造血干细胞移植术后可溶性不规则趋化因子与急性移植物抗宿主病关系的初步研究

Relationship between Soluble Fractalkine and Acute Graft-Versus Host Disease after Hematopoietic Stem Cell Transplantation

目的观察造血干细胞移植(hematopoietic stemcell transplantation,HSCT)患者体内可溶性不规则趋化因子(soluble fractalkine,sFkn)的变化,探讨sFkn与急性移植物抗宿主病(aute graft-versus-host disease,aGVHD)的关系。方法用酶联免疫的方法定量检测接受HSCT的恶性血液病患者(n=12)移植前和移植后不同时间(15、30、45、60、90 d)血清sFkn的质量浓度,以35例正常人血清sFkn的质量浓度为对比,分析恶性血液病患者移植前和移植后不同时间血清sFkn的质量浓度变化及与aGVHD的关系。结果全部患者移植前,自体造血干细胞移植(auto-HSCT)患者(n=3)、异基因造血干细胞移植(allo-HSCT)后未发生aGVHD的患者(n=5)移植后15 d,血清sFkn的质量浓度和正常人比较差异无统计学意义(P>0.05);发生aGVHD的allo-HSCT患者(n=4)出现典型临床症状前血清sFkn的质量浓度显著升高,移植后15 d与正常人比较差异有统计学意义(P<0.001)。结论 sFkn与aGVHD可能有一定关系,其升高可能预警aGVHD的发生。allo-HSCT术后动态监测sFkn水平变化可能有助于aGVHD的诊断。

Objective To observe the changes in serum levels of soluble fractalkine（sFkn） in hematopoietic stem cell transplant（HSCT） recipients,and to investigate the relationship between sFkn and acute graft-versus-host disease（aGVHD）.Methods The serum levels of sFkn were measured by ELISA in 12 patients with malignant hematologic diseases who underwent HSCT before and 15,30,45,60 and 90 days after transplantation.The levels of sFkn in 35 normal subjects were detected as the control.The relationship between sFkn and aGVHD was analyzed.Results There were no differences in sFkn concentration between normal subjects and patients with acute leukemia before HSCT.At 15 days after HSCT,compared with the control,the levels of sFkn did not changed in 3 autologous HSCT recipients and 5 allogeneic HSCT recipients without aGVHD（P0.05）,but significantly increased in 4 allogeneic HSCT recipients with aGVHD（P0.001）.Conclusion The increase of sFkn may associated with aGVHD in patients who underwent HSCT.Therefore,monitoring of sFkn may be beneficial for the diagnosis of aGVHD after allogeneic HSCT.