CAJ | 학술논문

目的探讨异基因造血干细胞移植(allo-HSCT)后外周血细胞因子(CK)表达水平的变化及其与移植物抗宿主病(GVHD)的关系.方法 21例行allo-HSCT的血液病和实体瘤患者,根据预处理方案分为非清髓性(A组)和清髓性allo-HSCT组(B组);根据发生GVHD情况分为1组(A组发生aGVHD).2组(A组发生cGVHD),3组(B组发生aGVHD),4组(B组未发生GVHD),5组(A组未发生GVHD).采用半定量反转录聚合酶链反应(RT-PCR)和双抗体夹心酶联免疫吸附法(ELISA)对21例allo-HSCT患者动态监测外周血可溶性白细胞介素-2受体(sIL-2R)、干扰素-γ(IFN-γ)、转化生长因子β1(TGF-β1)表达变化情况.结果 21例患者均获得造血重建,A、B两组发生GVHD情况无差别(X2=3.711,P=0.144);RT-PCR方法及ELISA法检测CK,术后患者IL-2R、IFN-γ的表达均逐渐增高,IL-2R在+7天时已明显高于术前(P＜0.05),发生GVHD时达高峰,TGF-β1的表达随时间延长而逐渐降低,发生GVHD时最低;经治疗后,各指标逐渐接近术前水平;三指标在A组和B组表达不同(P＜0.01);发生GVHD组与无GVHD组相比,差异有统计学意义(P＜0.001).结论 sIL-2R、IFN-γ、TGF-β1可以作为allo-HSCT后预测aGVHD早期发生的指标;sIL-2R、TGF-β1独立于其他参数,更能影响GVHD发生;RT-PCR和ELISA两种方法检测CK的敏感性无差别.
목적 탐토이기인조혈간세포이식(allo-HSCT)후외주혈세포인자(CK)표체수평적변화급기여이식물항숙주병(GVHD)적관계.방법 21례행allo-HSCT적혈액병화실체류환자,근거예처리방안분위비청수성(A조)화청수성allo-HSCT조(B조);근거발생GVHD정황분위1조(A조발생aGVHD).2조(A조발생cGVHD),3조(B조발생aGVHD),4조(B조미발생GVHD),5조(A조미발생GVHD).채용반정량반전록취합매련반응(RT-PCR)화쌍항체협심매련면역흡부법(ELISA)대21례allo-HSCT환자동태감측외주혈가용성백세포개소-2수체(sIL-2R)、간우소-γ(IFN-γ)、전화생장인자β1(TGF-β1)표체변화정황.결과 21례환자균획득조혈중건,A、B량조발생GVHD정황무차별(X2=3.711,P=0.144);RT-PCR방법급ELISA법검측CK,술후환자IL-2R、IFN-γ적표체균축점증고,IL-2R재+7천시이명현고우술전(P＜0.05),발생GVHD시체고봉,TGF-β1적표체수시간연장이축점강저,발생GVHD시최저;경치료후,각지표축점접근술전수평;삼지표재A조화B조표체불동(P＜0.01);발생GVHD조여무GVHD조상비,차이유통계학의의(P＜0.001).결론 sIL-2R、IFN-γ、TGF-β1가이작위allo-HSCT후예측aGVHD조기발생적지표;sIL-2R、TGF-β1독립우기타삼수,경능영향GVHD발생;RT-PCR화ELISA량충방법검측CK적민감성무차별.
Objective To investigate the relationship between cytokines and human graft-versus-host disease (GVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Methods In 21 patients undergoing allo-HSCT,the plasma concentrations of cytokines[soluble interleukin 2 receptor(sIL-2R), interferon-gama (IFN-γ), transforming growth factor-betal (TGF-β1)] were measured by using sandwich enzyme-linked immunological assay (ELISA) and the gene expressions of three cytokines were analysed by using semi-quantitate reverse transcriptase-polymerase chain reaction(RT-PCR). Results The concentrations and gene expressions of sIL-2R and IFN-γin the patients with GVHD were significantly higher than those without GVHD (P <0.01), and they were higher in the patients with aGVHD than with cGVHD and without GVHD(P <0.05); the levels of TGF-β1 in the patients with GVHD were significantly declined(P <0.01), but in those without aGVHD were obviously increased(P <0.05). After effective treatment, unnormal sIL-2R, IFN-γand TGF-β1 expressions recovered to the levels before transplantation. A multivariate COX analysis showed sIL-2R and TGF-β1 are independent prognostic factors for GVHD (P<0.001). Conclusion Monitoring the changes of sIL-2R, IFN-γand TGF-β1 expression levels (especially sIL-2R and TGF-β1) might provide predictive markers for GVHD after allo-HSCT. The sensitivity between RT-PCR and ELISA for detecting cytokines expressions had no difference.