粒细胞集落刺激因子及其受体与血液相关疾病

G-CSF and Its Receptor in Hematonosis——Review

粒细胞集落刺激因子(G-CSF),又称集落刺激因子3(CSF3),是体内非常重要的细胞生长因子,能够调节粒系细胞的增殖、分化与存活,诱导T细胞免疫耐受,可以抑制急性移植物抗宿主病(GVHD)的发生。G-CSF的受体CSF3R属于I型细胞因子受体超家族,与G-CSF结合后激活JAK-STAT、Ras/Raf/MEK/ERK等信号通路。在临床上G-CSF广泛应用于粒细胞减少性疾病及化疗后粒细胞缺乏,也是自体或异基因移植时外周血干细胞动员剂,在G-CSF联合化疗的预激方案中,G-CSF通过诱导白血病细胞分化、生长停滞、细胞凋亡,以增强白血病细胞对化疗的敏感性。近年来随着分子遗传学以及临床研究的进展,CSF3R突变被发现与重型先天性粒细胞减少症(SCN)向白血病转化有关,而且常见于慢性中性粒细胞白血病(CNL),这些可能为疾病的靶向治疗提供理论基础。本文将对G-CSF及其受体在血液相关疾病领域的临床应用进展进行综述。

The granulocyte colony-stimulating factor （G-CSF）, now referred to as CSF3, is a very important cell growth factor that supports the proliferation, survival, and differentiation of neutrophilic progenitor cells, and also is a strong immune regulator of T cells and a promising therapeutic tool in acute graft versus host disease（GVHD）. G-CSF acts by binding to its receptor G-CSFR（ also called CSF3R）, a member of the cytokine receptor type I superfamily, which after binding with G-CSF activates the canonical Janus kinase （Jak）/signal transducer, activator of transcription （STAT） and Ras/Raf/MAP kinase pathways. G-CSF has been applied to the clinic to treat congenital and acquired neutropenia before or during courses of intensive chemotherapy. It has also been applied to mobilize hematopoietic stem cells into the peripheral blood for Auto-or allogeneic transplantation, and the priming strategies designed to enhance the sensitivity of leukemia stem cells to cytotoxic agents in protocols aimed to induce their differentiation, accompanying growth arrest, and cell death. With the rapid development of molecular genetics and clinical research, CSF3R mutations have been implicated in the progression of severe congenital neutropenia （SCN） to leukemia. Recently, CSF3R mutations have been discovered frequently in chronic neutrophilic leukemia （CNL）. Such findings might provide the theoretical basis for the targeted therapy. In this review, the clinical application of G-CSF receptor in hematonosis is briefhy summarized.