急性移植物抗宿主病患者外周血中T细胞功能亚群的变化及临床意义

Change and Clinical Significance of Peripheral Blood T-lymphocyte Functional Subsets in Acute Graft-Vers us-Host Disease

目的:本研究探讨CCR7及CD45RA标记的T细胞功能亚群在异基因造血干细胞移植术(allo-HSCT)后100d内的数量变化,分析其在急性移植物抗宿主病(a GVHD)中的临床意义。方法:42例allo-HSCT患者移植后自造血重建起每2周取外周血,以流式细胞术监测表达CD3、CD4、CD8、CCR7、CD45RA抗原的T细胞数,分析其与a GVHD发生的关系。结果:在a GVHD组患者中CCR7阳性的T细胞数量显著低于无GVHD组,以CCR7及CD45RA标记的初始T细胞(Tnaive)、中枢记忆T细胞(TCM)、效应记忆T细胞(TEM)百分比及Tnaive、TEM、终末分化T细胞(TTD)绝对计数显著低于无a GVHD组,并伴随a GVHD的转归而相应变化,而以CD3、CD4、CD8标记的T细胞亚群数量在两组中无显著性差异。结论:以CCR7及CD45RA标记的T细胞功能亚群在移植后监测急性GVHD中具有一定临床意义,为早期监测免疫重建提供了新的手段。

Objective： This study was aimed to detect the change of T-lymphocyte functional subsets marked by CCR7 and CD45RA in the aGVHD within 100 days after allo-HSCT and to explore its clinical significance. Methods： The peripheral blood of 42 patients after allo-HSCT was collected every two weeks since hematopoietic reconstitution. The expression of CD3, CD4, CD8, CCR7 and CD45RA-marked T-lymphocytes was detected by flow cytometry, the relationship between their expression and the prognosis of aGVHD was analyzed. Results： The percentage and the absolute count of CCR7＋ T lymphocyte were significantly reduced in aGVHD. The percentage of Tnaive, TCM, TEM and the absolute count of Tnaive, TEM, TTD were sharply reduced in aGVHD, moreover has changed correspondingly with outcome of aGVHD. The percentage of CD3, CD4, CDS-marked T-lymphocyte subsets did not significantly changed. Conclusion ： T-lymphocyte functional subsets marked by CCR7 and CD45RA are a valuable indicator to monitor early immune reconstruction for patients with the aGVHD after allo-HSCT.