摘要
目的研究恶性血液病患者经异基因造血干细胞移植(allo-HSCT)后骨髓免疫重建中T淋巴细胞的重建规律及其与外周血中T淋巴细胞重建的差异。方法本研究采用前瞻性研究设计。收集2015年9月至2017年1月在我院血液科行allo-HSCT的41例恶性血液病患者的骨髓及外周血标本,收集同期7名健康供者的骨髓及外周血标本作为对照样本。用流式细胞术分析移植前和移植后15、30、60、90、180 d时的T淋巴细胞亚群分布,包括CD4+T淋巴细胞、CD8+T淋巴细胞、辅助性T细胞(Th)1、Th2,并用Luminex技术检测Th1相关细胞因子白细胞介素2受体(IL-2R)、白细胞介素18(IL-18)水平。结果恶性血液病患者在移植后15 d和30 d时骨髓中CD4+T淋巴细胞比例均低于对照组(P均<0.05),至移植后180 d仍未见回升;CD8+T淋巴细胞比例在移植后早期(15、30 d)低于对照组(P均<0.01),60 d时恢复至正常水平;骨髓中CD4+和CD8+T淋巴细胞比例整体水平均低于外周血中水平(P=0.001、0.002)。恶性血液病患者在移植后15、30、60、90、180 d时骨髓中Th1比例均高于对照组(P均<0.05),且整体水平高于外周血中水平(P=0.006);骨髓中Th2比例在移植后90 d内均无明显变化,在180 d时高于对照组(P=0.034),但整体水平与外周血中水平无明显差异(P>0.05)。骨髓中CD4+/CD8+T淋巴细胞比值在移植后逐渐下降,至移植后180 d时低于对照组(P=0.040);而骨髓中Th1/Th2比值在移植后90 d内各时间节点(15、30、60、90 d)均高于对照组(P均<0.01),180 d时与对照组差异无统计学意义(P>0.05)。恶性血液病患者骨髓和外周血中IL-2R水平在移植后15、30、60、90 d均高于对照组(P均<0.05);IL-18水平在移植后15、30、60 d高于对照组(P均<0.05),但移植后90 d时仅外周血中水平与对照组差异有统计学意义(P=0.021);骨髓与外周血中IL-2R和IL-18整体水平均无明显差异(P均>0.05)。结论恶性血液病患者allo-HSCT后,骨髓中各T淋巴�
Objective To explore the re-constitution rule of T lymphocyte subsets in bone marrow of patients with hematological malignancies after allogenic hematopoietic stem cell transplantation(allo-HSCT),and its differences with those in the peripheral blood.Methods This study was a prospective study.We collected the bone marrow and peripheral blood samples from 41 patients with hematological malignancies receiving allo-HSCT treatment in Department of Hematology of our hospital from Sep.2015 to Jan.2017.During the same period,bone marrow and peripheral blood samples of 7 healthy donors were collected as control samples.Flow cytometry was used to evaluate the distribution of T lymphocyte subsets,including CD4+T cells,CD8+T cells,T-helper cell(Th)1 and Th2 before transplantation and 15,30,60,90 and 180 d after transplantation.Luminex technique was used to evaluate Th1-related cytokines(interleukin 2 receptor[IL-2R]and interleukin 18[IL-18]).Results The proportions of CD4+T cells in bone marrow of the patients with hematological malignancies were significantly lower versus the healthy controls 15 and 30 d after transplantation(both P<0.05),and no recovery was found 180 d after transplantation.The proportions of CD8+T cells in bone marrow of the patients with hematological malignancies were significantly lower versus the healthy controls 15 and 30 d after transplantation(both P<0.01),and it recovered to normal level 60 d after transplantation.The total proportions of CD4+and CD8+T lymphocytes in bone marrow were both significantly lower than those in the peripheral blood of the patients with hematological malignancies(P=0.001,0.002).The proportions of Th1 in bone marrow of the patients with hematological malignancies were significantly higher than those of the healthy controls 15,30,60,90 and 180 d after transplantation(all P<0.05),and the total level was significantly higher than that in peripheral blood(P=0.006).The proportions of Th2 in bone marrow did not change significantly within 90 d after transplantation,but it was
作者
赵潇溟
黄爱杰
胡晓霞
唐古生
章卫平
杨建民
王健民
ZHAO Xiao-ming;HUANG Ai-jie;HU Xiao-xia;TANG Gu-sheng;ZHANG Wei-ping;YANG Jian-min;WANG Jian-min(Department of Hematology,Changhai Hospital,Naval Medical University(Second Military Medical University),Shanghai 200433,China)
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2019年第12期1285-1291,共7页
Academic Journal of Second Military Medical University
基金
国家自然科学基金(81530047,81870143)
上海市卫生系统优秀人才培养计划(2017BR012)~~
关键词
异基因造血干细胞移植
骨髓
T淋巴细胞亚群
免疫重建
外周血
allogenetic hematopoietic stem cell transplantation
bone marrow
T lymphocyte subsets
immune re-constitution
peripheral blood
