况。结果表明:UCBT后NK细胞重建较早,植活时外周血中NK细胞数即高于正常水平;植活后30天达峰值,60天时绝对值达峰值水平。NK表面活化性受体NKG2D的重建早,植活时即高表达,并逐步上升,约60天达峰值(82.55±9.10)%;NK细胞的另一种活化性受体NKp46也获得早期重建,至植活后90天仍维持在高水平。NK细胞抑制性受体NKG2A在UCBT后表达较活化性受体低并持续至移植后90天。UCBT后T细胞的重建较晚,表达水平低。结论:急性白血病患者UCBT后早期NK细胞的重建较早;NK细胞表面活化性受体特别是NKG2D的重建早于抑制性受体,提示NK细胞的活化可能在UCBT后早期移植物抗白血病(GVL)作用中承担了重要角色。This study was to investigate the reconstitution of NK cells and their receptors after unrelated cord blood stem cell transplantation （UCBT） and its clinical importance. 11 cases of acute leukemia underwent UCBT were enrolled in this study. The reconstitution of NK cells and their surface receptors as well as the the recovery of T and B cells within 90 days after clinical engrafment following UCBT were measured and analysed by flow cytometry. The results indicated that the recovery of NK cells appears to be relatively early. CD3^-56＋ NK cell count was （35. 12 ± 18.66 ）% of peripheral blood （PB） lymphocytes on the day of clinical engrafment and higher than that in normal. The peak of the NK cells reached to （37.8 ± 17.52 ） % of lymphocyte at 30 days after clinical engraftment. NK count was （30.4 ± 19. 14 ） % at 60 days after clinical engraftment when the absolute NK cell count reached to the peak （ up to 544 cells/p3） in PB. The activated receptor NKG2D was reconstituted fast and high expressed [ （79.58 ± 8.71 ）% ] at the time of clinical engrafment with a tendency of gradual elevation, which reached to peak value （82.55 ± 9.10 ）% at day 60. Another activated receptor NKp46 also reconstituted fast, and maintained at a high level even at 90 days after clinical engraftment. The expression of NKG2A was lower than that of the activated receptor of NK cells, which tendency lasted for at least 90 days after clinical engraftment. The reconstitution of T cells in PB after UCBT was relatively slow with lower expreassion rate. It is concluded that the reconstitution of NK cells in patients with acute leukemia is earlier following UCBT. The earlier recovery of activated receptor of NK cells, especially NKG2D, suggests that the activation of NK cells may play a role in graft versus leukemia （GVL） effect in the early period after UCBT.

关 键 词：NK细胞 急性白血病 非血缘脐血移植 NK细胞表面受体 

分 类 号：R457.7[医药卫生—治疗学] R331.1[医药卫生—临床医学]