脐血间充质干细胞移植治疗多发性肌炎/皮肌炎：Th细胞因子的变化  

Umbilical cord blood mesenchymal stem cells transplantion for polymyositis/dermatomyositis:variation of Th cytokines

作　　者：赖勤[1,2] 余莲[1,2] 邱永荣[1,3] 陈隆天[1,2] 黄建清[1,2] 李玉闽[1,4] 张力[1,5] 吴维颢[1,2] 吴爱瑜[1,2] 罗必华[1,2] 田畔[1,2] 

机构地区：[1]福建医科大学附属龙岩第一医院 [2]龙岩市第一医院血液风湿科,福建省龙岩市364000 [3]龙岩市第一医院骨科,福建省龙岩市364000 [4]龙岩市第一医院输血科,福建省龙岩市364000 [5]龙岩市第一医院妇产科,福建省龙岩市364000

出　　处：《中国组织工程研究》2015年第14期2186-2191,共6页Chinese Journal of Tissue Engineering Research

基　　金：福建省医学创新课题(2011-CXB-29);福建医科大学非直属附属医院科学研究发展专项基金(FZS13011Y);福建省龙岩市重点科技项目(2012LY116)~~

摘　　要：背景:近年来,应用干细胞治疗免疫性疾病已成为研究热点,国内外有关脐血间充质干细胞移植治疗多发性肌炎/皮肌炎的报道较少。目的:观察脐血间充质干细胞移植治疗多发性肌炎/皮肌炎患者血清干扰素γ、白细胞介素4、白细胞介素17水平变化,探讨Th细胞因子在多发性肌炎/皮肌炎发生发展中的免疫机制。方法:81例多发性肌炎/皮肌炎患者,其中44例为常规治疗组,给予糖皮质激素联合免疫抑制剂治疗,37例为脐血间充质干细胞移植组,静脉输注脐血间充质干细胞(3.5-5.2)×107,用药方案与常规治疗组相同。随访治疗后1,3,6个月肌酸激酶、肌力变化及治疗后3,6个月肺部影像学改变,并在治疗前及治疗后3,6个月检测移植组Th细胞因子水平。结果与结论:1两组治疗后1,3,6个月与治疗前比较肌酸激酶值明显下降、肌力评分明显增高(均P<0.001);移植组治疗后各时间点肌酸激酶值较常规治疗组低、肌力评分较常规治疗组高(均P<0.001)。2脐血间充质干细胞移植治疗能明显改善肺部影像学异常,且安全性好。3移植治疗后6个月干扰素γ水平显著升高,而白细胞介素4水平显著下降(均P<0.01);移植治疗后3,6个月白细胞介素17水平显著下降(均P<0.01)。4移植治疗后6个月白细胞介素4、白细胞介素17水平与肌酸激酶水平成正相关(r=0.467和0.488,均P<0.05);干扰素γ水平与肌酸激酶水平无明显相关(r=0.213,P>0.05)。结果表明给予糖皮质激素及免疫抑制剂治疗同时,联合脐血间充质干细胞移植治疗多发性肌炎/皮肌炎安全、有效,可调节多发性肌炎/皮肌炎患者免疫网络效应、改善免疫耐受。BACKGROUND：In recent years, the application of stem cel s to treat autoimmune diseases has become a hot spot. But, studies on umbilical cord blood mesenchymal stem cel s transplantation for the treatment of polymyositis/dermatomyositis are rarely reported. OBJECTIVE：To explore the immunologic mechanism of Th cytokines on the occurrence and development of polymyositis/dermatomyositis by observing the changes in serum interferon-γ, interleukin-4 and interleukin-17 in patients after umbilical cord blood mesenchymal stem cel s transplantation. METHODS：Eighty-one polymyositis/dermatomyositis patients were selected and divided into conventional therapy group （n=44） undergoing glucocorticoid and immunosuppressants therapy and cel transplantation group （n=37） undergoing intravenous infusion of umbilical cord blood mesenchymal stem cel s at a density of （3.5-5.2 ）＆#215;107 . Dosing regimen was same in the two groups. After fol ow-up of 1, 3, 6 months, the changes of creatine kinase and myodynamia were evaluated;after fol ow-up of 3 and 6 months, lung imaging was evaluated;in the cel transplantation group, interferon-γ, interleukin-4 and interleukin-17 levels were detected before treatment and at 3 and 6 months after treatment. RESULTS AND CONCLUSION：At 1, 3, 6 months after treatment, the creatine kinase level was significantly decreased, and the muscle force grade was significantly increased in both groups （both P〈0.001）. Compared with the conventional therapy group, the creatine kinase level was lower and the muscle force grade was higher in the cel transplantation group （both P〈0.001）. Results from lung imaging test showed a remarkable improvement after cel transplantation, and it indicated that umbilical cord blood mesenchymal stem cel s transplantation had good stability. At 6 months after transplantation, the level of interferon-γwas significantly increased, while the interleukin-4 level was decreased significantly （both P〈0.01）;at 3, 6 months after cel transplantation, the

关 键 词：干细胞 移植 多发性肌炎/皮肌炎 脐血间充质干细胞 TH细胞因子 干扰素γ 白细胞介素4 白细胞介素17 

分 类 号：R394.2[医药卫生—医学遗传学]