肿瘤坏死因子-α与异基因造血干细胞移植相关并发症

Tumor necrosis factor-α and the complication of allogenic hematopoietic stem cell transplantation

肿瘤坏死因子-α(TNF-α)是参与异基因造血干细胞移植(allo-HSCT)后相关并发症的关键细胞因子之一,近年来对其日益深入的研究显示,编码TNF-α的基因及微卫星的多态性与移植后移植物抗宿主病(GVHD)可能相关;TNF-α在移植后GVHD、特发性肺炎综合征(IPS)、巨细胞病毒(CMV)感染的发生发展过程中发挥了重要作用。为此,人们尝试针对TNF-α为靶点来治疗上述并发症,TNF-α的单克隆抗体依那西普(etanercept)、inflixi mab单药或联合免疫抑制剂等治疗移植相关并发症有着良好的耐受性,也取得了较好的疗效。

TNF-α is one of the key cytokines that participate in complications of allogenic hematopoietic stem cell transplantation （allo-HSCT）. Recently, the increasingly developing researches demonstrated that polymorphism of genes encoding TNF-α and TNF microsatellites perhaps correlates to graft verse host disease （GVHD）after allo-HSCT. TNF-α plays important roles in develop- ment of post transplant complications including GVHD, idiopathic pneumonia syndrome （IPS） or cytomegalovirus （CMV） infection. Therefore, it is targeted as a new approach to treat post transplant complications. The administration of monoclonal antibody of TNF-α such as etanercept or infliximab, in combination with immunosuppressive agents or not, is well tolerated and associated with ideal improvements in post transplant complications.