受者特异性产生干扰素γ细胞与急性移植物抗宿主病的关系

目的研究异基因造血干细胞移植(allo-HSCT)中针对受者特异性产生干扰素γ细胞 (IFN-γ PC)与急性移植物抗宿主病(aGVHD)的关系。方法以37例HLA相合的同胞allo-HSCT患者为研究对象,将移植前供者、移植后患者外周血单个核细胞(PBMNC)分别作为反应细胞(RC),移植前受者PBMNC作为异基因刺激细胞(allo-SC),在混合淋巴细胞反应后用酶联免疫斑点法检测针对受者特异性IFN-γ PC,分析其与aGVHD的关系。结果 allo-HSCT前检测受者特异性IFN-γ PC水平, 移植后发生aGVHD组显著高于无aGVHD组(P<0．01);供者针对受者特异性IFN-γ Pc≥20／2×10~5 RC时,发生Ⅱ-Ⅳ度aGVHD的比例显著高于<20／2×10~5RC组(P<0．05)。aGVHD发生时患者针对移植前受者特异性IFN-γ PC水平显著高于移植前相应供者针对受者的水平(P<0．05);亦显著高于 aGVHD患者针对移植前供者的水平(P<0．01)。移植后14天(+14天)和+28天时,aGVHD组受者特异性IFN-γ PC水平均显著高于无aGVHD组(P值均<0．01)。aGVHD患者经过免疫抑制剂治疗7 d后,受者特异性IFN-γ PC较aGVHD发生时显著降低(P<0．05)。结论受者特异性IFN-γ PC的水平能够反映allo-HSCT前后的同种异体反应,有助于临床aGVHD的预测、诊断和监测。

Relationship between the IFN-γ producing cells specific for recipient and acute graft versus host dis-ease

OBJECTIVE: To study the relationship between the IFN-gamma producing cell specific for recipient (IFN-gamma-PCSR) in allogeneic stem cell transplantation (allo-HSCT) and acute graft versus host disease (aGVHD). METHODS: In 37 consecutive HLA-identical sibling allo-HSCT pairs, peripheral blood mononuclear cells (PBMNC) from donors before allo-HSCT and recipients after allo-HSCT were taken as responder cells (RC), and PBMNC from recipients before allo-HSCT as allogeneic stimulator cells (allo-SC) in mixed lymphocyte reaction (MLR). IFN-gamma-PCSR in PBMNC were assayed using enzyme linked immunospot assay (ELISPOT). RESULTS: Pretransplantation frequencies of IFN-gamma-PCSR in donor PBMNC were significantly higher in aGVHD group than in non-aGVHD group (P < 0.01) and IFN-gamma PCSRs (>or= 20/2 x 10(5)RC) were significantly associated with the occurrence of grade II-IV GVHD (P < 0.05). Compared with that before allo-HSCT, IFN-gamma PCSR in PBMNC of aGVHD patients was significantly increased (P < 0.05). When PBMNC from aGVHD patients reacted with donor PBMNC, the IFN-gamma PC was significantly lower than that with recipient PBMNC before allo-HSCT. Longitudinal analysis of IFN-gamma PCSR following allo-HSCT showed that compared with that in patients without aGVHD, the IFN-gamma PCSR were significantly higher in patients with that in aGVHD on day +14 (P < 0.01) and day +28 (P < 0.01), respectively. After immunosuppressive therapy for 7 days, IFN-gamma PC declined significantly (P < 0.05). CONCLUSION: The recipient-specific IFN-gamma PC is closely correlated with the alloresponse during allo-HSCT and may be helpful for the prediction, diagnosis and monitoring of aGVHD.