肠道菌群失衡对同种异体造血干细胞移植的影响  

Effects of intestinal microbiota imbalance on allogeneic hematopoietic stem cells transplantation

作　　者：谢景春 谢保平 余丽梅 XIE Jing-chun;XIE Bao-ping;YU Li-mei(The People's Hospital of Yudu County,Yudu,Jiangxi 342300;Key Laboratory of Prevention and Treatment of Cardiovascular and Cerebrovascular Diseases of Ministry of Education,Gannan Medical University,Ganzhou,Jiangxi 341000;Key Laboratory of Cell Engineering in Guizhou Province,Talent Base of Biological Treatment in Guizhou Province,Affiliated Hospital of Zunyi Medical University,Zunyi,Guizhou 563003)

机构地区：[1]于都县人民医院,江西于都342300 [2]赣南医学院心脑血管疾病防治教育部重点实验室,江西赣州341000 [3]遵义医科大学附属医院贵州省细胞工程重点实验室,贵州省生物治疗人才基地,贵州遵义563003

出　　处：《赣南医学院学报》2020年第6期588-593,603,共7页JOURNAL OF GANNAN MEDICAL UNIVERSITY

基　　金：国家自然科学基金项目(81260507);贵州省科技重大专项项目[黔科合重大专项字(2011)6002];江西省教育厅项目(GJJ180809)

摘　　要：同种异体造血干细胞移植是治愈血液系统恶性肿瘤和其它多种疾病的重要手段,移植并发症是导致受者死亡的主要原因。受者长期使用免疫抑制剂、抗菌药物和其他化学治剂,可导致肠道菌群发生重大变化,极大地影响造血干细胞移植并发症的发生。本文从菌群多样性、细菌数量变化、细菌移位、基因改变和调节并发症相关免疫机制等方面,综述了肠道菌群失衡与同种异体造血干细胞移植并发症移植物抗宿主病和炎症感染发生、发展的密切关系;阐述了包括饮食、益生元、益生菌及抗生素和粪菌移植在内,多种肠道菌群保护策略对同种异体造血干细胞移植并发症的有效治疗作用,为精准检测和有效防治同种异体干细胞移植并发症提供了新思路和理论依据。Allogeneic hematopoietic stem cell transplantation is an important means to cure malignant tumors of the blood system and many other diseases.Transplantation complications are the leading main cause of death among recipients.Long-term use of immunosuppressants,antimicrobial agents and other chemical agents in recipients can lead to significant changes in intestinal microbiome,so that greatly affect the occurrence of hematopoietic stem cell transplantation complications.This paper summarizes the close relationship between intestinal microbiome imbalance and the occurrence and development of allogeneic hematopoietic stem cell transplantation complications,graft-versus host disease and inflammatory infection from the aspects of diversity of bacteria,change of bacterial quantity,bacterial translocation,gene change and immune mechanism related to regulating complications.The effective therapeutic effects of various intestinal microbiome protection strategies,including diet,prebiotics,probiotics,antibiotics and fecal bacteria transplantation,on the complications of allogeneic hematopoietic stem cell transplantation were expounded.It will provide new ideas and theoretical basis for accurate detection and effective prevention and treatment of complications of allogeneic stem cells transplantation.

关 键 词：肠道菌群 同种异体造血干细胞移植 移植物抗宿主病 炎症 感染 

分 类 号：R457.7[医药卫生—治疗学]