中华内科杂志
中華內科雜誌
중화내과잡지
CHINESE JOURNAL OF INTERNAL MEDICINE
2010年
4期
320-324
,共5页
金莱%肖浩文%来晓瑜%吴功强%罗依%施继敏%谭亚敏%黄河
金萊%肖浩文%來曉瑜%吳功彊%囉依%施繼敏%譚亞敏%黃河
금래%초호문%래효유%오공강%라의%시계민%담아민%황하
造血干细胞移植,异基因%肿瘤坏死因子%多态性,单核苷酸%移植物抗宿主病
造血榦細胞移植,異基因%腫瘤壞死因子%多態性,單覈苷痠%移植物抗宿主病
조혈간세포이식,이기인%종류배사인자%다태성,단핵감산%이식물항숙주병
Hematopoietic stem cell transplantation,allogeneic%Tumor necrosis factor%Polymorphism,single nucleotide%Graft-versus-host disease
目的 探讨无关供者异基因造血干细胞移植(allo-HSCT)患者及其干细胞供者的肿瘤坏死因子(TNF)单核苷酸多态性(SNP)与急性移植物抗宿主病(aGVHD)之间的关系.方法 回顾性分析浙江大学医学院附属第一医院移植中心接受无关供者allo-HSCT患者及其供者,共76对,采用多重单碱基延伸SNP分型技术检测TNF基因5个位点的SNP(TNFα-238、TNFα-857、TNFα-863、TNFα-1031、TNFβ+252),分析与aGVHD的发生风险、临床严重程度之间的关系.结果 在23例发生Ⅱ-Ⅳ度aGVHD患者中,其干细胞供者基因型TNFα-857 CC的频率(91.3%)高于基因型CT(8.7%)(P=0.039);TNFβ+252(A/G)位点未检出从基因型,19例患者为GA基因型(82.6%),4例患者为GG基因型(17.4%),3组之间比较差异有统计学意义(P=0.006).而患者与干细胞供者TNFα-238(G/A)、TNFα-863(C/A)和TNFα-1031(T/C)位点的基因多态性均未发现与aGVHD的发生风险相关.结论 干细胞供者TNFα-857 CC基因型与Ⅱ～Ⅳ度aGVHD的发生密切相关,而TNFβ+252为AA基因型的患者不易发生Ⅱ～Ⅳ度aGVHD.
目的 探討無關供者異基因造血榦細胞移植(allo-HSCT)患者及其榦細胞供者的腫瘤壞死因子(TNF)單覈苷痠多態性(SNP)與急性移植物抗宿主病(aGVHD)之間的關繫.方法 迴顧性分析浙江大學醫學院附屬第一醫院移植中心接受無關供者allo-HSCT患者及其供者,共76對,採用多重單堿基延伸SNP分型技術檢測TNF基因5箇位點的SNP(TNFα-238、TNFα-857、TNFα-863、TNFα-1031、TNFβ+252),分析與aGVHD的髮生風險、臨床嚴重程度之間的關繫.結果 在23例髮生Ⅱ-Ⅳ度aGVHD患者中,其榦細胞供者基因型TNFα-857 CC的頻率(91.3%)高于基因型CT(8.7%)(P=0.039);TNFβ+252(A/G)位點未檢齣從基因型,19例患者為GA基因型(82.6%),4例患者為GG基因型(17.4%),3組之間比較差異有統計學意義(P=0.006).而患者與榦細胞供者TNFα-238(G/A)、TNFα-863(C/A)和TNFα-1031(T/C)位點的基因多態性均未髮現與aGVHD的髮生風險相關.結論 榦細胞供者TNFα-857 CC基因型與Ⅱ～Ⅳ度aGVHD的髮生密切相關,而TNFβ+252為AA基因型的患者不易髮生Ⅱ～Ⅳ度aGVHD.
목적 탐토무관공자이기인조혈간세포이식(allo-HSCT)환자급기간세포공자적종류배사인자(TNF)단핵감산다태성(SNP)여급성이식물항숙주병(aGVHD)지간적관계.방법 회고성분석절강대학의학원부속제일의원이식중심접수무관공자allo-HSCT환자급기공자,공76대,채용다중단감기연신SNP분형기술검측TNF기인5개위점적SNP(TNFα-238、TNFα-857、TNFα-863、TNFα-1031、TNFβ+252),분석여aGVHD적발생풍험、림상엄중정도지간적관계.결과 재23례발생Ⅱ-Ⅳ도aGVHD환자중,기간세포공자기인형TNFα-857 CC적빈솔(91.3%)고우기인형CT(8.7%)(P=0.039);TNFβ+252(A/G)위점미검출종기인형,19례환자위GA기인형(82.6%),4례환자위GG기인형(17.4%),3조지간비교차이유통계학의의(P=0.006).이환자여간세포공자TNFα-238(G/A)、TNFα-863(C/A)화TNFα-1031(T/C)위점적기인다태성균미발현여aGVHD적발생풍험상관.결론 간세포공자TNFα-857 CC기인형여Ⅱ～Ⅳ도aGVHD적발생밀절상관,이TNFβ+252위AA기인형적환자불역발생Ⅱ～Ⅳ도aGVHD.
Objective To explore the relationship between tumor necrosis factor (TNF) gene polymorphisms in donors and recipients and the incidence and severity of acute graft-versus-host diseases (aGVHD) after unrelated allogeneic hematopoietic stem cell transplantation (alIo-HSCT). Methods Single nucleotide polymorphisms (SNPs) of TNFα-238 (G/A), TNFα-857 (C/T), TNFα-863 (C/A), TNFα-1031 (T/C), TNFβ + 252 (A/G) were analyzed by Multiplex SNaPshot analysis in 76 pairs of donors and recipients. Results Transplantation involving donors with TNFα-857 CC genotype resulted in a higher incidence of grade Ⅱ-Ⅳ aGVHD than donors with CT genotype (91.3% vs 8. 7% , P =0. 039). In the 23 patients with grade Ⅱ-Ⅳ aGVHD, no patients had TNFβ +252 AA genotype, 19 (82.6%) had GA genotype and 4 (17.4%) had GG genotype. There was a significant difference in the distribution pattern of the TNFβ +252 (AA, GA and GG) genotypes in these patients (P =0.03). There was no significant association of TNFα-238 (G/A), TNFα-863 (C/A) and TNFα-1031 (T/C) polymorphisms with the risk of aGVHD. Conclusion These results suggest donor TNFα-857 CC genotype is related to a higher incidence of grade Ⅱ -Ⅳ aGVHD, and patients with TNFβ +252 AA genotype have protection against the risk of grade Ⅱ -Ⅳ aGVHD.
