T细胞亚群Ⅰ和Ⅱ型细胞比例与急性移植物抗宿主病相关性研究

Study on relationship between the ratio of T cell subtype Ⅰand Ⅱ and the acute graft-versus-host disease

目的:研究T细胞亚群Ⅰ、Ⅱ型细胞比例在异基因造血干细胞移植(alloHSCT)早期的变化,探讨其在急性移植物抗宿主病(aGVHD)发生中的作用。方法:移植后7、14、21、28d采取21例alloHSCT受者外周血,加入佛波醇酯、伊能霉素、莫能霉素体外培养4h。3色荧光标记后用流式细胞仪检测T细胞亚群Ⅰ、Ⅱ型细胞比例。结果:发生aGVHD组Ⅰ型T细胞比例明显高于无aGVHD组。发生aGVHD时Th1、Tc1和CD4+IL2+T细胞比例明显高于发生前和治疗后。与轻度相比,中、重度aGVHD发生时Tc1、Tc2和CD8+IL2+T细胞比例更加升高,Th2细胞比例明显下降。移植早期CD3+干扰素γ(INFγ)+T细胞比例≥8%者aGVHD的发生率增加。移植后第7天Th1细胞比例>5.5%者发生中、重度aGVHD的危险性显著增高(P<0.05)。aGVHD腹泻者Th1细胞比例显著高于非aGVHD腹泻者(P<0.05)。结论:Th1和Tc1细胞比例在aGVHD发生时明显升高,因此移植早期动态检测T细胞亚群的I型细胞比例有助于aGVHD的诊治。

Objective：To study the ratio change of T cell subtype Ⅰ and Ⅱ in patients with acute graft-versushost disease（aGVHD） in the early stage of post allogeneic hematopoietic stein cell transplantation （allo-HSCT）. Method：Peripheral blood samples of 21 patients with allo-HSCT were collected on day 7, 14, 21, 28 after transplantation. The whole blood was diluted with IMDM in the ratio of 1：1 and then incubated with PMA＋ionomycin＋monensin in 37℃ with 5% CO2 incubator for 4 hours. After permeablized and stained, the IL-4, IFN-7, IL- 2 positive T cells were counted with three-color flow cytometry. Result：The percentage of type Ⅰ T cells in aGVHD group is significantly higher than that in non-aGVHD group. There are significantly high percentages of Th1, Tc1, CD4^＋ IL-2^＋ T cells in mild aGVHD and Tc1, Tc2, CD8^＋ IL-2^＋ T cells in severe aGVHD. The Th2 cells decreased significantly in severe aGVHD group. The patients with More than 8% of type Ⅰ CD3^＋ T cells is correla- ted with high aGVHD incident in the earlier stage of post alIo-HSCT. The patients with more than 5.5 percent of Thl cells on day 7 are prone to suffer severe aGVHD. The patients with diarrhea induced by aGVHD have significantly high percentage of Thl cells than those without aCVHD （P〈0.05）. Conclusion：Th1 and Tcl cells were increased significantly when aGVHD occur. Detecting the percentage of type Ⅰ T cells in the early stage of post alko-HSCT is useful for diagnosis and therapy of aGVHD.