allo—HSCT后急性GVHD患者外周血中T淋巴细胞CD47表达变化的观察  

Expression changes of CD47 on peripheral blood T-iymphocytes in aGVHD after allo-HSCT

作　　者：武倩[1] 周芳[1] 解琳娜[1] 宋宁霞[1] 李欣[1] 

机构地区：[1]济南军区总医院血液科,250031

出　　处：《中华器官移植杂志》2016年第5期275-279,共5页Chinese Journal of Organ Transplantation

基　　金：总后勤部卫生部面上项目（13CXZ040）

摘　　要：目的探讨异基因造血干细胞移植（a110-HsCT）后发生急性移植物抗宿主病（GVHD）时CD3^＋CD4^＋、CD3^＋CD8^＋标记T淋巴细胞亚群CD47的表达变化，分析T淋巴细胞亚群CD47在急性GVHD中的临床意义。方法采集30例患者allo-HSCT移植前、移植后自造血重建起每2周取外周血，以流式细胞术检测CD3^＋CD4^＋和CD3^＋CD8^＋T淋巴细胞亚群CD47的表达变化，分析其与急性GVHD发生的关系。结果急性GVHD组与无急性GVHD组间CD3^＋CD4^＋T淋巴细胞亚群、CD3^＋CD8^＋T淋巴细胞亚群百分比分别为（38．95±6．18）％和（37．38±4．6）％，（22．35±3．32）％和（20．34±4．56）％，差异均无统计学意义（P〉0．05）。与移植前、移植后没发生急性GVHD组比较，发生急性GVHD组的CD3^＋CD4^＋、CD3^＋CD8^＋T淋巴细胞亚群CD47的表达明显升高，无急性GVHD组受者CD3^＋CD4^＋、CD3^＋CD8^＋T淋巴亚群CD47的表达同预处理前无明显变化；与无急性GVHD组[（71．27±11．32）和（53．93±8．35）]比较，急性GVHD组CD3^＋CD4^＋、CD3^＋CD8^＋T淋巴细胞亚群CD47的平均荧光强度分别为（93．70±14．88）和（70．09±12．51），差异有统计学意义（P〈0．05）。与无急性GVHD组移植前比较，急性GVHD组移植前CD3^＋CD4^＋、CD3^＋CD8^＋T淋巴细胞亚群CD47的表达水平无明显差异，差异无统计学意义（P〉0．05）；在急性GVHD组CD3^＋CD4^＋、CD3^＋CD8^＋T淋巴细胞亚群CD47的表达随着治疗转归而变化。结论以CD3^＋CD4^＋、CD3^＋CD8^＋标记的T淋巴细胞亚群CD47的表达变化在allo-HSCT后监测急性GVHD中具有一定临床意义，可为早期监测急性GVHD的发生提供了新的方法。Objective To detect the changeof CD47 on T-lymphocyte subsets marked by CD3^＋ CD4^＋ and CD3^＋ CD8^＋ in the acute graft versus host disease （aGVHD） after allogeneic hematopoietic stem cell transplantation （allo-HSCT） and to explore its clinical significance. Methods The peripheral blood of 30 patients was collected before and every two weeks from hematopoietic reconstitution after allo-HSCT. The expression of CD47 on T-lymphocyte subsets marked by CD3^＋ CD4^＋ and CD3^＋ CD4^＋ was detected by flow cytometry, and the relationship between their expression and the occurrence of aGVHD was analyzed. Results The percentage of CD3^＋ CD4^＋- and CD3^＋ CD8^＋- marked T- lymphocyte subsets showed no statistically significant difference between aGVHD group and non- aGVHDgroup [-（38.95 ± 6.18）% vs. （37.38 ±4.6）%, and （22.35 ±3.32）% vs. （20.34 ± 4. 56）%, respectively3 （P〉0. 05）. The expression levels of CD47 on T-lymphocyte subsets marked by CD3^＋ CD4^＋ and CD3^＋ CD8^＋ was obviously increased in aGVHD group when compared to before transplantation and non-aGVHD group after transplantation, and that had no changes in non-aGVHD group when compared to before conditioning regimen after transplantation. Mean fluorescence intensity of CD47 on T-lymphocyte subsets marked by CD3^＋ CD4^＋ and CD3^＋ CD8^＋ [（93. 70 ＋ 14. 88） and （70. 09 ± 12. 51）] in aGVHD group significantly increased as compared with non-aGVHD group [（71.27＋ 11.32） and （53.93 ± 8.35）] （P〈0.05）. There was no significant difference in the expression of CD47 on T-lymphocyte subsets marked by CD3^＋ CD4^＋ and CD3^＋ CD8^＋ before and after transplantation in non-aGVHD group （P〉0. 05）. Moreover the expression of CD47 on T-lymphocyte subsets marked by CD3^＋CD4 ^＋ and CD3^＋ CD8^＋ changed correspondingly with the outcome of aGVHD in aGVHD group. Conclusion The change of CD47 on T-lymphocyte subsets marked by CD3^＋ CD4^＋ and CD3^＋ CD8^＋ is valuable to monit

关 键 词：异基因造血干细胞移植 急性移植物抗宿主病 T淋巴细胞亚群 CD47 

分 类 号：R457.7[医药卫生—治疗学]