摘要
目的 :探讨慢性移植物抗宿主病 (graft-versus-hostdisease,GVHD)症状期及缓解期CD15 8分子的表达变化。方法 :观察异基因造血干细胞移植后发生广泛性慢性GVHD的儿童患者 ,应用他克莫司 (FK5 0 6 ) ,霉酚酸酯(MMF)和甲基强的松龙 (MP)联合治疗的毒副作用和疗效 ;同时采用流式细胞仪检测外周血中CD15 8在NK细胞和T细胞的表达 ,比较治疗前后CD15 8的表达。结果 :移植前、慢性GVHD症状期和治疗后CD4 + CD15 8a+ 和CD4 +CD15 8b+ 表达水平极其低下 ,但无明显差异。 5例急性GVHD患者CD3+ CD15 8b+ 和CD3+ CD8+ CD15 8b+ 的表达水平分别为 4 . 97%± 2 . 36 %和 4 . 5 8%± 2 90 % ,与移植前相比差异显著 (P <0 . 0 5 ) ,CD3-CD16 + CD15 8b+ 的表达也明显高于移植前 (P <0 . 0 5 )。 6例慢性GVHD患者症状期 ,CD3+ CD15 8b+ 和CD3+ CD8+ CD15 8b+ 的表达均高于移植前的水平(P <0 . 0 5 ) ;在缓解期 ,CD3+ CD15 8b+ 、CD3+ CD8+ CD15 8b+ 和CD3-CD16 + CD15 8b+ 的表达水平逐渐下降 ,与慢性GVHD症状期相比差异显著 (P <0 . 0 5 ) ,与移植前无明显差异。移植后 6 - 12个月CD3-CD16 + CD15 8b+ 表达水平与移植前无明显差异。结论 :CD15 8b分子在T细胞表达水平增加与慢性GVHD的发生有关 ,FK5 0 6 ,MMF和MP联合有?
AIM: To investigate the sequence expression o f CD158 molecule after tacrolimus (FK506), mycophenolate mofetil (MMF) combined with methylprednisone (MP) treatment for refractory chronic graft-versus-host di seases (cGVHD). METHODS: The efficacy and the side effect were observed in 6 chi ld patients with extensive cGVHD after allogeneic hematopoietic stem cell transp lantation treated with the combination of FK506, MMF and MP, meanwhile the chang es of the CD158 expressions on T lymphocytes and NK cells in peripheral blood be fore and after treatment were observed. RESULTS: The expression of CD4+CD158a+ and CD4+CD158b+ were very low before and after transplantation and treatment, there was no stati stical significance. The expression of CD3+CD158b+ and CD3+CD8+CD158b + were 4.97%±2.36% and 4.58%±2.90% respectively in five patients with acut e GVHD, and there was statistical significance compared with that of before-tran splantation (P<0.05). The expression of CD3-CD16+CD158b+ was also hi gher than that of before transplantation (P<0.05). In the six patients wit h chronic GVHD, the expressions of CD3+CD158b+ and CD3+CD8+CD158b+ wer e higher than those of before transplantation (P<0.05), and decreased grad ually after the effective combined treatment, there was statistical significance (P<0.05) compared with those during the time of cGVHD, but were still hig her than that before transplantation. The expression of CD3-CD16+CD158b+ d ecreased at the late stage after transplantation and was closed to the level of before-transplantation. CONCLUSIONS: The increase in expression of CD158b on T cells mig h t be related to cGVHD. The combined immunosuppression with FK506, MMF and MP is feasible for the treatment of cGVHD. The possible mechanism of the combined immu nosuppression with FK506, MMF and MP may be the down-regulation of CD158 express ion on T lymphocytes and NK cells.
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2005年第2期285-288,共4页
Chinese Journal of Pathophysiology
基金
广东省自然科学基金资助项目 (No .0 10 72 2 )
广东省卫生厅基金资助项目 (No .B2 0 0 10 2 9)
