HLA-肽四聚体和过继性免疫疗法与巨细胞病毒疾病(英文)

HLA-peptide tetramers and adoptive immunotherapy in prevention of cytomegalovirus disease

背景:抗病毒药物能减少早期的巨细胞病毒疾病,但有较强的毒性和引起晚期巨细胞病毒疾病发生的可能。为了更好地防治巨细胞病毒疾病,研究细胞毒性T淋巴细胞控制巨细胞病毒再活化的作用是很关键的,荧光HLA-肽四聚体是一个很好的工具,被用来监测移植受者的巨细胞病毒特异细胞毒性T淋巴细胞的恢复。目的:探讨HLA-肽四聚体和过继性免疫疗法在治疗巨细胞病毒疾病中的作用。方法:由第一、二作者检索2003/2009PubMed数据库及万方数据库有关移植后巨细胞病毒特异细胞毒性T淋巴细胞检测、抗病毒药物应用、HLA肽四聚体应用、过继性免疫治疗作用的文献,英文检索词为"HLA-peptide tetramers,cytomegalovirus,specific CTL,adoptive immunotherapy",中文检索词为"HLA-肽四聚体,巨细胞病毒,特异细胞毒性T淋巴细胞,过继性免疫治疗"。排除重复性研究,纳入29篇归纳总结。结果与结论:用巨细胞病毒特异细胞毒性T淋巴细胞进行的过继性免疫治疗是非常完美的策略,然而,产生这些细胞是昂贵和耗时的,因此治疗不是在每个移植中心都能进行。用HLA-肽四聚体从巨细胞病毒血清阳性供者外周血中选择巨细胞病毒特异细胞毒性T淋巴细胞是非常有希望的策略,使过继性免疫疗法更容易进行。

BACKGROUND： Antiviral drugs can reduce the incidence of early-onset cytomegalovirus （CMV） disease, but are associated with strong toxicity and the development of late-onset CMV disease. In order to prevent CMV disease better, cytotoxic T lymphocytes （CTL） may play a critical role in controlling CMV reactivation. Fluorescent HLA-peptide tetramers are used to monitor the recovery of CMV CTL in recipients of allogeneic transplants. OBJECTIVE： To explore the effect of HLA-peptide tetramers and adoptive immunotherapy in treating CMV disease. METHODS： A computer-based online search of Pubmed and Wanfang databases was performed for articles related to CTL detection, application of antiviral drugs and HLA-peptide tetramers, and adoptive immunotherapy with ＂HLA-peptide tetramers, cytomegalovirus, specific CTL, adoptive immunotherapy＂ in English and Chinese. Repetitive articles were excluded and 29 articles were included. RESULTS AND CONCLUSION： Adoptive immunotherapy with CMVs cytotoxic T cells as preemptive therapy is a very elegant strategy; however, generation of these cells is costly and time-consuming, and therefore the therapy is not available at every transplantation center. Magnetic selection of CMVs CD8＋ T cells from peripheral blood of CMV-seropositive donors by using HLA-peptide tetramers may be very hopeful, which simplifies adoptive immunotherapy.