CAJ | 학술논문

目的研究双份脐血移植(DCBT)受者骨髓间充质干细胞(MSC)的嵌合状态.方法急性粒细胞白血病M2a型男性患者1例,接受改良白消安环磷酰胺方案+抗胸腺细胞球蛋白(ATG)预处理,输注5个抗原(5/6)相合和4个抗原(4/6)相合的非血源脐血各1份,移植后19 d粒系造血重建.移植后87 d,采用密度梯度离心法分离DCBT后受者及正常供者的骨髓单个核细胞,分别培养MSC,用流式细胞术检测细胞表面标志,诱导其向成脂肪细胞和成骨细胞分化,应用逆转录聚合酶链反应法检测MSC表面造血及免疫相关分子的表达,短串联重复序列聚合酶链反应检测受者MSC、外周血、骨髓中供者细胞嵌合率.结果移植后受者MSC与正常供者MSC具有相似的细胞形态、免疫表型以及分化潜能,均能表达白细胞介素6、干细胞因子、白血病抑制因子和粒-巨噬细胞集落刺激因子等造血及免疫相关分子的mRNA.DCBT后受者骨髓优势脐血嵌合度达96.4％,外周血嵌合度达95.7％,MSC的优势脐血嵌合度为5.4％,MSC中受者本身部分占94.6％.结论 DCBT后,受者造血重建仅来自于其中1份脐血.移植后骨髓MSC大部分来源受者本身,部分嵌合的供者MSC来源于植入的单份脐血.
목적 연구쌍빈제혈이식(DCBT)수자골수간충질간세포(MSC)적감합상태.방법 급성립세포백혈병M2a형남성환자1례,접수개량백소안배린선알방안+항흉선세포구단백(ATG)예처리,수주5개항원(5/6)상합화4개항원(4/6)상합적비혈원제혈각1빈,이식후19 d립계조혈중건.이식후87 d,채용밀도제도리심법분리DCBT후수자급정상공자적골수단개핵세포,분별배양MSC,용류식세포술검측세포표면표지,유도기향성지방세포화성골세포분화,응용역전록취합매련반응법검측MSC표면조혈급면역상관분자적표체,단천련중복서렬취합매련반응검측수자MSC、외주혈、골수중공자세포감합솔.결과 이식후수자MSC여정상공자MSC구유상사적세포형태、면역표형이급분화잠능,균능표체백세포개소6、간세포인자、백혈병억제인자화립-거서세포집락자격인자등조혈급면역상관분자적mRNA.DCBT후수자골수우세제혈감합도체96.4％,외주혈감합도체95.7％,MSC적우세제혈감합도위5.4％,MSC중수자본신부분점94.6％.결론 DCBT후,수자조혈중건부래자우기중1빈제혈.이식후골수MSC대부분래원수자본신,부분감합적공자MSC래원우식입적단빈제혈.
Objcetive To study the chimerism status ot bone marrow mesenchymal stem cells (BMSC) following double-unit cord blood stem cell transplantation (DCBT).Methods Bone marrow mononuclear cells were isolated by ficoll density gradient centrifugation from the patient following DCBT and healthy donors.After cultured for about 20 days,BMSC surface makers,the ability to differentiate into adipocytes and osteoblast and the expression of hematopoietic and immune molecules were detected,moreover,chimerism status of BMSC were also evaluated by STR-PCR.Results MSC derived from the patient were similar to normal adult BMSC in morphology,surface and differentiation ability.Besides,MSC from the patient can express a variety of hematopoietic and immune molecules normally.The results of STR-PCR showed that the patient demonstrated complete donor chimerism,hematopoiesis in BM and PB were from a single unit cord blood (donor chimerism was 96.4％ and 95.7％,respectively).But the predominant cord blood chimerism of BMSC was 5.4％,the remaining part was from the patient himself.Conclusion Sustained hematopoiesis was derived from a single unit cord blood following DCBT.The majority of BMSC were origin from host tissue,mixed chimerism donor part of MSC stemed from the engrafted unit of cord blood.