代谢在移植物抗宿主病中的研究进展

Research progress of metabolism in graft-versus-host disease

异基因造血干细胞移植(allogeneic hemopoietic stem cell transplantation,allo-HSCT)是白血病等血液系统疾病有效甚至唯一的根治手段,但移植物抗宿主病(graft versus host disease,GVHD)严重影响患者预后,是移植相关死亡的主要原因之一。新陈代谢是细胞最常见的特点,在免疫应答对T细胞的活化和分化等功能中具有重要作用。初始T细胞是主要介导GVHD的免疫细胞,其可以通过特异性的代谢过程获得相应的免疫功能。巨噬细胞、树突状细胞等固有免疫细胞的增殖和分化也需要通过代谢进行调节。Allo-HSCT后,以代谢途径作为靶点,抑制与GVHD相关的初始T细胞、保留移植物抗白血病相关的记忆性T细胞,可能对提高allo-HSCT的疗效、降低GVHD的发生率具有重要作用和意义。因此,深入研究和探讨代谢在移植中的意义及其机制并寻找可能的特异性治疗靶点至关重要。本文就GVHD代谢相关发病机制和研究进展做一综述。

Allogeneic hematopoietic stem cell transplantation(allo-HSCT) provides the only curative therapy for hematological disease, such as leukemia. Nevertheless, graft versus host disease(GVHD) remain a major obstacle to a more favorable therapeutic outcome and prognosis, and relate to a main reason of treatment-related mortality. Metabolism is the most common feature of cells and plays an important role in the activation and differentiation of T cells in the immune response. Na?ve T cells mainly mediate GVHD, which can obtain corresponding immune function via specific metabolic process. Besides, the proliferation and differentiation of innate immune cells such as macrophages and dendritic cells also need to be regulated by metabolism. Targeting the metabolic pathway after allo-HSCT is important for improving the prognosis and reducing the GVHD by inhibiting the na? vel T cells related to GVHD and retaining the memory T cells related to graft-versus-leukemia effect. Therefore, it is very important to investigate the significance and mechanism of metabolism in transplantation and to search for possible specific therapeutic targets. This article reviews the pathogenesis and research progress of metabolism in GVHD.