异基因造血干细胞移植后急性移植物抗宿主病的治疗新靶点  

New targets for the treatment of acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation

作　　者：段昊良 茹煜华 陈佳[1] DUAN Haoliang;RU Yuhua;CHEN Jia(Department of Hematology,National Clinical Research Center for Hematologic Diseases,Jiangsu Institute of Hematology,the First Affiliated Hospital of Soochow University,Suzhou 215006,Jiangsu,China)

机构地区：[1]国家血液系统疾病临床医学研究中心、江苏省血液研究所、苏州大学附属第一医院血液科,江苏苏州215006

出　　处：《实用医学杂志》2025年第5期634-640,共7页The Journal of Practical Medicine

基　　金：国家自然科学基金面上项目(编号:82370215);江苏省血液病医学创新中心(编号:CXZX202201);苏州市医学应用基础研究项目(编号:SKY2023047)。

摘　　要：异基因造血干细胞移植(allo-HSCT)是血液系统恶性肿瘤的根治性手段,其疗效取决于预处理过程中对原发肿瘤的清除效果及移植物抗白血病(GVL)效应。然而,急性移植物抗宿主病(a GVHD)是allo-HSCT后的主要并发症之一,严重影响患者的生存和生活质量。目前的临床前研究重点在于探索如何在减少aGVHD的同时保留足够的GVL效应以提高移植疗效。对此,我们归纳总结了近年来该领域的临床前研究成果,重点阐述了a GVHD中关于T细胞、抗原提呈细胞、髓源性抑制细胞及间充质干细胞相关的调控及其具体分子机制,分析了临床前研究中aGVHD的最新治疗策略,以期开发更多的治疗靶点与方案。Allogeneic haematopoietic stem cell transplantation(allo-HSCT)is the most effective curative treatment for hematologic malignancies.Its efficacy hinges on eliminating primary hematological disorders and restoring bone marrow hematopoiesis during conditioning,as well as leveraging the graft-versus-leukemia(GVL)effect.However,acute graft-versus-host disease(aGVHD)remains a significant complication following allo-HSCT,substantially affecting patient survival and quality of life.Current preclinical studies focus on strategies to mitigate aGVHD while preserving adequate GVL effects to improve transplant outcomes.This review summarizes recent preclinical research findings in this field,emphasizing the regulatory roles and specific molecular mechanisms of T cells,antigen-presenting cells,myeloid-derived suppressor cells,and mesenchymal stem cells in aGVHD.It further highlights the latest therapeutic strategies for aGVHD from preclinical studies,aiming to provide valuable insights for researchers and clinicians to develop more effective therapeutic targets and strategies.

关 键 词：造血干细胞移植 急性移植物抗宿主病 移植物抗白血病效应 T细胞 抗原提呈细胞 髓源性抑制细胞 间充质干细胞 信号通路 

分 类 号：R552[医药卫生—血液循环系统疾病]