调节性T细胞在移植物抗宿主病中的应用现状

Application status of regulatory T cells in graft versus host disease

移植物抗宿主病(GVHD)是异基因造血干细胞移植(allo-HSCT)后的常见并发症,是导致患者移植相关死亡的主要原因之一。目前,GVHD的一线治疗药物为糖皮质激素,迄今尚缺乏标准的二线治疗方案。近年来,相关研究发现,增加移植物中调节性T细胞(Treg)数量,可提高对GVHD的疗效。笔者拟就Treg亚群及其免疫抑制机制,优先促进Treg免疫重建的途径,以及扩增数量有限的Treg应用于临床进行阐述,旨在揭示Treg防治GVHD的安全性与可行性,为临床更好地应用Treg提高GVHD疗效提供参考。

Graft versus host disease(GVHD)is the common complication of allogeneic hematopoietic stem cell transplantation(allo-HSCT),which is also one of the leading causes of transplantation related mortality.At present,besides standard first-line treatment of glucocorticosteroid,there is no standard second-line treatment for GVHD.In recent years,related studies have found that increasing the amount of regulatory T cells(Treg)in the graft can improve GVHD.It is important to understand the subgroups of Treg and mechanism of its immunosuppression,as well as how to preferentially contribute to the reconstitution of Treg and expand the limited numbers of Treg applied to clinical trials.This review aims to demonstrate the feasibility and safety of Treg in prevention and treatment of GVHD,in order to provide reference for application of Treg improving curative effect of GVHD in the clinical practice.