供受体血清白介素-2、肿瘤坏死因子-α水平与急性移植物抗宿主病的关系

Correlation of donor and recipient serum interleukin 2 and tumor necrosis factor α levels to acute graft-versus-host disease in hematopoietic stem cell transplantation

目的探讨异基因造血干细胞移植供受体细胞因子IL-2、TNF-α水平与急性移植物抗宿主病(aGVHD)的关系。方法采用HLA部分相合或全相合同胞以及HLA相合非亲缘志愿者为供体,对22例白血病患者进行异基因造血干细胞移植,用ELISA方法检测供体和受体血清中IL-2、TNF-α水平,并比较移植后发生0-I度aGVHD组和II～IV度aGVHD组细胞因子水平有无差别。结果5例患者无aGVHD发生(0度),I度aGVHD10例,II～IV度aGVHD7例。发生II～IV度aGVHD组患者(n=7)在预处理后及移植后的血清IL-2、TNF-α水平均明显较0～I度aGVHD组患者(n=15)高(P均<0.05),预处理前两组IL-2、TNF-α水平无差别;供体动员后IL-2水平在II～IV度aGVHD组高于0～I度aGVHD组,TNF-α浓度两组无差别。结论白血病患者预处理后及移植后血清中IL-2、TNF-α水平及供体动员后IL-2水平可能与aGVHD发生及严重程度有关,可作为预测发生II～IV度aGVHD指标。

Objective To study the relationship between the donor and recipient serum interleukin 2 （IL-2） and tumor necrosis factor α （TNF-α） levels and the occurrence of acute graft-versus-host disease （aGVHD） following hematopoietic stem cell transplantation.Methods Twenty-two leukemic patients undergoing allo-hematopoietic stem cells transplantation and their donors were examined for serum levels of IL-2 and TNF-α using ELISA during conditioning and after the transplantation.IL-2 and TNF-α levels were also detected in the donors during mobilization to analyze the relationship between the cytokines and aGVHD.Results Five recipients showed no aGVHD,10 developed grade I aGVHD,and 7 developed grade II-IV aGVHD.The serum levels of IL-2 and TNF-α after conditioning and post-transplantation were significantly higher in the recipients with grade II-IV aGVHD than in those with grade 0-I aGVHD,but no difference was found before the pre-conditioning.The serum IL-2 levels in the mobilized donors for the recipients with grade II-IV aGVHD were significantly higher than that in donors for recipients with grade 0-I aGVHD,whereas the levels of TNF-α showed no such a difference.Conclusion Serum IL-2 and TNF-α levels in the leukemic patients after conditioning and post-transplantation,and the donor serum IL-2 level after mobilization may be correlative to the severity of aGVHD and can be used as indicators for predicting the severity of aGVHD after the transplantation.