摘要
目的探讨移植物非去T细胞的无关供体造血干细胞移植(HSCT)后患者巨细胞病毒(CMV)激活与供受体杀伤细胞免疫球蛋白样受体(KIR)和HLA—Cw基因的相关性。方法以2003年1月至2008年12月48例行无关供体HSCT患者为研究对象,采用PCR—SSP和PCR.SSOP方法检测供受体KIR基因单体型和HLA—Cw位点,免疫组化监测这些患者移植后CMV感染情况。结果供受体HLA—Cw相合33例,不合15例,CMV激活率分别为48.5%和66.7%,两组比较差异无统计学意义(x2=1.39,P=0.2375),供受体均属于HLA—C1组的有37例,均属于HLA—C2组11例,CMV激活率分别为64.9%和18.2%,两组比较差异有统计学意义(X2=18.13,P〈0.19001)。供体为KIR单体型A的移植有26例,供体为KIR单体型B的移植有22例,CMV激活率分别为57.7%和50.0%,两者比较差异无统计学意义(x2=0.28,P=0.5941)。供体激活性KIR基因小于、等于受体的激活性KIR基因的有34例,CMV激活率为70.6%,供体激活性KIR基因大于受体激活性KIR基因的有14例,CMV激活率为14.3%,两者比较差异有统计学意义(x2=12.44,P=0.0004)。结论在无关供体HSCT中受体和供体不同激活性KIR的数量和HLA—Cw位点差异可能与CMV激活存在相关性。
Objective To explore the relationship between CMV reactivation and KIR haplotype or HLA-Cw genotype in patients after unrelated-donor hematopoietic stem cell transplantation(HSCT). Methods From January 2003 to December 2008 the HLA-Cw/KIR genotypc of 48 patient-donor pairs were determined by polymerase chain reaction with sequence specific primers ( PCR-SSP ) and sequence specific nucleotide (PCR-SSOP). Posttransplant CMV reactivation was performed by immune histochemically assay. Re- suits Of 48 patients, 15 were transplanted from unrelated donors with an antigen mismatch for HLA Cw and 33 patient-donor pairs were matched for HLA-Cw. The CMV reaction rate was 66.7% for HLA-Cw mismatch group and 48.5% for HLA-Cw match group ( X2 = 1.39, P = 0.2375). Thirty-seven donor-patients pairs belonged to group C1 and 11 to group C2, and CMV reaction rate was 64.9% in group C1 and 18.2% in group C2(X2 = 18.13, P 〈0. 0001 ). Twenty-six patients received graft from KIR haplotype A (group A donor) and 22 from KIR haplotype B donors ( group B donor) and CMV reaction rate was 57.7% in group A donor and 50.0% in group B donor ( X2 = 0.28, P = 0.5941 ). The number of donor activating KIRs (aKIRs) was less than that of recipient aKIRs in 34 patient-donor pairs in which the CMV reaction rate was 70.6% , and the number of donor aKIRs was more than that of recipient aKIRs in 14 patient-donor pairs in which the CMV reactivation was 14.3 %. There was a significan difference between the two group (X2 = 12.44, P = 0.0004 ). Conclusion KIR and HLA-Cw genotypes influence the rate of CMV reactivation following non-T cell deleted unrelated donor hematopoietic cell transplantation.
出处
《中华血液学杂志》
CAS
CSCD
北大核心
2009年第11期741-744,共4页
Chinese Journal of Hematology
基金
基金项目:江苏省领军人才项目(2007016)
卫生部重大研究基金(wkj2006-2-023)
江苏省六大人才高峰项目(07一B-21)
江苏省高校自然科学基金(07kj320106)
苏州市中外国际合作项目(SWH0716)
苏州市科教兴卫项目(SWQ10)
苏州大学研究生创新基金
关键词
造血干细胞移植
KIR单体型
HLA—Cw基因
巨细胞病毒
Hematopoietic stem cell transplantation
KIR haplotype
HLA-Cw genotype
Cytomegalovirus reactivation